(Circulation. 1996;94:932-938.)
© 1996 American Heart Association, Inc.
Articles |
Magnetic Resonance Images Lipid, Fibrous, Calcified, Hemorrhagic, and Thrombotic Components of Human Atherosclerosis In Vivo
Service de Cardiologie, Hopital Cochin, Paris, Service Hospitalier Frederic Joliot, CEA, Orsay, France (J-F.T.); the Cardiac Unit and NMR Center (J-F.T., H.L.K.), Division of Vascular Surgery (G.M.LaM.), and Pathology Department (J.F.S.), Massachusetts General Hospital, Boston; and the Cardiovascular Institute, Mount Sinai Medical Center, New York, NY (V.F.).
Correspondence to J.F. Toussaint, MD, PhD, Service Hospitalier Frederic Joliot, Groupe de RMN, CEA, 4 Place du General Leclerc, 91401 Orsay, Cedex, France. E-mail toussain@uriens.shfj.cea.fr.
Background Although MRI can discriminate the lipid core from the collagenous cap of atherosclerotic lesions in vitro with T2 contrast, it has not yet produced detailed in vivo images of these human plaque components.
Methods and Results We imaged seven lesions from six patients who required surgical carotid endarterectomy and calculated T2 in vivo before surgery in various plaque regions. Using the same acquisition parameters, we repeated these measurements in vitro on the resected fragment and compared MR images with histology. T2 values calculated in vivo correlate with in vitro measurements for each plaque component; the in vitro discrimination we demonstrated previously with T2 contrast can therefore be performed similarly in vivo.
Conclusions MRI is the first noninvasive imaging technique that allows the discrimination of lipid cores, fibrous caps, calcifications, normal media, and adventitia in human atheromatous plaques in vivo. This technique also characterizes intraplaque hemorrhage and acute thrombosis. This result may support further investigations that include MRI of plaque progression, stabilization, and rupture in human atherosclerosis.
Key Words: magnetic resonance imaging • lipids • fibrous cap • thrombosis • carotid arteries
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X.-Q. Zhao, C. Yuan, T. S. Hatsukami, E. H. Frechette, X.-J. Kang, K. R. Maravilla, and B. G. Brown Effects of Prolonged Intensive Lipid-Lowering Therapy on the Characteristics of Carotid Atherosclerotic Plaques In Vivo by MRI: A Case-Control Study Arterioscler. Thromb. Vasc. Biol., October 1, 2001; 21(10): 1623 - 1629. [Abstract] [Full Text] [PDF]
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 S. M. Schwartz, T. S. Hatsukami, and C. Yuan Molecular Markers, Fibrous Cap Rupture, and the Vulnerable Plaque: New Experimental Opportunities Circ. Res., September 14, 2001; 89(6): 471 - 473. [Full Text] [PDF]
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S. Flacke, S. Fischer, M. J. Scott, R. J. Fuhrhop, J. S. Allen, M. McLean, P. Winter, G. A. Sicard, P. J. Gaffney, S. A. Wickline, et al. Novel MRI Contrast Agent for Molecular Imaging of Fibrin: Implications for Detecting Vulnerable Plaques Circulation, September 11, 2001; 104(11): 1280 - 1285. [Abstract] [Full Text] [PDF]
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M. T. Johnstone, R. M. Botnar, A. S. Perez, R. Stewart, W. C. Quist, J. A. Hamilton, and W. J. Manning In Vivo Magnetic Resonance Imaging of Experimental Thrombosis in a Rabbit Model Arterioscler. Thromb. Vasc. Biol., September 1, 2001; 21(9): 1556 - 1560. [Abstract] [Full Text] [PDF]
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Z. A. Fayad and V. Fuster Clinical Imaging of the High-Risk or Vulnerable Atherosclerotic Plaque Circ. Res., August 17, 2001; 89(4): 305 - 316. [Abstract] [Full Text] [PDF]
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M. Kawasaki, H. Takatsu, T. Noda, Y. Ito, A. Kunishima, M. Arai, K. Nishigaki, G. Takemura, N. Morita, S. Minatoguchi, et al. Noninvasive quantitative tissue characterization and two-dimensional color-coded map of human atherosclerotic lesions using ultrasound integrated backscatter: Comparison between histology and integrated backscatter images J. Am. Coll. Cardiol., August 1, 2001; 38(2): 486 - 492. [Abstract] [Full Text] [PDF]
