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Jansen CHP, Perera D, Wiethoff AJ, Phinikaridou A, Razavi RM, Rinaldi A, Marber MS, Greil GF, Nagel E, Maintz D, Redwood S, Botnar RM, Makowski MR. Contrast-enhanced magnetic resonance imaging for the detection of ruptured coronary plaques in patients with acute myocardial infarction. PLoS One 2017; 12:e0188292. [PMID: 29190694 PMCID: PMC5708680 DOI: 10.1371/journal.pone.0188292] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 11/03/2017] [Indexed: 12/19/2022] Open
Abstract
Purpose X-ray coronary angiography (XCA) is the current gold standard for the assessment of lumen encroaching coronary stenosis but XCA does not allow for early detection of rupture-prone vulnerable plaques, which are thought to be the precursor lesions of most acute myocardial infarctions (AMI) and sudden death. The aim of this study was to investigate the potential of delayed contrast-enhanced magnetic resonance coronary vessel wall imaging (CE-MRCVI) for the detection of culprit lesions in the coronary arteries. Methods 16 patients (13 male, age 61.9±8.6 years) presenting with sub-acute MI underwent CE-MRCVI within 24-72h prior to invasive XCA. CE-MRCVI was performed using a T1-weighted 3D gradient echo inversion recovery sequence (3D IR TFE) 40±4 minutes following the administration of 0.2 mmol/kg gadolinium-diethylenetriamine-pentaacetic acid (DTPA) on a 3T MRI scanner equipped with a 32-channel cardiac coil. Results 14 patients were found to have culprit lesions (7x LAD, 1xLCX, 6xRCA) as identified by XCA. Quantitative CE-MRCVI correctly identified the culprit lesion location with a sensitivity of 79% and excluded culprit lesion formation with a specificity of 99%. The contrast to noise ratio (CNR) of culprit lesions (9.7±4.1) significantly exceeded CNR values of segments without culprit lesions (2.9±1.9, p<0.001). Conclusion CE-MRCVI allows the selective visualization of culprit lesions in patients immediately after myocardial infarction (MI). The pronounced contrast uptake in ruptured plaques may represent a surrogate biomarker of plaque activity and/or vulnerability.
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Affiliation(s)
- Christian H. P. Jansen
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- * E-mail:
| | - Divaka Perera
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- Cardiovascular Centre, Guy’s and St. Thomas’ Hospital, London, United Kingdom
| | - Andrea J. Wiethoff
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
- Philips Healthcare, Guildford, United Kingdom
| | - Alkystis Phinikaridou
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
| | - Reza M. Razavi
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- Wellcome Trust and EPSRC Medical Engineering Center, London, United Kingdom
| | - Aldo Rinaldi
- Cardiovascular Centre, Guy’s and St. Thomas’ Hospital, London, United Kingdom
| | - Mike S. Marber
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- Cardiovascular Centre, Guy’s and St. Thomas’ Hospital, London, United Kingdom
| | - Gerald F. Greil
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
| | - Eike Nagel
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- Wellcome Trust and EPSRC Medical Engineering Center, London, United Kingdom
| | - David Maintz
- Department of Radiology, University Muenster, Muenster, Germany
| | - Simon Redwood
- Cardiovascular Centre, Guy’s and St. Thomas’ Hospital, London, United Kingdom
| | - Rene M. Botnar
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- Wellcome Trust and EPSRC Medical Engineering Center, London, United Kingdom
- Pontificia Universidad Católica de Chile, Escuela de Ingeniería, Santiago, Chile
| | - Marcus R. Makowski
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- Department of Radiology, Charité, Berlin, Germany
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Pozo E, Agudo-Quilez P, Rojas-González A, Alvarado T, Olivera MJ, Jiménez-Borreguero LJ, Alfonso F. Noninvasive diagnosis of vulnerable coronary plaque. World J Cardiol 2016; 8:520-533. [PMID: 27721935 PMCID: PMC5039354 DOI: 10.4330/wjc.v8.i9.520] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 07/01/2016] [Accepted: 07/22/2016] [Indexed: 02/06/2023] Open
Abstract
Myocardial infarction and sudden cardiac death are frequently the first manifestation of coronary artery disease. For this reason, screening of asymptomatic coronary atherosclerosis has become an attractive field of research in cardiovascular medicine. Necropsy studies have described histopathological changes associated with the development of acute coronary events. In this regard, thin-cap fibroatheroma has been identified as the main vulnerable coronary plaque feature. Hence, many imaging techniques, such as coronary computed tomography, cardiac magnetic resonance or positron emission tomography, have tried to detect noninvasively these histomorphological characteristics with different approaches. In this article, we review the role of these diagnostic tools in the detection of vulnerable coronary plaque with particular interest in their advantages and limitations as well as the clinical implications of the derived findings.
