Comparison of Cardiovascular MRI and DSA in the Selection of Stent-Treatment for Carotid Atherosclerosis Patients

Objective To compare the efficacy of cardiovascular MRI and DSA in stent-treatment selection for patients with carotid atherosclerosis.Methods Forty-six patients with carotid plaque detected by ultrasound were enrolled in this study.Carotid plaque MRI and DSA was performed.Images were evaluated for luminal stenosis(NASCET standard), fibrous cap rupture, intra-plaque hemorrhage and calcification.Kappa value and paired chi-square test were used for the statistical analysis.Results These 92 carotid arteries were divided into two groups, that were the symptomatic artery group with 25 vessels and asymptomatic artery group with 64 vessels, and the other 3 arteries were excluded due to stent placement.There was good concordance between the degree of stenosis measured by MRI and DSA (Kappa value 0.882).There was significant difference in detecting FC rupture by two modalities (P<0.01).As to the indication selection for stent treatment by two modalities, there was significant difference for asymptomatic group(22 vessels by MRI and 14 vessels by DSA, P<0.05), neither did the symptomatic group.There were two patients, among those 14 who underwent the stent treatment, that decided stent treatment only rely on the FC rupture detected by MRI.Furthermore, MRI detected 37 vessels with intra-plaque hemorrhage and 71 vessels with calcification in the plaque.Conclusion MRI was much more suitable for the selection of stent treatment for patients with carotid atherosclerosis as compared with DSA.