Contract-Enhanced MRI for Evaluating Carotid Atheroma

描述（由申请人提供）：本研究的总体目标是 阐明病理生理学的发展和组成的基础 通过分析钆对比增强MRI（CE-MRI） 颈动脉粥样硬化的特征。我们特别感兴趣的是 动脉粥样硬化在其最早阶段，在一个石灰时，医疗干预是 很危险早期动脉粥样硬化形成及其成分与动脉粥样硬化的关系 疾病的替代标记物知之甚少。CE-MRI提供了一个直接的 评估血管壁内的动脉粥样硬化变化， 与疾病的血清学指标有关。我们将在 多种族动脉粥样硬化研究（梅萨）的框架，一个NHLBI资助的， 在6,500名无动脉粥样硬化的受试者中进行的亚临床动脉粥样硬化的前瞻性研究 临床上明显的动脉粥样硬化疾病。梅萨的主要目标是 确定哪些因素影响轻度亚临床 动脉粥样硬化到更严重的亚临床疾病。庞大的数据库和 梅萨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， 表征颈动脉壁的动脉粥样硬化变化， 早期和晚期阶段。我们的数据表明，CE-MRI能够 甚至在明显的壁增厚发展之前检测动脉粥样硬化， 它可以区分动脉粥样硬化的形态学成分。通过将成像 血清学，我们将评估的意义，否则非特异性 与CE-MRI结构结果相关的异常。在这方面，委员会注意到， 我们将对动脉粥样硬化的早期特征有更深入的了解 形成和其成分的临床意义，以减少 动脉粥样硬化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基础 动脉粥样硬化进展的纵向评估，因为它与 潜在心血管风险因素和医疗干预，仅可能 用这种非侵入性的技术。

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.