Fat-suppression performance for in-stent plaque imaging after carotid artery stenting using three-dimensional T₁-weighted MRI: a phantom study

This study investigated the optimal fat suppression technique for accurate in-stent plaque characterization after carotid artery stenting using three-dimensional T1-weighted magnetic resonance imaging. A carotid artery phantom containing a stent and a reference vessel was imaged with a 3.0-T system using a three-dimensional gradient-echo sequence combined with chemical shift selective, spectral attenuated inversion recovery, water excitation, and Dixon fat suppression techniques. Chemical shift selective and spectral attenuated inversion recovery showed increased signal intensity within the stent lumen and reduced contrast compared with the reference vessel, suggesting insufficient fat suppression likely related to radiofrequency shielding. In contrast, water excitation and Dixon provided more uniform fat suppression with comparable contrast ratios; however, Dixon imaging demonstrated susceptibility-related high signal along the stent contour that may compromise lumen assessment. Overall, water excitation combined with three-dimensional T1-weighted gradient-echo imaging achieved effective and uniform fat suppression without prominent susceptibility artifacts and appears to be the most suitable approach under phantom conditions for noninvasive in-stent plaque evaluation after carotid artery stenting.