Contract-Enhanced MRI for Evaluating Carotid Atheroma

描述(由申请人提供)：本研究的总体目标是 阐明其发生和组成的病理生理学基础 动脉粥样硬化的对比增强磁共振成像(CE-MRI)分析 颈动脉粥样硬化的特点。特别是，我们感兴趣的是 动脉粥样硬化在其最早的阶段，在医疗干预的时候 危急时刻。早期动脉粥样硬化的形成及其成分与动脉粥样硬化的关系 人们对疾病的替代标志物知之甚少。CE-MRI提供了直接的 评估血管壁内动脉粥样硬化的变化 与疾病的血清学测量有关的。我们将在以下时间进行这项研究 NHLBI资助的动脉粥样硬化(MESA)多民族研究框架， 6500例无动脉粥样硬化患者亚临床动脉粥样硬化的前瞻性研究 临床表现为动脉粥样硬化性疾病。MESA的一个主要目标是 确定哪些因素影响轻度亚临床进展 动脉粥样硬化到更严重的亚临床疾病。庞大的数据库和 MESA提供的基础设施为此提供了理想的环境 分析。我们的初步研究表明，CE-MRI具有独特的能力 描述颈动脉壁的动脉粥样硬化性改变 早期阶段和晚期阶段。我们的数据表明CE-MRI能够 甚至在显性室壁增厚发生之前就检测到动脉粥样硬化 它可以区分动脉粥样硬化的形态成分。通过链接图像 对于血清学，我们将评估其他非特异性的意义 异常与CE-MRI结构表现的关系。在这方面， 我们将对动脉粥样硬化的早期特征有更深入的了解 其成分的形成及其临床意义 动脉粥样硬化性疾病的发展及其伴随的风险， 尤其是中风。这项研究的结果可能会形成一个更大的 动脉粥样硬化进展的纵向评估与 潜在的心血管危险因素和医疗干预，仅有可能 使用这种非侵入性技术。

DESCRIPTION (provided by applicant): The overall goal of this study is to elucidate the pathophysiology that underlies the development and composition of atherosclerosis by analyzing gadolinium-based contrast-enhanced MRI (CE-MRI) features of atheroma of the carotid artery. In particular, we are interested in atherosclerosis in its earliest stage, at a lime when medical intervention is critical. Early atheroma formation and the relationships of its components to surrogate markers of disease are poorly understood. CE-MRI offers a direct assessment of atherosclerotic changes within the vessel wall that can be related to serologic measures of disease. We will conduct this study within the framework of the Multi-Ethnic Study of Atherosclerosis (MESA), an NHLBI-funded, prospective study of subclinical atherosclerosis in 6,500 subjects without clinically manifest atherosclerotic disease. A primary objective of MESA is to determine what factors influence the progression of mild subclinical atherosclerosis to more severe subclinical disease. The extensive database and infrastructure offered by MESA provides the ideal environment for this analysis. Our preliminary studies have shown the unique ability of CE-MRI to characterize atherosclerotic changes in the wall of the carotid artery, both at early and advanced stages. Our data indicate that CE-MRI is capable of detecting atherosclerosis even before overt wall thickening develops, and that it can discriminate the morphologic components of atheroma. By linking imaging to serology, we will assess the significance of otherwise nonspecific abnormalities in relationship to structural findings of CE-MRI. In this regard, we will develop a greater understanding of the earliest features of atheroma formation and the clinical implications of its components in order to reduce the development of atherosclerotic disease and its attendant risks, particularly stroke. The results of this study may form the basis of a larger longitudinal evaluation of the progression of atherosclerosis as it relates to underlying cardiovascular risk factors and medical intervention, possible only with this noninvasive technique.