Lipid-rich atherosclerotic plaques detected by gadofluorine-enhanced in vivo magnetic resonance imaging

• Published in: Circulation (New York, N.Y.) Vol. 109; no. 23; pp. 2890 - 2896
• Main Authors: SIROL, Marc, ITSKOVICH, Vitalii V, MANI, Venkatesh, AGUINALDO, Juan Gilberto S, FALLON, John T, MISSELWITZ, Bernd, WEINMANN, Hanns-Joachim, FUSTER, Valentin, TOUSSAINT, Jean-Francois, FAYAD, Zahi A
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 15.06.2004
• Subjects: Animals; Aorta, Abdominal - injuries; Aorta, Abdominal - metabolism; Aorta, Abdominal - pathology; Aortic Diseases - metabolism; Aortic Diseases - pathology; Arteriosclerosis - metabolism; Arteriosclerosis - pathology; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Catheterization - adverse effects; Contrast Media; Diet, Atherogenic; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Fibrosis; General and cellular metabolism. Vitamins; Lipids - analysis; Magnetic Resonance Imaging - methods; Medical sciences; Organometallic Compounds; Pharmacology. Drug treatments; Rabbits; Vascular disease; magnetic resonance imaging; plaque; Atherosclerotic plaque; Atherosclerosis; Cardiovascular disease; Nuclear magnetic resonance imaging; Contrast media
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.cir.0000129310.17277.e7

MRI of specific components in atherosclerotic plaque may provide information on plaque stability and its potential to rupture. We evaluated gadofluorine in atherosclerotic rabbits using a new MR sequence that allows plaque detection within 1 hour after injection and assessed enhancement in lipid-rich and non-lipid-rich plaques. Twelve rabbits with aortic plaque and 6 controls underwent MRI before and up to 24 hours after gadofluorine injection (50 micromol/kg). Two T1-weighted, segmented gradient-echo sequences (TFL) were compared to enhance vessel wall delineation after injection: (1) an inversion-recovery prepulse (IR-TFL) or (2) a combination of inversion-recovery and diffusion-based flow suppression prepulses (IR-DIFF-TFL). With the use of IR-TFL at 1 hour after injection, the vessel wall was not delineated because of poor flow suppression; at 24 hours after injection, the enhancement was 37% (P<0.01). IR-DIFF-TFL showed significant enhancement after versus before contrast (1 hour: 164% [P<0.005]; 24 hours: 207% [P<0.001]). At 1 hour and 24 hours after injection, the contrast-to-noise ratio was higher with the use of IR-DIFF-TFL than with IR-TFL (1 hour: 13.0+/-7.7 versus -19.8+/-10.3 [P<0.001]; 24 hours: 15.2+/-5.9 versus 11.4+/-8.9, respectively [P=0.052]). There was no enhancement in the vessel wall after gadofluorine injection in the control group. A strong correlation was found (r2=0.87; P<0.001) between the lipid-rich areas in histological sections and signal intensity in corresponding MR images. This suggests a high affinity of gadofluorine for lipid-rich plaques. Gadofluorine-enhanced MRI improves atherosclerotic plaque detection. The IR-DIFF-TFL method allows early detection of atherosclerotic plaque within 1 hour after gadofluorine injection.