Abdominal Aortic Aneurysm Growth Predicted by Uptake of Ultrasmall Superparamagnetic Particles of Iron Oxide A Pilot Study
Abdominal Aortic Aneurysm Growth Predicted by Uptake of Ultrasmall Superparamagnetic Particles of Iron Oxide A Pilot Study
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DOI：
10.1161/circimaging.110.959866
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发表时间：
2011-05-01
影响因子：
7.5
通讯作者：
Newby, David E.
中科院分区：
文献类型：
--
作者：
Richards, Jennifer M. J.;Semple, Scott I.;Newby, David E.
背景：腹主动脉瘤是导致死亡的主要原因。动脉瘤扩张和破裂的预测是具有挑战性的，目前依赖于动脉瘤直径的简单测量。使用MRI，我们旨在评估细胞炎症区域是否与腹主动脉瘤扩张率相关。方法与结果：从监测项目中招募稳定的无症状腹主动脉瘤（4.0 ~ 6.6 cm）患者（29例，男性27例，年龄70±5岁），在给予超顺磁氧化铁颗粒（USPIO）之前和之后24 ~ 36小时使用3-T MRI扫描仪进行成像。通过T2*加权成像上T2*值的变化，检测腹主动脉瘤内USPIO的堆积。动脉瘤组织的组织学检查证实了巨噬细胞浸润区USPIO的共定位和摄取。尽管动脉瘤直径相似（分别为5.4 +/- 0.6、5.1 +/- 0.5和5.0 +/- 0.5 cm），但明显壁面摄取USPIO患者的生长速度（n=11, 0.66 cm/y， P=0.020）比没有（n=6, 0.22 cm/y）或非特异性USPIO摄取（n=8, 0.24 cm/y）的患者高3倍（P= 0.05）。在1例炎症性动脉瘤患者中，USPIO强烈且广泛摄取，延伸至主动脉壁以外。结论：腹主动脉瘤摄取USPIO可识别细胞炎症，并可区分那些进展更快的腹主动脉瘤扩张患者。这项技术有望成为腹主动脉瘤患者风险分层的新方法，它超越了动脉瘤直径的简单解剖测量。
Background-Abdominal aortic aneurysms are a major cause of death. Prediction of aneurysm expansion and rupture is challenging and currently relies on the simple measure of aneurysm diameter. Using MRI, we aimed to assess whether areas of cellular inflammation correlated with the rate of abdominal aortic aneurysm expansion.Methods and Results-Stable patients (n=29; 27 male; age, 70 +/- 5 years) with asymptomatic abdominal aortic aneurysms (4.0 to 6.6 cm) were recruited from a surveillance program and imaged using a 3-T MRI scanner before and 24 to 36 hours after administration of ultrasmall superparamagnetic particles of iron oxide (USPIO). The change in T2* value on T2*-weighted imaging was used to detect accumulation of USPIO within the abdominal aortic aneurysm. Histological examination of aneurysm tissue confirmed colocalization and uptake of USPIO in areas with macrophage infiltration. Patients with distinct mural uptake of USPIO had a 3-fold higher growth rate (n=11, 0.66 cm/y; P=0.020) than those with no (n=6, 0.22 cm/y) or nonspecific USPIO uptake (n=8, 0.24 cm/y) despite having similar aneurysm diameters (5.4 +/- 0.6, 5.1 +/- 0.5, and 5.0 +/- 0.5 cm, respectively; P>0.05). In 1 patient with an inflammatory aneurysm, there was a strong and widespread uptake of USPIO extending beyond the aortic wall.Conclusions-Uptake of USPIO in abdominal aortic aneurysms identifies cellular inflammation and appears to distinguish those patients with more rapidly progressive abdominal aortic aneurysm expansion. This technique holds major promise as a new method of risk-stratifying patients with abdominal aortic aneurysms that extends beyond the simple anatomic measure of aneurysm diameter.