Characterization of human atherosclerotic plaques by intravascular magnetic resonance imaging
Characterization of human atherosclerotic plaques by intravascular magnetic resonance imaging
复制标题
DOI：
10.1161/circulationaha.105.538942
复制
发表时间：
2005-10-11
期刊：
影响因子：
37.8
通讯作者：
Ganz, P
中科院分区：
文献类型：
--
作者：
Larose, E;Yeghiazarians, Y;Ganz, P
研究背景：开发和验证评估人类动脉粥样硬化斑块成分的新型影像学方法将提高对动脉粥样硬化演变的理解，并有助于评估斑块修饰的治疗策略。表面MRI可以表征颈动脉的组织含量，但不能表征更深的动脉。本研究评估的有用性血管内MRI（IVMRI）辨别人体髂动脉invivo.Methods和结果的组成-初步研究验证IVMRI对人体动脉粥样硬化动脉离体组织病理学。将直径为0.030英寸的IVMRI探测器线圈推进到离体人髂动脉中，并与1.5-T扫描仪耦合。结合T1、中等T2和质子密度加权图像的信息，可以区分脂质、纤维和钙化成分，具有良好的灵敏度和特异性，并可以准确定量斑块大小。验证的方法，然后应用于图像髂动脉的25人在体内，并与血管内超声（IVUS）的结果进行了比较。IVMRI可以很容易地显示所有动脉的内外斑块边界，即使是那些广泛钙化的动脉，也无法进行IVUS解释。它还揭示了在离体验证期间观察到的动脉粥样硬化斑块含量的预期异质性。同样，IVUS没有揭示这种异质性。观察者间和观察者内的协议在解释斑块组成的水平是高的IVMRI，但穷人IVUS.Conclusions - IVMRI可以可靠地识别斑块的组成和大小在体内动脉深处。通过IVMRI在体内鉴定斑块成分对于理解和改变人类动脉粥样硬化具有重要意义。
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.