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R. Corti, Z. A. Fayad, V. Fuster, S. G. Worthley, G. Helft, J. Chesebro, M. Mercuri, and J. J. Badimon Effects of Lipid-Lowering by Simvastatin on Human Atherosclerotic Lesions: A Longitudinal Study by High-Resolution, Noninvasive Magnetic Resonance Imaging Circulation, July 17, 2001; 104(3): 249 - 252. [Abstract] [Full Text] [PDF]
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M.-L. M. Gronholdt, B. G. Nordestgaard, T. V. Schroeder, S. Vorstrup, and H. Sillesen Ultrasonic Echolucent Carotid Plaques Predict Future Strokes Circulation, July 3, 2001; 104(1): 68 - 73. [Abstract] [Full Text] [PDF]
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K. A. Shunk, J.e. Garot, E. Atalar, and J. A. C. Lima Transesophageal magnetic resonance imaging of the aortic arch and descending thoracic aorta in patients with aortic atherosclerosis J. Am. Coll. Cardiol., June 15, 2001; 37(8): 2031 - 2035. [Abstract] [Full Text] [PDF]
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K. J. Hunt, G. W. Evans, A. R. Folsom, A. R. Sharrett, L. E. Chambless, C. H. Tegeler, and G. Heiss Acoustic Shadowing on B-Mode Ultrasound of the Carotid Artery Predicts Ischemic Stroke : The Atherosclerosis Risk in Communities (ARIC) Study Stroke, May 1, 2001; 32(5): 1120 - 1126. [Abstract] [Full Text] [PDF]
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M. Stuber, R. M. Botnar, K. V. Kissinger, and W. J. Manning Free-Breathing Black-Blood Coronary MR Angiography: Initial Results Radiology, April 1, 2001; 219(1): 278 - 283. [Abstract] [Full Text]
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G.e. Helft, S. G. Worthley, V. Fuster, A. G. Zaman, C. Schechter, J. I. Osende, O. J. Rodriguez, Z. A. Fayad, J. T. Fallon, and J. J. Badimon Atherosclerotic aortic component quantification by noninvasive magnetic resonance imaging: an in vivo study in rabbits J. Am. Coll. Cardiol., March 15, 2001; 37(4): 1149 - 1154. [Abstract] [Full Text] [PDF]
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S. G. Ruehm, C. Corot, P. Vogt, S. Kolb, and J. F. Debatin Magnetic Resonance Imaging of Atherosclerotic Plaque With Ultrasmall Superparamagnetic Particles of Iron Oxide in Hyperlipidemic Rabbits Circulation, January 23, 2001; 103(3): 415 - 422. [Abstract] [Full Text] [PDF]
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R. M. Botnar, M. Stuber, K. V. Kissinger, W. Y. Kim, E. Spuentrup, and W. J. Manning Noninvasive Coronary Vessel Wall and Plaque Imaging With Magnetic Resonance Imaging Circulation, November 21, 2000; 102(21): 2582 - 2587. [Abstract] [Full Text] [PDF]
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X. Yang and E. Atalar Intravascular MR Imaging-guided Balloon Angioplasty With an MR Imaging Guide Wire: Feasibility Study in Rabbits Radiology, November 1, 2000; 217(2): 501 - 506. [Abstract] [Full Text]
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T. S. Hatsukami, R. Ross, N. L. Polissar, and C. Yuan Visualization of Fibrous Cap Thickness and Rupture in Human Atherosclerotic Carotid Plaque In Vivo With High-Resolution Magnetic Resonance Imaging Circulation, August 29, 2000; 102(9): 959 - 964. [Abstract] [Full Text] [PDF]
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Z. A. Fayad, V. Fuster, J. T. Fallon, T. Jayasundera, S. G. Worthley, G. Helft, J. G. Aguinaldo, J. J. Badimon, and S. K. Sharma Noninvasive In Vivo Human Coronary Artery Lumen and Wall Imaging Using Black-Blood Magnetic Resonance Imaging Circulation, August 1, 2000; 102(5): 506 - 510. [Abstract] [Full Text] [PDF]
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G. Pasterkamp, E. Falk, H. Woutman, and C. Borst Techniques characterizing the coronary atherosclerotic plaque: influence on clinical decision making? J. Am. Coll. Cardiol., July 1, 2000; 36(1): 13 - 21. [Abstract] [Full Text] [PDF]