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Abstract
Advances in atherosclerosis imaging technology and research have provided a range of diagnostic tools to characterize high-risk plaque in vivo; however, these important vascular imaging methods additionally promise great scientific and translational applications beyond this quest. When combined with conventional anatomic- and hemodynamic-based assessments of disease severity, cross-sectional multimodal imaging incorporating molecular probes and other novel noninvasive techniques can add detailed interrogation of plaque composition, activity, and overall disease burden. In the catheterization laboratory, intravascular imaging provides unparalleled access to the world beneath the plaque surface, allowing tissue characterization and measurement of cap thickness with micrometer spatial resolution. Atherosclerosis imaging captures key data that reveal snapshots into underlying biology, which can test our understanding of fundamental research questions and shape our approach toward patient management. Imaging can also be used to quantify response to therapeutic interventions and ultimately help predict cardiovascular risk. Although there are undeniable barriers to clinical translation, many of these hold-ups might soon be surpassed by rapidly evolving innovations to improve image acquisition, coregistration, motion correction, and reduce radiation exposure. This article provides a comprehensive review of current and experimental atherosclerosis imaging methods and their uses in research and potential for translation to the clinic.
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Affiliation(s)
- Jason M Tarkin
- From the Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK (J.M.T., A.J.B., J.H.F.R.); Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK (N.R.E.); Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom (M.R.D); Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA (R.A.P.T., A.T.); Imaging Sciences Laboratories, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, NY (Z.A.F., M.R.D.); and Department of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, NY (Z.A.F.)
| | - Marc R Dweck
- From the Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK (J.M.T., A.J.B., J.H.F.R.); Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK (N.R.E.); Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom (M.R.D); Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA (R.A.P.T., A.T.); Imaging Sciences Laboratories, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, NY (Z.A.F., M.R.D.); and Department of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, NY (Z.A.F.)
| | - Nicholas R Evans
- From the Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK (J.M.T., A.J.B., J.H.F.R.); Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK (N.R.E.); Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom (M.R.D); Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA (R.A.P.T., A.T.); Imaging Sciences Laboratories, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, NY (Z.A.F., M.R.D.); and Department of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, NY (Z.A.F.)
| | - Richard A P Takx
- From the Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK (J.M.T., A.J.B., J.H.F.R.); Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK (N.R.E.); Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom (M.R.D); Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA (R.A.P.T., A.T.); Imaging Sciences Laboratories, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, NY (Z.A.F., M.R.D.); and Department of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, NY (Z.A.F.)
| | - Adam J Brown
- From the Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK (J.M.T., A.J.B., J.H.F.R.); Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK (N.R.E.); Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom (M.R.D); Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA (R.A.P.T., A.T.); Imaging Sciences Laboratories, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, NY (Z.A.F., M.R.D.); and Department of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, NY (Z.A.F.)
| | - Ahmed Tawakol
- From the Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK (J.M.T., A.J.B., J.H.F.R.); Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK (N.R.E.); Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom (M.R.D); Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA (R.A.P.T., A.T.); Imaging Sciences Laboratories, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, NY (Z.A.F., M.R.D.); and Department of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, NY (Z.A.F.)
