Selective coronary artery plaque visualization and differentiation by contrast-enhanced inversion prepared MRI

Maintz, David
Ozgun, Murat
Hoffmeier, Andreas
Fischbach, Roman
Kim, Won Yong
Stuber, Matthias
Manning, Warren J.
Heindel, Walter
Botnar, René M.

¹Department of Clinical Radiology, University of Muenster, Münster 48129, Germany
²Department of Thoracic Surgery, University of Muenster, Germany
³Cardiac MR Center, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
⁴Institute of Clinical Medicine and Department of Cardiology, MR Center, Aarhus University Hospital, Skejby Sygehus, Aarhus, Denmark
⁵Department of Radiology, Division of MR Research, Johns Hopkins Hospital, Baltimore, MD, USA
⁶Department of Nuclear Medicine, Technical University Munich, Munich, Germany

Received 28 November 2005; revised 11 May 2006; accepted 26 May 2006; online publish-ahead-of-print 20 June 2006

^*Corresponding author. Tel: +49 251 8347301; fax: +49 251 8347312. E-mail address: [email protected]

European Heart Journal 27(14):p 1732-1736, July 2006.

Aims

We sought to evaluate the utility of contrast-enhanced coronary magnetic resonance imaging (CE-MRI) for selective visualization and non-invasive differentiation of atherosclerotic coronary plaque in humans.

Methods and results

Nine patients with coronary artery disease (CAD) as confirmed by X-ray angiography and multidetector computed tomography (MDCT) were studied by T1-weighted black blood inversion recovery coronary MRI before (N-IR) and after administration of Gd-DTPA (CE-IR). Plaques were categorized as calcified, non-calcified, and mixed based on their Hounsfield number derived from MDCT. With MDCT, a total of 29 plaques were identified, including calcified (n=6), non-calcified (n=6), and mixed calcified/non-calcified (n=17). On N-IR MRI, 26 plaques (90%) were dark, whereas three plaques (two non-calcified and one mixed) appeared bright. On CE-MRI, 13/29 (45%) plaques, 11 of which were mixed, one non-calcified, and one calcified showed contrast uptake. All others remained dark.

Conclusion

In this preliminary study, we demonstrate the potential utility of CE-IR MRI for selective plaque visualization and differentiation of plaque types. The observed contrast uptake may be associated with endothelial dysfunction, neovascularization, inflammation, and/or fibrosis.