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 B. Axisa, A. R. Naylor, N. London, P. R. F. Bell, and M. M. Thompson The Influence of Carotid Plaque Morphology on the Development of Cerebral Symptoms Vascular and Endovascular Surgery, July 1, 2000; 34(4): 309 - 318. [Abstract] [PDF]
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W. J. Rogers, J. W. Prichard, Y.-L. Hu, P. R. Olson, D. H. Benckart, C. M. Kramer, D. A. Vido, and N. Reichek Characterization of Signal Properties in Atherosclerotic Plaque Components by Intravascular MRI Arterioscler. Thromb. Vasc. Biol., July 1, 2000; 20(7): 1824 - 1830. [Abstract] [Full Text] [PDF]
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S. G. Worthley, G. Helft, V. Fuster, Z. A. Fayad, O. J. Rodriguez, A. G. Zaman, J. T. Fallon, and J. J. Badimon Noninvasive In Vivo Magnetic Resonance Imaging of Experimental Coronary Artery Lesions in a Porcine Model Circulation, June 27, 2000; 101(25): 2956 - 2961. [Abstract] [Full Text] [PDF]
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Z. A. Fayad, T. Nahar, J. T. Fallon, M. Goldman, J. G. Aguinaldo, J. J. Badimon, M. Shinnar, J. H. Chesebro, and V. Fuster In Vivo Magnetic Resonance Evaluation of Atherosclerotic Plaques in the Human Thoracic Aorta : A Comparison With Transesophageal Echocardiography Circulation, May 30, 2000; 101(21): 2503 - 2509. [Abstract] [Full Text] [PDF]
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R Erbel, A Schmermund, S Mohlenkamp, S Sack, and D Baumgart Electron-beam computed tomography for detection of early signs of coronary arteriosclerosis Eur. Heart J., May 1, 2000; 21(9): 720 - 732. [PDF]
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 P. A. Tunick, G. A. Krinsky, V. S. Lee, and I. Kronzon Diagnostic Imaging of Thoracic Aortic Atherosclerosis Am. J. Roentgenol., April 1, 2000; 174(4): 1119 - 1125. [Full Text] [PDF]
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 S Manzi, L H Kuller, D Edmundowicz, and K Sutton-Tyrrell Vascular imaging: changing the face of cardiovascular research Lupus, March 1, 2000; 9(3): 176 - 182. [Abstract] [PDF]
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S. Aoki, H. Nakajima, H. Kumagai, and T. Araki Dynamic Contrast-Enhanced MR Angiography and MR Imaging of the Carotid Artery: High-Resolution Sequences in Different Acquisition Planes AJNR Am. J. Neuroradiol., February 1, 2000; 21(2): 381 - 385. [Abstract] [Full Text]
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 R A Coulden, H Moss, M J Graves, D J Lomas, D S Appleton, and P L Weissberg High resolution magnetic resonance imaging of atherosclerosis and the response to balloon angioplasty Heart, February 1, 2000; 83(2): 188 - 191. [Abstract] [Full Text]
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P. L Weissberg Coronary disease: Atherogenesis: current understanding of the causes of atheroma Heart, February 1, 2000; 83(2): 247 - 252. [Full Text]
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P. Greenland, J. Abrams, G. P. Aurigemma, M. G. Bond, L. T. Clark, M. H. Criqui, J. R. Crouse III, L. Friedman, V. Fuster, D. M. Herrington, et al. Prevention Conference V : Beyond Secondary Prevention : Identifying the High-Risk Patient for Primary Prevention : Noninvasive Tests of Atherosclerotic Burden : Writing Group III Circulation, January 4, 2000; 101 (1): e16 - e22. [Full Text] [PDF]
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M. Shinnar, J. T. Fallon, S. Wehrli, M. Levin, D. Dalmacy, Z. A. Fayad, J. J. Badimon, M. Harrington, E. Harrington, and V. Fuster The Diagnostic Accuracy of Ex Vivo MRI for Human Atherosclerotic Plaque Characterization Arterioscler. Thromb. Vasc. Biol., November 1, 1999; 19(11): 2756 - 2761. [Abstract] [Full Text] [PDF]
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M. V. McConnell, M. Aikawa, S. E. Maier, P. Ganz, P. Libby, and R. T. Lee MRI of Rabbit Atherosclerosis in Response to Dietary Cholesterol Lowering Arterioscler. Thromb. Vasc. Biol., August 1, 1999; 19(8): 1956 - 1959. [Abstract] [Full Text] [PDF]
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