| | - Zahi A Fayad
- From the Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK (J.M.T., A.J.B., J.H.F.R.); Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK (N.R.E.); Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom (M.R.D); Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA (R.A.P.T., A.T.); Imaging Sciences Laboratories, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, NY (Z.A.F., M.R.D.); and Department of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, NY (Z.A.F.)
| | - James H F Rudd
- From the Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK (J.M.T., A.J.B., J.H.F.R.); Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK (N.R.E.); Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom (M.R.D); Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA (R.A.P.T., A.T.); Imaging Sciences Laboratories, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, NY (Z.A.F., M.R.D.); and Department of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, NY (Z.A.F.).
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Qiao H, He Q, Chen Z, Xu D, Huang L, He L, Jiang L, Li R, Luo J, Yuan C, Zhao X. Identification of early atherosclerotic lesions in carotid arteries with quantitative characteristics measured by 3D MRI. J Magn Reson Imaging 2016; 44:1270-1276. [PMID: 27079951 DOI: 10.1002/jmri.25264] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 03/21/2016] [Accepted: 03/22/2016] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To evaluate the usefulness of quantitative characteristics of morphology and signal intensity of arterial wall measured by 3D multicontrast magnetic resonance vessel wall imaging (MRVWI) in identification of carotid early atherosclerosis (CEAS). MATERIALS AND METHODS In all, 61 older subjects (mean age 71.8 ± 5.6 years old; 25 males) without cardiovascular symptoms in the last 6 months were recruited. The carotid arteries without advanced plaque features on 3.0T MRI were included for analysis. Ultrasound imaging was used as a reference to identify CEAS. The morphological parameters including lumen area (LA), wall area (WA), wall thickness (WT), and normalized wall index (NWI = WA/[WA+LA] × 100%) and the signal intensity on 3.0T MR T2 -weighted images (T2 SI) of the carotid arterial wall were measured. Three regression models were built to identify CEAS with the following parameters: Model 1 with both morphological and T2 SI parameters; Model 2 with T2 SI parameters; and Model 3 with morphological parameters. All models were adjusted for age and sex. Area under the curve (AUC) was calculated to validate models. RESULTS Of the 86 carotid arteries without advanced plaques, 47 (54.7%) were found to have early plaques determined by ultrasound. Among three regression models, Model 1 showed the highest AUC values in identifying CEAS (left: AUC = 0.856, P < 0.001; right: AUC = 0.867, P < 0.001), followed by Model 2 (left: AUC = 0.843, P < 0.001; right: AUC = 0.798, P = 0.001), and Model 3 (left: AUC = 0.790, P = 0.002; right: AUC = 0.806, P < 0.001). CONCLUSION The combination of morphology and normalized T2 SI of arterial wall measured by MRVWI is more effective than each characteristic alone in identification of CEAS. J. Magn. Reson. Imaging 2016;44:1270-1276.
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Affiliation(s)
- Huiyu Qiao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Qiong He
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Zhensen Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Dongxiang Xu
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Lingyun Huang
- Clinical Sites Research Program, Philips Research China, Shanghai, China
| | - Le He
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Li Jiang
- Philips Healthcare (Suzhou), Jiangsu, China
| | - Rui Li
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Jianwen Luo
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Chun Yuan
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China.,Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China.
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Dweck MR, Puntmann VO, Vesey AT, Fayad ZA, Nagel E. MR Imaging of Coronary Arteries and Plaques. JACC Cardiovasc Imaging 2016; 9:306-16. [DOI: 10.1016/j.jcmg.2015.12.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 11/25/2015] [Accepted: 12/03/2015] [Indexed: 01/13/2023]
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6
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Keegan J. Coronary artery wall imaging. J Magn Reson Imaging 2014; 41:1190-202. [PMID: 25303707 DOI: 10.1002/jmri.24766] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 08/06/2014] [Accepted: 08/06/2014] [Indexed: 12/12/2022] Open
Abstract
Like X-Ray contrast angiography, MR coronary angiograms show the vessel lumens rather than the vessels themselves. Consequently, outward remodeling of the vessel wall, which occurs in subclinical coronary disease before luminal narrowing, cannot be seen. The current gold standard for assessing the coronary vessel wall is intravascular ultrasound, and more recently, optical coherence tomography, both of which are invasive and use ionizing radiation. A noninvasive, low-risk technique for assessing the vessel wall would be beneficial to cardiologists interested in the early detection of preclinical disease and for the safe monitoring of the progression or regression of disease in longitudinal studies. In this review article, the current state of the art in MR coronary vessel wall imaging is discussed, together with validation studies and recent developments.
