Cross-sectional, prospective study of MRI reproducibility in the assessment of plaque burden of the carotid arteries and aorta

Background: The reliability of imaging techniques to assess early atherosclerosis remains unclear. We did a cross-sectional, prospective study to test reproducibility of MRI when imaging arteries, to assess risk of cardiovascular disease and correlations with age and sex. Methods: Between January 2003 and December 2006 we performed black-blood MRI of both common carotid arteries and the thoracic descending aorta in patients with cardiovascular risk factors who were referred from clinics in New York, NY, USA. Mean wall area, wall thickness, lumen area, total vessel area, and ratio of the mean wall area to the mean total vessel area (WA/TVA) were manually measured. Reproducibility within and between readers was tested on subsets of images from randomly chosen patients. Results: MRI was performed on 300 patients. Intrareader reproducibility, assessed in images from 20 patients, was high for all parameters (intraclass correlation coefficients >0.8), except WA/TVA ratio in the descending aorta. The inter-reader reproducibility, assessed in images from 187 patients, was acceptable (intraclass correlation coefficients >0.7) for the mean wall, lumen, and total vessel areas. Values for all MRI parameters in all vessels increased with increasing age for both sexes (all P <0.0005) but were always significantly higher in men than in women, except for aortic mean wall thickness and WA/TVA ratio in the carotid arteries. Mean wall area values correlated well between the carotid arteries and aorta, reflecting the systemic nature of atherosclerosis. Conclusions: Our findings support MRI as a reproducible measurement of plaque burden and demonstrate the systemic distribution of atherosclerosis.