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

Area of Science:

• Cardiovascular Imaging
• Medical Physics
• Radiology

Background:

• Atherosclerotic coronary plaque characterization is crucial for assessing cardiovascular disease risk.
• Non-invasive imaging techniques are needed for detailed plaque analysis.

Purpose of the Study:

• To evaluate the effectiveness of contrast-enhanced coronary magnetic resonance imaging (CE-MRI) for visualizing and differentiating atherosclerotic coronary plaque.
• To assess CE-MRI's ability to identify plaque composition non-invasively.

Main Methods:

• Nine patients with confirmed coronary artery disease underwent T1-weighted black blood inversion recovery coronary MRI before and after Gd-DTPA contrast administration.
• Plaques were categorized as calcified, non-calcified, or mixed using multidetector computed tomography (MDCT) Hounsfield numbers.
• Coronary magnetic resonance imaging (MRI) findings were compared with MDCT classifications.

Main Results:

• A total of 29 plaques were identified by MDCT (6 calcified, 6 non-calcified, 17 mixed).
• On non-contrast MRI, 90% of plaques appeared dark; three appeared bright.
• Contrast-enhanced MRI visualized 45% of plaques, with contrast uptake predominantly in mixed plaques, suggesting potential for plaque differentiation.

Conclusions:

• CE-MRI demonstrates potential for selective plaque visualization and differentiation of plaque types.
• Observed contrast uptake in plaques may indicate underlying processes like endothelial dysfunction, neovascularization, inflammation, or fibrosis.