Comparison between 2D and 3D high‐resolution black‐blood techniques for carotid artery wall imaging in clinically significant atherosclerosis

PURPOSE: To compare two- (2D) and three-dimensional (3D) black-blood imaging methods for morphological measurements of the carotid artery wall and atherosclerotic plaque. MATERIALS AND METHODS: A total of 18 subjects with 50% to 79% carotid stenosis were scanned with 2D (2-mm slice thickness) and 3D (1-mm/0.5-mm actual/interpolated slice thickness) T1-weighted fast spin-echo (FSE) black-blood imaging sequences with double inversion-recovery (DIR) blood suppression. Morphological measurements (lumen area, wall area, vessel area, mean wall thickness, and maximal wall thickness), signal-to-noise ratio (SNR) in the wall and lumen, and wall-lumen contrast-to-noise ratio (CNR) were compared between 2D and 3D images. The effect of improved slice resolution in 3D imaging was evaluated for visualization of small plaque components. RESULTS: Lumen SNR (P = 0.16), wall SNR (P = 0.65), and CNR (P = 0.94) were comparable between 2D/3D. There was no difference in average lumen area (P = 0.16), average wall area (P = 0.99), average vessel area (P = 0.0.58), mean wall thickness (P = 0.09), and maximum wall thickness (P = 0.06) between 2D/3D. Distributions of small plaque components such as calcification were better characterized by the 3D acquisition. There was a higher sensitivity to motion artifacts with 3D imaging, resulting in three examinations with low image quality. CONCLUSION: 2D and 3D protocols provided comparable morphometric measurements of the carotid artery. The major advantage of 3D imaging is improved small plaque component visualization, while the 2D technique provides higher reliability for image quality.