High-Intensity Signals in Coronary Plaques on Noncontrast T1-Weighted Magnetic Resonance Imaging as a Novel Determinant of Coronary Events

Noguchi, Teruo; Kawasaki, Terukazu; Tanaka, Atsushi; Yasuda, Satoshi; Goto, Yoichi; Ishihara, Masaharu; Nishimura, Kunihiro; Miyamoto, Yoshihiro; Node, Koichi; Koga, Nobuhiko

doi:10.1016/j.jacc.2013.11.034

Cited by 161 publications

(134 citation statements)

References 21 publications

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“…T1-weighted imaging can also provide useful prognostic information: in a study that included 568 patients with suspected CAD, an increased coronary plaque intensity in T1-weigthed imaging was independent predictor of future adverse cardiovascular events at 55 months follow-up (hazard ratio: 3.96; 95% confidence interval: 1.92-8.17; P < 0.001); nevertheless, there is no data today about the efficacy of MRI in detecting lesions that are likely to progress and cause cardiovascular events [116].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Invasive or non-invasive imaging for detecting high-risk coronary lesions?

Patel

Tarkin

Serruys

et al. 2017

Expert Review of Cardiovascular Therapy

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Introduction: Advances in our understanding about atherosclerotic evolution have enabled us to identify specific plaque characteristics that are associated with coronary plaque vulnerability and cardiovascular events. With constant improvements in signal and image processing an arsenal of invasive and non-invasive imaging modalities have been developed that are capable of identifying these features allowing in vivo assessment of plaque vulnerability. Areas covered: This review article presents the available and emerging imaging modalities introduced to assess plaque morphology and biology, describes the evidence from the first large scale studies that evaluated the efficacy of invasive and non-invasive imaging in detecting lesions that are likely to progress and cause cardiovascular events and discusses the potential implications of the in vivo assessment of coronary artery pathology in the clinical setting. Expert commentary: Invasive imaging, with its high resolution, and in particular hybrid intravascular imaging appears as the ideal approach to study the mechanisms regulating atherosclerotic disease progression; whereas non-invasive imaging is expected to enable complete assessment of coronary tree pathology, detection of high-risk lesions, more accurate risk stratification and thus to allow a personalized treatment of vulnerable patients. ARTICLE HISTORY

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Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Invasive or non-invasive imaging for detecting high-risk coronary lesions?

Patel

Tarkin

Serruys

et al. 2017

Expert Review of Cardiovascular Therapy

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“…In addition, noncontrast, TIW CMR was able to directly visualize thrombus in acute myocardial infarction and to detect the presence of coronary high-intensity plaques (HIPs), which correspond to positive remodeling and low-density plaques on CT [76,77]. Noguchi et al [78] took a further step by demonstrating that HIPs identified by non-contrast T1W MRI were significantly associated with coronary events. The authors calculated the plaqueto-myocardium signal intensity ratio (PMR) for each coronary plaque.…”

Section: Coronary Artery Wall Imagingmentioning

confidence: 99%

Cardiac MR Assessment of Coronary Arteries

Hamdy

Ishida

Sakuma

2017

Cardiovasc Imaging Asia

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Imaging of coronary arteries with magnetic resonance has undergone undeniable progress during the past two decades. Although coronary computed tomography angiography detects coronary artery disease (CAD) with excellent diagnostic accuracy, the inevitable exposure to ionizing radiation and iodinated contrast administration make it less appealing in certain patient populations. Coronary magnetic resonance angiography (MRA) is now performed mostly as a whole heart, free breathing, three-dimensional study. Several factors influence quality and speed of the scan, including use of the appropriate pulse sequence according to the strength of the magnetic field, cardiac and respiratory gating, preparation pulses, multi-channel cardiac coils, parallel imaging, and contrast material injection. The use of coronary MRA is well established in coronary artery anomalies and aneurysms. While diagnostic performance has also improved markedly for the detection of CAD, coronary MRA is not yet a routine clinical study. However, coronary MRA is expected to be play a major role in the near future due to continuous research and technical achievements.