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Affiliation(s)
- Jennifer Keegan
- Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London
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7
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Bloch LØ, Hansen AYKG, Pedersen SF, Honge JL, Kim WY, Hansen ESS. Imaging of carotid artery vessel wall edema using T2-weighted cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2014; 16:22. [PMID: 24593873 PMCID: PMC3973999 DOI: 10.1186/1532-429x-16-22] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 02/10/2014] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Atherothrombosis remains a major health problem in the western world, and carotid atherosclerosis is an important contributor to embolic ischemic strokes. It remains a clinical challenge to identify rupture-prone atherosclerotic plaques before clinical events occur. Inflammation, endothelial injury and angiogenesis are features of vulnerable plaques and may all be associated with plaque edema. Therefore, vessel wall edema, which can be detected by 2D T2-weighted cardiovascular magnetic resonance (CMR), may be used as a dynamic marker of disease activity in the atherosclerotic plaque. However, 2D imaging is limited by low spatial resolution in the slice-select direction compared to 3D imaging techniques. We sought to investigate the ability of novel 3D techniques to detect edema induced in porcine carotid arteries by acute balloon injury compared to conventional 2D T2-weighted black-blood CMR. METHODS Edema was induced unilaterally by balloon overstretch injury in the carotid artery of nine pigs. Between one to seven hours (average four hours) post injury, CMR was performed using 2D T2-weighted short-tau inversion recovery (T2-STIR), 3D volumetric isotropic turbo spin echo acquisition (VISTA) and 3D T2 prepared gradient-echo (T2prep-GE). The CMR images were compared in terms of signal-to-noise ratio (SNR) and contrast-to-noise (CNR) ratio. Furthermore, the presence of vessel wall injury was validated macroscopically by means of Evans Blue dye that only enters the injured vessel wall. RESULTS All three imaging sequences classified the carotid arteries correctly compared to Evans Blue and all sequences demonstrated a significant increase in SNR of the injured compared to the non-injured carotid vessel wall (T2-STIR, p = 0.002; VISTA, p = 0.004; and T2prep-GE, p = 0.003). There was no significant difference between sequences regarding SNR and CNR. CONCLUSION The novel 3D imaging sequences VISTA and T2prep-GE perform comparably to conventional 2D T2-STIR in terms of detecting vessel wall edema. The improved spatial coverage of these 3D sequences may facilitate visualization of vessel wall edema to enable detection and monitoring of vulnerable carotid atherosclerotic plaques.
