3 years ago

Identification of intraplaque haemorrhage in carotid artery by simultaneous non-contrast angiography and intraPlaque haemorrhage (SNAP) imaging: a magnetic resonance vessel wall imaging study

Chun Yuan, Huiyu Qiao, Xihai Zhao, Jianrong Xu, Shuo Chen, Huilin Zhao, Dongye Li, Rui Li, Le He, Xiaoyi Chen



To investigate the usefulness of Simultaneous Non-contrast Angiography and intraPlaque haemorrhage (SNAP) imaging in characterising carotid intraplaque haemorrhage (IPH) compared with magnetisation-prepared rapid acquisition gradient-echo (MP-RAGE) sequence.


Fifty-four symptomatic patients (mean age: 63.1 ± 5.7 years, 38 males) with carotid atherosclerosis were recruited and underwent carotid MR imaging. The presence and area of IPH on SNAP and MP-RAGE images were determined. The agreement in identifying IPH and its area between SNAP and MP-RAGE was analysed.


Of 1368 slices with acceptable image quality in 54 patients, 13% and 22.6% were found to have IPH on MP-RAGE and SNAP images, respectively. There was moderate agreement between MP-RAGE and SNAP sequences in identifying IPH (κ = 0.511, p = 0.029). The area of IPH on SNAP images was significantly larger than that on MP-RAGE images (17.9 ± 18.2 mm2 vs. 9.2 ± 10.5 mm2, p < 0.001). For IPHs detected by SNAP imaging, the area of IPHs also detected by the MP-RAGE sequence was significantly larger than that of IPHs not detected by the MP-RAGE sequence (17.9 ± 19.2 mm2 vs. 6.4 ± 6.2 mm2, p < 0.001).


Compared with the MP-RAGE sequence, SNAP imaging detects more IPHs, particularly for smaller IPHs, suggesting that SNAP imaging might be a more sensitive tool for identification of carotid haemorrhagic plaques.

Key Points

Moderate agreement was found between SNAP and MP-RAGE in identification of IPH

SNAP imaging might be a more sensitive tool to detect carotid IPHs

Compared with the MP-RAGE sequence, SNAP imaging can detect carotid IPHs with smaller size

SNAP imaging can help clinicians to optimise the treatment strategy

Publisher URL: https://link.springer.com/article/10.1007/s00330-017-5096-1

DOI: 10.1007/s00330-017-5096-1

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