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“…To investigate the prognostic impact of coronary HIPs, we examined 568 patients with suspected or known coronary artery disease (CAD), 25) who were initially screened by CT angiography (CTA) and subsequently underwent 1.5-T MRI examinations to evaluate coronary plaques. During a median of 55 months of follow-up, 55 coronary events were observed.…”

Section: Clinical Significance Of Coronary Hips Detected By Non-mentioning

confidence: 99%

“…25,35) In most institutes where MRI is available, the MRI facility is also used for neurovascular or orthopedic patients ; consequently, few scan time slots are available to perform additional examinations of CVD patients. In contemporary clinical practice, in order to balance scan time and clinical signifi cance, most institutes tend to choose other modalities to evaluate coronary plaques (e.g., coronary CT or invasive coronary angiography).…”

Section: Unresolved Issues Of Coronary Mri and Future Perspectivesmentioning

confidence: 99%

Clinical Significance of Non-invasive Magnetic Resonance Imaging to Identify High-risk Coronary Plaques as Potential Biomarkers for Preemptive Medicine

2015

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─ 278 ─ Cardiovascular diseases (CVDs) account for > 17 million deaths globally each year (30% of all deaths), and the number is expected to grow to 23.6 million by 2030. Among CVDs, coronary artery disease (CAD) is the most prevalent.1) In around 50%of cases, sudden cardiac death (SCD) is the first manifestation of heart disease, 2) and CAD underlies 80% of SCDs. In this review, we will discuss the potential of MRI for screening and managing coronary atherosclerosis. I. Magnetic resonance imaging for atherosclerotic plaquesAtherosclerotic plaque characterization by MRI is based on the signal intensity and morphologic appearance of plaques in multiple contrast weightings. MRI detects electromagnetic signals at radio wavelengths emitted by protons in a strong magnetic field. In clinical practice, MRI mainly visualizes signals from Clinical Significance of Non-invasive Magnetic Resonance Imaging to Identify High-risk Coronary Plaques as Potential Biomarkers for Preemptive MedicineYasuhide Asaumi, Teruo Noguchi, Satoshi YasudaIdentification of high-risk coronary plaques is important for management of patients with coronary artery disease (CAD) to prevent future cardiovascular events including death, heart failure, and fatal myocardial infarction. Many studies have described the characteristics of coronary plaques and their clinical outcomes, based on invasive intravascular coronary imaging. Recent technical advancements in multi-slice computed tomography, positron emission tomography, and magnetic resonance imaging (MRI) provide methods for less invasive detection of high-risk coronary atherosclerosis. Our research has focused on understanding the development of coronary atherosclerosis and its clinical outcomes using non-contrast T1-weighted MRI (T1WI), which is non-invasive and does not require the use of ionizing radiation or iodide contrast medium. We have shown that coronary high-intensity plaques (HIPs) detected by non-contrast T1WI are associated with high clinical risk, and therefore might have potential applications in monitoring pharmacological interventions and advancing preemptive medicine in CAD patients. However, the histopathological and molecular mechanisms underlying coronary HIPs remain undetermined. Future studies using a combination of multi-modality images and molecular analysis may facilitate an improved understanding of the molecular dynamics of coronary HIPs.

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High-Intensity Signals in Coronary Plaques on Noncontrast T1-Weighted Magnetic Resonance Imaging as a Novel Determinant of Coronary Events

Abstract: HIPs identified in a noninvasive, quantitative manner are significantly associated with coronary events and may thus represent a novel predictive factor.

Cited by 161 publications

References 21 publications

Invasive or non-invasive imaging for detecting high-risk coronary lesions?

Invasive or non-invasive imaging for detecting high-risk coronary lesions?

Cardiac MR Assessment of Coronary Arteries

Clinical Significance of Non-invasive Magnetic Resonance Imaging to Identify High-risk Coronary Plaques as Potential Biomarkers for Preemptive Medicine

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