© 1997 American Heart Association, Inc.
Articles |
Intravascular Magnetic Resonance Imaging of Aortic Atherosclerotic Plaque Composition
Correspondence to Joao A.C. Lima, MD, Cardiology Division, Blalock 569, The Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287-6568. E-mail lucorrei{at}welchlink.welch.jhu.edu.
Abstract Magnetic resonance imaging (MRI) may be an
excellent tool to define atherosclerotic plaque composition, but
surface MRI (SMRI) suffers from a low signal-to-noise ratio and low
resolution of arterial images. Intravascular MRI (IVMRI)
represents a potential solution for acquiring high-quality in
vivo images of atherosclerotic plaques. Isolated segments of 11
thoracic human aortas obtained at autopsy were imaged by IVMRI using an
intravascular receiver catheter coil designed and built at our
institution. Images obtained by IVMRI were compared with corresponding
images obtained by SMRI and with histopathological aortic cross
sections. The intensity of intimal thickness and plaque components was
graded by IVMRI and histopathology using a score of 1 for mild, 2 for
moderate, and 3 for severe intensity. IVMRI had an agreement of 75%
with histopathology in fibrous cap grading (37.5% expected, 
=0.60,
P<0.001) and of 74% in necrotic core grading (39%
expected, =0.57, P<0.001). Intraplaque calcification
was correctly graded by IVMRI in six of the eight plaques in which
histopathology recognized calcium. The analysis of intimal
thickness showed 80% agreement between IVMRI and histopathology (52%
expected, =0.59, P<0.001). IVMRI image features were
similar to those of SMRI. In addition, IVMRI accurately determined
atherosclerotic plaque size in comparison with histopathology and SMRI
(slope=1.25 cm2, r=0.99,
P<0.001 for luminal area by IVMRI vs histopathology;
slope=0.97 cm2, r=0.996,
P<0.001 for luminal area by IVMRI vs SMRI). IVMRI has
the potential to provide important prognostic information in patients
with atherosclerosis because of its ability to
accurately assess both plaque composition and size.
Key Words: intravascular magnetic resonance imaging • atherosclerotic plaque • human aorta
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