T1-weighted MRI for the detection of coronary artery plaque haemorrhage
May Lin Oei1, Murat Ozgun, Harald Seifarth
1Department of Clinical Radiology, University of Münster, Albert-Schweitzer-Str. 33, 48149 Münster, Germany.
Insights
T1-weighted inversion recovery MRI can detect T1 hyperintensity in coronary artery plaques, indicating intraplaque hemorrhage. This imaging technique shows promise for non-invasive characterization of atherosclerotic plaques in coronary artery disease patients.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Biomedical Engineering
Background:
- Intraplaque hemorrhage (IPH) is a critical factor in atherosclerotic plaque instability.
- Pre-contrast T1-weighted magnetic resonance imaging (MRI) shows potential for detecting IPH in atherosclerotic plaques.
Purpose of the Study:
- To evaluate T1 hyperintensity in coronary artery plaques of patients with coronary artery disease (CAD).
- To correlate T1 hyperintensity findings with multi-detector computed tomography (MDCT) characteristics.
Main Methods:
- Fifteen CAD patients underwent MDCT and T1-weighted inversion recovery (IR) MRI.
- Plaques were analyzed for Hounsfield number (MDCT) and signal intensity (MRI).
- Regions of interest were defined for signal and density measurements.
Main Results:
- Forty-three plaques were identified; 12% showed T1 hyperintensity on IR-MRI.
- Hyperintense plaques had higher signal-to-noise and contrast-to-noise ratios.
- Hyperintense plaques demonstrated significantly lower CT density compared to hypointense plaques.
Conclusions:
- T1-weighted IR-MRI is a potential tool for non-invasively detecting intraplaque hemorrhage in coronary artery plaques.
- This technique may aid in the characterization of atherosclerotic plaques in CAD.
Objective:
Hyperintense areas in atherosclerotic plaques on pre-contrast T1-weighted MRI have been shown to correlate with intraplaque haemorrhage. We evaluated the presence of T1 hyperintensity in coronary artery plaques in coronary artery disease (CAD) patients and correlated results with multi-detector computed tomography (MDCT) findings.
Methods:
Fifteen patients with CAD were included. Plaques detected by MDCT were categorised based on their Hounsfield number. T1-weighted inversion recovery (IR) MRI prepared coronary MRI for the detection of plaque and steady-state free-precession coronary MR-angiography for anatomical correlation was performed. After registration of MDCT and MRI, regions of interest were defined on MDCT-visible plaques and in corresponding vessel segments acquired with MRI. MDCT density and MR signal measurement were performed in each plaque.
Results:
Forty-three plaques were identified with MDCT. With IR-MRI 5/43 (12%) plaques were hyperintense, 2 of which were non-calcified and 3 mixed. Average signal-to-noise and contrast-to-noise ratios of hyperintense plaques were 15.7 and 9.1, compared with 5.6 and 1.2 for hypointense plaques. Hyperintense plaques exhibited a significantly lower CT density than hypointense plaques (63.6 vs. 140.8). There was no correlation of plaque signal intensity with degree of stenosis.
Conclusion:
T1-weighted IR-MRI may be useful for non-invasive detection and characterisation of intraplaque haemorrhage in coronary artery plaques.
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