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Affiliation(s)
- Lars Ølgaard Bloch
- Department of Cardiology, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
- MR Research Centre, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
| | - Anne Yoon Krogh Grøndal Hansen
- MR Research Centre, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
- Department of Cardiothoracic & Vascular Surgery, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
| | - Steen Fjord Pedersen
- MR Research Centre, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
- Department of Cardiothoracic & Vascular Surgery, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
| | - Jesper Langhoff Honge
- Department of Cardiothoracic & Vascular Surgery, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
| | - Won Yong Kim
- Department of Cardiology, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
- MR Research Centre, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
| | - Esben Søvsø Szocska Hansen
- MR Research Centre, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark
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Makowski MR, Henningsson M, Spuentrup E, Kim WY, Maintz D, Manning WJ, Botnar RM. Characterization of coronary atherosclerosis by magnetic resonance imaging. Circulation 2013; 128:1244-55. [PMID: 24019445 DOI: 10.1161/circulationaha.113.002681] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Marcus R Makowski
- Division of Imaging Sciences and Biomedical Engineering (M.R.M., M.H., R.M.B.), BHF Center of Research Excellence (M.R.M., M.H., R.M.B.), Wellcome Trust and EPSRC Medical Engineering Center (M.H., R.M.B.), and NIHR Biomedical Research Center (M.H., R.M.B.), King's College London, London, UK; Department of Radiology, Charité, Berlin, Germany (M.R.M.); Department of Radiology and Nuclear Medicine, Hospital Saarbrucken, Saarbrucken, Germany (E.S.); Department of Cardiology, Aarhus University Hospital, Skejby Sygehus, Denmark (W.Y.K.); Department of Radiology, University of Cologne, Cologne, Germany (D.M.); and Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (W.J.M.)
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Holm NR, Kim WY, Maeng M, Thrysøe SA, Bøtker HE, Thuesen L, Høyer S, Tu S, Falk E, Lassen JF, Nielsen PH, Christiansen EH. Coronary Edema Demonstrated by Cardiovascular Magnetic Resonance in Patients With Peri-Stent Inflammation and Aneurysm Formation After Treatment by Drug-Eluting Stents. Circ Cardiovasc Imaging 2013; 6:352-4. [DOI: 10.1161/circimaging.112.979997] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Niels R. Holm
- From the Department of Cardiology (N.R.H., W.Y.K., M.M., H.E.B., L.T., E.F., J.F.L., E.H.C.), MR-Center (W.Y.K., S.A.T.), and Department of Pathology (S.H.), Aarhus University Hospital, Skejby, Denmark; Division of Image Processing, Leiden University Medical Center, Leiden, the Netherlands (S.T.); and Department of Thoracic Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark (P.H.N.)
| | - Won Yong Kim
- From the Department of Cardiology (N.R.H., W.Y.K., M.M., H.E.B., L.T., E.F., J.F.L., E.H.C.), MR-Center (W.Y.K., S.A.T.), and Department of Pathology (S.H.), Aarhus University Hospital, Skejby, Denmark; Division of Image Processing, Leiden University Medical Center, Leiden, the Netherlands (S.T.); and Department of Thoracic Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark (P.H.N.)
| | - Michael Maeng
- From the Department of Cardiology (N.R.H., W.Y.K., M.M., H.E.B., L.T., E.F., J.F.L., E.H.C.), MR-Center (W.Y.K., S.A.T.), and Department of Pathology (S.H.), Aarhus University Hospital, Skejby, Denmark; Division of Image Processing, Leiden University Medical Center, Leiden, the Netherlands (S.T.); and Department of Thoracic Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark (P.H.N.)
| | - Samuel A. Thrysøe
- From the Department of Cardiology (N.R.H., W.Y.K., M.M., H.E.B., L.T., E.F., J.F.L., E.H.C.), MR-Center (W.Y.K., S.A.T.), and Department of Pathology (S.H.), Aarhus University Hospital, Skejby, Denmark; Division of Image Processing, Leiden University Medical Center, Leiden, the Netherlands (S.T.); and Department of Thoracic Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark (P.H.N.)
| | - Hans Erik Bøtker
- From the Department of Cardiology (N.R.H., W.Y.K., M.M., H.E.B., L.T., E.F., J.F.L., E.H.C.), MR-Center (W.Y.K., S.A.T.), and Department of Pathology (S.H.), Aarhus University Hospital, Skejby, Denmark; Division of Image Processing, Leiden University Medical Center, Leiden, the Netherlands (S.T.); and Department of Thoracic Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark (P.H.N.)
