Evaluation of Plaque Imaging Techniques for Calcified Lesions Using MRI Termed Modified Liver Acquisition With Volume Acceleration (mLAVA)

As some calcified plaques are associated with an increased risk of future ischemic events, imaging evaluation of calcified lesions is clinically important. CT and CT angiography (CTA) are commonly used for the imaging evaluation of calcified lesions. However, the exposure to ionizing radiation has been associated with an increased lifetime risk of cancer, and the use of iodinated contrast media has the potential risk of renal dysfunction. In this study, we introduce the modified Liver Acquisition With Volume Acceleration (mLAVA) sequence, which is a novel MRI sequence for detecting carotid artery calcifications. We present two cases in which the mLAVA sequence identified high-risk calcified plaques and subsequently conducted carotid endarterectomy (CEA). The first case was a 54-year-old man with symptomatic carotid artery stenosis with a rim sign who underwent CEA. The second case was an 82-year-old man with asymptomatic carotid artery stenosis associated with a calcified nodule who also underwent CEA. In both cases, preoperative assessment of the calcified lesions was performed using the mLAVA sequence, and the imaging findings are presented. Our findings suggest that the mLAVA sequence may help preoperative evaluation of plaque imaging of calcified plaques as well as evaluation by CTA, particularly in patients with renal dysfunction or radiocontrast media allergy. Further advancements that enable precise visualization of fine calcified lesions would enhance their clinical utility.