Atherosclerosis

2000

DOI: 10.1016/s0021-9150(99)00386-x

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High resolution ex vivo magnetic resonance imaging of in situ coronary and aortic atherosclerotic plaque in a porcine model

Stephen G. Worthley

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Valentı́n Fuster

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et al.

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Larose Et Al Ivmri For Plaque Characterization1

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Cited by 90 publications

(57 citation statements)

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“…We initially evaluated the signal from our IVMRI system with reference to histopathologic study. Our results agree with those of Worthley and colleagues, 22 using surface MRI, that fibrous tissues in human atheroma yield bright signal in T1w sequences compared with lipid and for lipid compared with calcium. Our data also reinforce those of Zhao and colleagues, 4 who described T2 signals as brighter for fibrous tissue compared with lipid.…”

Section: Larose Et Al Ivmri For Plaque Characterizationsupporting

confidence: 93%

Characterization of Human Atherosclerotic Plaques by Intravascular Magnetic Resonance Imaging

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³

et al. 2005

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Background-Development and validation of novel imaging modalities to assess the composition of human atherosclerotic plaques will improve the understanding of atheroma evolution and could facilitate evaluation of therapeutic strategies for plaque modification. Surface MRI can characterize tissue content of carotid but not deeper arteries. This study evaluated the usefulness of intravascular MRI (IVMRI) to discern the composition of human iliac arteries in vivo. Methods and Results-Initial studies validated IVMRI against histopathology of human atherosclerotic arteries ex vivo.A 0.030-inch-diameter IVMRI detector coil was advanced into isolated human aortoiliac arteries and coupled to a 1.5-T scanner. Information from combined T1-, moderate T2-, and proton-density-weighted images differentiated lipid, fibrous, and calcified components with favorable sensitivity and specificity and allowed accurate quantification of plaque size. The validated approach was then applied to image iliac arteries of 25 human subjects in vivo, and results were compared with those of intravascular ultrasound (IVUS). IVMRI readily visualized inner and outer plaque boundaries in all arteries, even those with extensive calcification that precluded IVUS interpretation. It also revealed the expected heterogeneity of atherosclerotic plaque content that was noted during ex vivo validation. Again, IVUS did not disclose this heterogeneity. The level of interobserver and intraobserver agreement in the interpretation of plaque composition was high for IVMRI but poor for IVUS. Conclusions-IVMRI can reliably identify plaque composition and size in arteries deep within the body. Identification of plaque components by IVMRI in vivo has important implications for the understanding and modification of human atherosclerosis.

“…We initially evaluated the signal from our IVMRI system with reference to histopathologic study. Our results agree with those of Worthley and colleagues, 22 using surface MRI, that fibrous tissues in human atheroma yield bright signal in T1w sequences compared with lipid and for lipid compared with calcium. Our data also reinforce those of Zhao and colleagues, 4 who described T2 signals as brighter for fibrous tissue compared with lipid.…”

Section: Larose Et Al Ivmri For Plaque Characterizationsupporting

confidence: 93%

Characterization of Human Atherosclerotic Plaques by Intravascular Magnetic Resonance Imaging

¹

,

²

,

³

et al. 2005

View full text Add to dashboard Cite

Background-Development and validation of novel imaging modalities to assess the composition of human atherosclerotic plaques will improve the understanding of atheroma evolution and could facilitate evaluation of therapeutic strategies for plaque modification. Surface MRI can characterize tissue content of carotid but not deeper arteries. This study evaluated the usefulness of intravascular MRI (IVMRI) to discern the composition of human iliac arteries in vivo. Methods and Results-Initial studies validated IVMRI against histopathology of human atherosclerotic arteries ex vivo.A 0.030-inch-diameter IVMRI detector coil was advanced into isolated human aortoiliac arteries and coupled to a 1.5-T scanner. Information from combined T1-, moderate T2-, and proton-density-weighted images differentiated lipid, fibrous, and calcified components with favorable sensitivity and specificity and allowed accurate quantification of plaque size. The validated approach was then applied to image iliac arteries of 25 human subjects in vivo, and results were compared with those of intravascular ultrasound (IVUS). IVMRI readily visualized inner and outer plaque boundaries in all arteries, even those with extensive calcification that precluded IVUS interpretation. It also revealed the expected heterogeneity of atherosclerotic plaque content that was noted during ex vivo validation. Again, IVUS did not disclose this heterogeneity. The level of interobserver and intraobserver agreement in the interpretation of plaque composition was high for IVMRI but poor for IVUS. Conclusions-IVMRI can reliably identify plaque composition and size in arteries deep within the body. Identification of plaque components by IVMRI in vivo has important implications for the understanding and modification of human atherosclerosis.