| | - Leif Thuesen
- From the Department of Cardiology (N.R.H., W.Y.K., M.M., H.E.B., L.T., E.F., J.F.L., E.H.C.), MR-Center (W.Y.K., S.A.T.), and Department of Pathology (S.H.), Aarhus University Hospital, Skejby, Denmark; Division of Image Processing, Leiden University Medical Center, Leiden, the Netherlands (S.T.); and Department of Thoracic Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark (P.H.N.)
| | - Søren Høyer
- From the Department of Cardiology (N.R.H., W.Y.K., M.M., H.E.B., L.T., E.F., J.F.L., E.H.C.), MR-Center (W.Y.K., S.A.T.), and Department of Pathology (S.H.), Aarhus University Hospital, Skejby, Denmark; Division of Image Processing, Leiden University Medical Center, Leiden, the Netherlands (S.T.); and Department of Thoracic Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark (P.H.N.)
| | - Shengxian Tu
- From the Department of Cardiology (N.R.H., W.Y.K., M.M., H.E.B., L.T., E.F., J.F.L., E.H.C.), MR-Center (W.Y.K., S.A.T.), and Department of Pathology (S.H.), Aarhus University Hospital, Skejby, Denmark; Division of Image Processing, Leiden University Medical Center, Leiden, the Netherlands (S.T.); and Department of Thoracic Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark (P.H.N.)
| | - Erling Falk
- From the Department of Cardiology (N.R.H., W.Y.K., M.M., H.E.B., L.T., E.F., J.F.L., E.H.C.), MR-Center (W.Y.K., S.A.T.), and Department of Pathology (S.H.), Aarhus University Hospital, Skejby, Denmark; Division of Image Processing, Leiden University Medical Center, Leiden, the Netherlands (S.T.); and Department of Thoracic Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark (P.H.N.)
| | - Jens Flensted Lassen
- From the Department of Cardiology (N.R.H., W.Y.K., M.M., H.E.B., L.T., E.F., J.F.L., E.H.C.), MR-Center (W.Y.K., S.A.T.), and Department of Pathology (S.H.), Aarhus University Hospital, Skejby, Denmark; Division of Image Processing, Leiden University Medical Center, Leiden, the Netherlands (S.T.); and Department of Thoracic Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark (P.H.N.)
| | - Per Hostrup Nielsen
- From the Department of Cardiology (N.R.H., W.Y.K., M.M., H.E.B., L.T., E.F., J.F.L., E.H.C.), MR-Center (W.Y.K., S.A.T.), and Department of Pathology (S.H.), Aarhus University Hospital, Skejby, Denmark; Division of Image Processing, Leiden University Medical Center, Leiden, the Netherlands (S.T.); and Department of Thoracic Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark (P.H.N.)
| | - Evald Høj Christiansen
- From the Department of Cardiology (N.R.H., W.Y.K., M.M., H.E.B., L.T., E.F., J.F.L., E.H.C.), MR-Center (W.Y.K., S.A.T.), and Department of Pathology (S.H.), Aarhus University Hospital, Skejby, Denmark; Division of Image Processing, Leiden University Medical Center, Leiden, the Netherlands (S.T.); and Department of Thoracic Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark (P.H.N.)
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Lindsay AC, Choudhury RP. MRI of acute vascular syndromes: the emerging role of cardiovascular MRI in the diagnosis and treatment of AMI and stroke. Expert Rev Cardiovasc Ther 2012; 10:1101-8. [PMID: 23098146 DOI: 10.1586/erc.12.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
MRI is a safe and reproducible noninvasive method of obtaining high-resolution images of the heart and vascular system. As MRI has developed a more widespread clinical application over the last decade, attention has been increasing on how this technique can be used to aid the diagnosis of cardio- and cerebro-vascular diseases in the acute setting. While much of the initial development of cardiac MRI was based around describing the myocardium in the chronic stable state, much recent research has investigated the use of MRI to assess acute coronary syndromes. Similarly, arterial wall imaging using MRI was initially confined to relatively stable research populations; however, more recent work has suggested a possible future clinical role for vascular MRI techniques in acute settings. This study highlights recent advances in MRI of the cardiovascular system, with a particular emphasis on those techniques that can be of use in the setting of acute vascular syndromes, namely acute coronary syndrome, transient ischemic attack and stroke.
