Short-term tracking of atherosclerosis in operated and unoperated human carotid arteries by high resolution magnetic resonance imaging.
Short-term tracking of atherosclerosis in operated and unoperated human carotid arteries by high resolution magnetic resonance imaging.
复制标题
通过高分辨率磁共振成像对手术和未手术的人颈动脉中的动脉粥样硬化进行短期跟踪。
DOI：
10.1007/s00268-006-0711-3
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发表时间：
2007
影响因子：
2.6
通讯作者：
Morrisett,Joel
中科院分区：
文献类型：
--
作者：
Martin,Kirt;Brownfield,Douglas;Karmonik,Christof;Sanford,Lee;Torres,Lynne;Insull,William;Morrisett,Joel
一项先前的研究证实了磷脂（PL）与蛋白质（apoAI Milano）复合物的疗效，通过血管内超声（IVUS）评估，47例颈动脉粥样硬化患者的动脉粥样硬化体积消退4.6%。这项研究的结果提出了一个问题，是否单独的磷脂可以产生类似的effect.MethodsTo回答这个问题的一项试验的39名受试者在5个网站的设计。通过US确定的至少一个颈动脉狭窄> 15%的患者每周接受静脉内PL（200 mg/kg）或安慰剂输注，持续8周。在0、4、8和14周时，通过磁共振成像（MRI）测量血管壁/外壁比率、富脂/坏死核心百分比和钙化百分比，作为血管壁的比例。ResultsThe substudy在我们的研究中心对7例患者进行了评估，比较了5个未手术-未手术颈动脉对和2个手术-未手术对的尺寸。在患者1中，在14周研究期间，未手术左颈动脉和未手术右颈动脉的MRI测量结果几乎相同。两个颈动脉的总壁（+61% vs. 56%）、正常壁（+51% vs. 49%）和斑块（+99% vs. 85%）体积增加相似。两个颈动脉的管腔体积均显示出相似的减少（−11% vs. −17%）。其他4个未手术-未手术颈动脉对在14周内显示出与患者1相似的尺寸变化。在接受左动脉内膜切除术的患者2中，手术颈动脉的总动脉体积为2300 mm 3，约为未手术颈动脉（1100 mm 3）的两倍。并行跟踪手术和未手术颈动脉测量。未手术的颈动脉总壁体积增加25%（+200 mm 3），正常壁体积增加19%（+100 mm 3），斑块体积增加43%（+75 mm 3）。术后颈动脉管腔未见明显变化。同样接受左动脉内膜切除术的患者7，其颈动脉变化与患者2相似。结论个体未手术颈动脉对的体积轨迹几乎相同。在单侧手术的颈动脉对中，手术动脉的体积比未手术的颈动脉大1.5至2.0倍。在我们的两名单侧手术患者中，手术颈动脉斑块体积减少（-3%，-58%），而未手术颈动脉斑块体积增加（+43%，+7%）。在5名未手术的患者中，一对斑块体积增加85%/99%;一对减少-15%/-10%;其他三对有中度变化。这项研究提供了额外的支持，认为未经手术的人颈动脉是双侧对称的。
AbstractIntroductionA previous study demonstrated the efficacy of a phospholipid (PL) complexed with a protein (apoAI Milano) in causing 4.6% regression of atheroma volume as assessed by intravascular ultrasonography (IVUS) in a group of 47 patients with carotid atherosclerosis. The results of this study raised the question of whether the phospholipid alone could produce a similar effect.MethodsTo answer this question a trial of 39 subjects at five sites was designed. Patients with > 15% stenosis of at least one carotid artery as determined by US underwent intravenous PL (200 mg/kg) or placebo infusions weekly for 8 weeks. The wall/outer wall ratio, percent lipid‐rich/necrotic core, and percent calcification were measured as a proportion of the vessel wall by magnetic resonance imaging (MRI) at 0, 4, 8, and 14 weeks.ResultsThe substudy of seven of these patients evaluated at our site allowed comparison of the dimensions of five unoperated‐unoperated carotid pairs and two operated‐unoperated pairs. In patient 1, MRI measurements on unoperated left and unoperated right carotids tracked almost identically over the 14‐week study. Both carotids showed similar increases in the volumes of the total wall (+61% vs. 56%), the normal wall (+51% vs. 49%), and plaque (+99% vs. 85%). Both carotids showed similar decreases in lumen volume (−11% vs. −17%). The other four unoperated‐unoperated carotid pairs showed dimensional changes over 14 weeks similar to those of patient 1. In patient 2, who underwent left endarterectomy, the operated carotid had a total artery volume of 2300 mm3, about twofold greater than the unoperated carotid (1100 mm3). Operated and unoperated carotid measurements tracked in parallel. The unoperated carotid had volume increases of 25% (+200 mm3) in total wall, +19% (+100 mm3) in normal wall, and 43% (+75 mm3) in plaque. The operated carotid lumen showed no significant changes. Patient 7, who also underwent left endarterectomy, exhibited carotid changes similar to those of patient 2.ConclusionsIndividual unoperated carotid pairs have volumes that track almost identically. In unilateral operated carotid pairs, the operated artery has 1.5‐ to 2.0‐fold greater volume than unoperated carotids. In each of our two unilaterally operated patients, the operated carotid had decreased plaque volume (−3%, −58%), whereas the unoperated carotid had increased plaque volume (+43%, +7%). Among the five unoperated patients, one pair had 85%/99% increase in plaque volume; one pair had −15%/−10% decrease; and the other three pairs had intermediate changes. This study provides additional support to the view that unoperated human carotid arteries are bilaterally symmetrical.