Abstract: Objective To assess the value of high-resolution three-dimensional black-blood magnetic resonance imaging
(3D-BB-MRI) in quantitative measurement of carotid atherosclerotic plaque by comparison with two-dimensional black-blood
magnetic resonance imaging (2D-BB-MRI). Methods Forty patients were scanned with routine 2D and oblique-sagittal
3D-BB-MRI. The original oblique-sagittal 3D images were reformatted to an axial 2D-like dataset. Two experienced radiologists
identified the interested slice in consensus for every patient (unilateral carotid artery) in 2D-BB-MRI images and matched the
axial reformatted 3D images with 2D black-blood images. Plaque thickness (PT), lumen area (LA) and total vessel area (TVA)
were measured, and lumen stenosis (LS) and normalized wall index (NWI) were calculated. Results There was no
measurement difference between 2D-BB-MRI and reformatted 3D-BB-MRI (P>0.05), and these two methods had a good
correlation (r>0.9). The Bland-Altman chart showed that 2D-BB-MRI and 3D-BB-MRI were in good agreement in the
measurement of PT, LA and TVA. Conclusion 3D-BB-MRI and 2D-BB-MRI have no obvious difference in quantitative
measurement of the carotid plaques. 3D-BB-MRI can demonstrate the vessels and plaques by multiplanar reconstruction and
thus have better performance in evaluating carotid atherosclerosis compared with 2D-BB-MRI.