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Pedersen SF, Thrysøe SA, Paaske WP, Thim T, Falk E, Ringgaard S, Kim WY. Determination of edema in porcine coronary arteries by T2 weighted cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2011; 13:52. [PMID: 21936914 PMCID: PMC3192668 DOI: 10.1186/1532-429x-13-52] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 09/21/2011] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Inflammation plays a pivotal role in all stages of atherosclerosis. Since edema is known to be an integral part of inflammation, a noninvasive technique that can identify edema in the coronary artery wall may provide unique information regarding plaque activity. In this study, we aimed to determine whether edema induced in porcine coronary arteries by balloon injury could be reliably detected by cardiovascular magnetic resonance (CMR) using a water sensitive T2-weighted short tau inversion recovery sequence (T2-STIR). We also aimed to compare these results to those of conventional T2-weighted (T2W) imaging. METHODS Edema was induced in the proximal left anterior descending (LAD) coronary artery wall in seven pigs by balloon injury. At baseline, and 1-10 days (average four) post injury, the proximal LAD was assessed by water sensitive T2-STIR and conventional T2W sequences in cross-sectional planes. CMR images were matched to histopathology, validated against Evans blue as a marker of increased vessel wall permeability, and correlated with the arterial amount of fibrinogen used as an edema surrogate marker. RESULTS Post injury, the T2-STIR images of the injured LAD vessel wall showed a significant 72%, relative signal intensity (SI) increase compared with baseline (p = 0.028). Using a threshold value of SI 7 SD above the average SI of the myocardium, T2-STIR detected edema in the vessel wall (i.e. enhancement) with a sensitivity of 100 and a specificity of 71. Twelve out of the 14 (86%) T2-STIR images displaying coronary artery wall enhancement also showed Evans blue uptake in the corresponding histology. The relative signal intensity showed a linear correlation with the amount of fibrinogen detected on the corresponding histopathology (ρ = 0.750, p = 0.05). The conventional T2W images did not show significant changes in SI post injury. CONCLUSION T2-STIR CMR enabled detection of coronary artery wall edema and could therefore be a non-invasive diagnostic tool for evaluation of inflammatory coronary artery wall activity.
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Affiliation(s)
- Steen Fjord Pedersen
- Dept. of Cardiothoracic and Vascular Surgery T, Aarhus University Hospital Skejby, Brendstrupsgaardsvej 100, DK-8200 Aarhus N, Denmark
- MR-center, Aarhus University Hospital Skejby, Brendstrupsgaardsvej 100, DK-8200 Aarhus N, Denmark
| | - Samuel A Thrysøe
- MR-center, Aarhus University Hospital Skejby, Brendstrupsgaardsvej 100, DK-8200 Aarhus N, Denmark
| | - William P Paaske
- Dept. of Cardiothoracic and Vascular Surgery T, Aarhus University Hospital Skejby, Brendstrupsgaardsvej 100, DK-8200 Aarhus N, Denmark
| | - Troels Thim
- Dept. of Cardiology, Aarhus University Hospital Skejby, Brendstrupsgaardsvej 100, DK-8200 Aarhus N, Denmark
| | - Erling Falk
- Dept. of Cardiology, Aarhus University Hospital Skejby, Brendstrupsgaardsvej 100, DK-8200 Aarhus N, Denmark
| | - Steffen Ringgaard
- MR-center, Aarhus University Hospital Skejby, Brendstrupsgaardsvej 100, DK-8200 Aarhus N, Denmark
| | - Won Yong Kim
- Dept. of Cardiology, Aarhus University Hospital Skejby, Brendstrupsgaardsvej 100, DK-8200 Aarhus N, Denmark
- MR-center, Aarhus University Hospital Skejby, Brendstrupsgaardsvej 100, DK-8200 Aarhus N, Denmark
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