Comparison of in vivo carotid 3.0-T magnetic resonance to B-mode ultrasound imaging and histology in a porcine model.

Objectives: We compared in vivo 3.0-T magnetic resonance (MR) images of the carotid artery wall in piglets to intima-media thickness measurements of similar carotid segments by B-mode ultrasound (US) and histology to define the corresponding anatomical tissue characteristics and accuracy of carotid MR images.

Background: Carotid MR is increasingly used for the assessment of cardiovascular risk and cardiovascular drug efficacy. Therefore, determining the anatomical correlate and accuracy of this modality is of major importance.

Methods: In vivo 3.0-T MR and B-mode US scans of the left and right common carotid arteries were performed in 5 piglets (75 to 80 kg). The T(1)-weighted MR images were acquired with a noninterpolated pixel size of 0.25 x 0.25 mm for mean wall area (MWA) and mean wall thickness measurements. The B-mode US measured common carotid intima-media thickness and common carotid diameter. We calculated US MWA using common carotid intima-media thickness and carotid diameter. In histology, the intima and media tissue area was defined as histology MWA.

Results: Histology MWA was 4.69 (standard deviation [SD]: 0.95) mm(2), MR MWA was 4.57 (SD: 0.41) mm(2), and US MWA was 4.90 (SD: 0.50) mm(2). The mean difference was 0.12 (SD: 1.11) mm(2) for MR and -0.21 (SD: 1.01) mm(2) for US when compared with histology. Bland-Altman analysis showed no systematic biases between MR, US, or histology.

Conclusions: Absolute values for carotid artery histology, MR, and US measurements are in good agreement, indicating that both 3.0-T MR and B-mode US measurements can visualize the intima and media. Accuracy of 3.0-T MR is comparable to B-mode US. The present findings imply that carotid MR might be a novel asset in cardiovascular disease risk stratification and a valuable surrogate marker in cardiovascular prevention trials.