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ludc webb

Isabel Goncalves


ludc webb

The potential role of T2*-weighted multi-echo data image combination as an imaging marker for intraplaque hemorrhage in carotid plaque imaging


  • My Truong
  • Claes Håkansson
  • Makda HaileMichael
  • Jonas Svensson
  • Jimmy Lätt
  • Karin Markenroth Bloch
  • Roger Siemund
  • Isabel Gonçalves
  • Johan Wassélius

Summary, in English

Background: Carotid atherosclerotic plaques with intraplaque hemorrhage (IPH) are associated with elevated stroke risk. IPH is predominantly imaged based on paramagnetic properties of the upstream hemoglobin degradation product methemoglobin. This is an explorative observational study to test the feasibility of a spoiled gradient echo based T2* weighted MRI sequence (3D MEDIC) for carotid plaque imaging, and to compare signs suggestive of the downstream degradation product hemosiderin on 3D MEDIC with signs of methemoglobin on a T1wBB sequence. Methods: Patients with recent TIA or stroke were selected based on the presence on non-calcified plaque components on CTA to promote an enriched prevalence of IPH in the material. Patients (n = 42) underwent 3T MRI with 3D MEDIC and 2D turbo spin echo T1w black blood (T1wBB). Images were independently evaluated by two neuroradiologists and Cohens Kappa was used for inter-reader agreement for each sequence. Results: The technical feasibility for 3D MEDIC, was 34/42 patients (81%). Non-calcified plaque components with susceptibility effect without simultaneous T1-shortening—a combination suggestive of hemosiderin, was seen in 13/34 of the plaques. An equally large group display elevated T1w signal in combination with signal loss on 3D MEDIC, a combination suggestive of both hemosiderin and methemoglobin. Cohen’s kappa for inter-reader agreement was 0.64 (CI 0.345–0.925) for 3D MEDIC and 0.94 (CI 0.81–1.00) for T1wBB. Conclusions: 3D MEDIC shows signal loss, without elevated T1w signal on T1wBB, in non-calcified tissue in many plaques in this group of patients. If further studies, including histological verification, confirm that the 3D MEDIC susceptibility effect is indeed caused by hemosiderin, 3D MEDIC could aid in the detection of IPH, beyond elevation of T1w signal.


  • Diagnostic Radiology, (Lund)
  • Medical Radiation Physics, Malmö
  • Lund University Bioimaging Center
  • EpiHealth: Epidemiology for Health
  • Cardiovascular Research - Translational Studies
  • EXODIAB: Excellence of Diabetes Research in Sweden

Publishing year





BMC Medical Imaging





Document type

Journal article


BioMed Central (BMC)


  • Cardiac and Cardiovascular Systems
  • Radiology, Nuclear Medicine and Medical Imaging


  • Atherosclerosis
  • Carotid plaque
  • Intraplaque hemorrhage
  • MRI
  • Vessel wall imaging



Research group

  • Medical Radiation Physics, Malmö
  • Cardiovascular Research - Translational Studies


  • ISSN: 1471-2342