“…Preliminary studies in a porcine model of atherosclerosis showed that the major difficulties of MR coronary wall imaging are due to the combination of cardiac and respiratory motion artifacts, the nonlinear course of the coronary arteries, and their relatively small size and location. 13 Thus, an effective in vivo MRI technique for coronary artery imaging must overcome artifacts related to blood flow and cardiac, respiratory, and vessel wall motion to achieve high-resolution and high-contrast imaging.…”

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confidence: 99%

Noninvasive In Vivo Human Coronary Artery Lumen and Wall Imaging Using Black-Blood Magnetic Resonance Imaging

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et al. 2000

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Background-High-resolution MRI has the potential to noninvasively image the human coronary artery wall and define the degree and nature of coronary artery disease. Coronary artery imaging by MR has been limited by artifacts related to blood flow and motion and by low spatial resolution. Methods and Results-We used a noninvasive black-blood (BB) MRI (BB-MR) method, free of motion and blood-flow artifacts, for high-resolution (down to 0.46 mm in-plane resolution and 3-mm slice thickness) imaging of the coronary artery lumen and wall. In vivo BB-MR of both normal and atherosclerotic human coronary arteries was performed in 13 subjects: 8 normal subjects and 5 patients with coronary artery disease. The average coronary wall thickness for each cross-sectional image was 0.75Ϯ0.17 mm (range, 0.55 to 1.0 mm) in the normal subjects. MR images of coronary arteries in patients with Ն40% stenosis as assessed by x-ray angiography showed localized wall thickness of 4.38Ϯ0.71 mm (range, 3.30 to 5.73 mm). The difference in maximum wall thickness between the normal subjects and patients was statistically significant (PϽ0.0001). Conclusions-In

“…On the basis of previous work on atherosclerotic plaque characterization, we defined the presence of low-signal (dark) regions within the otherwise high-signal (bright) vessel wall on T2W images as indicating vessel wall hematoma. 7,8 With the presence of vessel wall hematoma as identified by histopathology as the gold standard, the sensitivity and specificity of MRI to detect vessel wall hematoma in this study were determined. …”

mentioning

confidence: 99%

“…17 MRI is unique in that it is the only potentially noninvasive imaging modality currently available that is able to identify all components of complex atherosclerotic lesions, including lipid-rich, fibrous, calcified, and hemorrhagic components. 7,8 The porcine model has been extensively used for the purposes of atherosclerosis research. The pig coronary anatomy closely resembles that of humans, and the size of the coronary arteries is similar.…”

mentioning

confidence: 99%

Noninvasive In Vivo Magnetic Resonance Imaging of Experimental Coronary Artery Lesions in a Porcine Model

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et al. 2000

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Background-The ability to characterize and quantify coronary artery atherosclerotic lesions accurately, reproducibly, and noninvasively may allow the stratification of risk for future acute coronary syndromes and help direct therapeutic management. MRI has been shown to accurately characterize and quantify atherosclerosis; however, because of the combination of cardiac and respiratory motion artifacts, nonlinear course, and relatively small size of the coronary arteries, these techniques have not been able to be translated to the coronary system in vivo. Methods and Results-Coronary lesions were induced in Yorkshire albino swine (nϭ6) with balloon angioplasty, and 4 weeks later MRI of the coronary artery lesions was performed. High-resolution in vivo images of the coronary artery wall and lesions were obtained with a double-inversion-recovery fast-spin-echo sequence in a 1.5-T MR system. There was good agreement between measurements of vessel wall thickness and area from MR images of the coronary arteries and the matched histopathology sections (nϭ43). The mean difference (MRI minus histopathology Ϯ SD) for mean wall thickness was 0.26Ϯ0.18 mm, and for vessel wall area, 5.65Ϯ3.51 mm 2 . MRI was also able to visualize intralesion hematoma (sensitivity 82%, specificity 84%). Conclusions-Using a clinical MR system, we were able to image coronary artery lesions in vivo in an experimental porcine model. Further studies are needed to assess the ability of MRI to characterize coronary atherosclerotic lesions in vivo. Key Words: magnetic resonance imaging Ⅲ arteries D espite advances in our understanding of the cellular and molecular mechanisms in the pathogenesis of atherosclerosis, coronary artery disease remains the single largest cause of mortality in Western society. 1,2 The composition of the atherosclerotic plaque, rather than the degree of vessel stenosis, is known to modulate both the risk of rupture and subsequent thrombogenicity. 3-5 MRI has been shown to accurately characterize and quantify atherosclerotic lesions in various arterial systems. 6 -10 The critical limitation of MRI has been the inability to translate these techniques to the coronary artery system in vivo, because of the combination of cardiac and respiratory motion artifacts, nonlinear course, and relatively small size of the coronary arteries. Using a doubleinversion-recovery fast-spin-echo MRI sequence in a clinical whole-body 1.5-T MR system, we were able to visualize coronary lesions in vivo in an experimental porcine model. The ability to noninvasively characterize and quantify coronary artery atherosclerotic lesions may allow stratification of risk for future acute coronary syndromes. Moreover, it could permit tailoring of therapeutic approaches on the basis of atherosclerotic plaque characteristics and sequential assessment of their efficacy.The process of atherogenesis is often unpredictable, because it is well documented that mild coronary lesions may be associated with significant progression to severe stenosis or total occlusion. 3,...

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