on April 20, 2006
Published online before print April 20, 2006, doi: 10.1161/01.ATV.0000222920.59760.df
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Submitted on January 9, 2006
Accepted on March 30, 2006
Identifying Inflamed Carotid Plaques Using In Vivo USPIO-Enhanced MR Imaging to Label Plaque Macrophages
Rikin A. Trivedi *;
From the University Department of Radiology (R.A.T., C.M., J.-M.U., M.J.G., J.H.G.), Addenbrooke’s Hospital, Cambridge, UK; the Department of Pathology (J.H., M.J.G.), Papworth Hospital, Cambridge, UK; GlaxoSmithKline (A.B., L.W., J.B.), Translational Medicine and Technology, Addenbrooke’s Centre for Clinical Investigation, Addenbrooke’s Hospital, Cambridge, UK; and the Academic Department of Neurosurgery (R.A.T., P.J.K.), Addenbrooke’s Hospital, Cambridge, UK.
* To whom correspondence should be addressed. E-mail: rt256{at}radiol.cam.ac.uk.
Background--Inflammation within atherosclerotic lesions contributes to plaque instability and vulnerability to rupture. We set out to evaluate the use of a macrophage labeling agent to identify carotid plaque inflammation by in vivo magnetic resonance imaging (MRI).
Methods and Results--Thirty patients with symptomatic severe carotid stenosis scheduled for carotid endarterectomy underwent multi-sequence MRI of the carotid bifurcation before and after injection of ultrasmall superparamagnetic particles of iron oxide (USPIOs). USPIO particles accumulated in macrophages in 24 of 30 plaques (80%). Areas of signal intensity reduction, corresponding to USPIO/macrophage-positive histological sections, were visualized in 24 of 27 (89%) patients, with an average reduction in signal intensity induced by the USPIO particles of 24% (range, 3.1% to 60.8%).
Conclusions--USPIO-enhanced MRI can identify plaque inflammation in vivo by accumulation of USPIO within macrophages in carotid plaques.
Key words: carotid • inflammation • MRI • USPIO • vulnerable plaque
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