Characterization of distensibility, plaque burden, and composition of the atherosclerotic carotid artery using magnetic resonance imaging
Purpose: Arterial distensibility is a marker that can measure vessel wall functional and structural changes resulting from atherosclerosis with applications including estimation of mechanical properties of the wall. We sought to assess the feasibility of using magnetic resonance imaging (MRI) to inc...
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| Published in | Medical physics (Lancaster) Vol. 39; no. 10; pp. 6247 - 6253 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
American Association of Physicists in Medicine
01.10.2012
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0094-2405 2473-4209 0094-2405 |
| DOI | 10.1118/1.4754302 |
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| Abstract | Purpose:
Arterial distensibility is a marker that can measure vessel wall functional and structural changes resulting from atherosclerosis with applications including estimation of mechanical properties of the wall. We sought to assess the feasibility of using magnetic resonance imaging (MRI) to include wall distensibility in the characterization of atherosclerotic carotid arteries and to analyze the relationship between distensibility and morphological and compositional plaque features.
Methods:
Five healthy volunteers were imaged with a multiple-slice CINE MR sequence twice, within 24 h, to determine the interscan reproducibility of distensibility measurements. Twenty-one subjects with >15% carotid stenosis and the five healthy volunteers were imaged using a multicontrast carotid MRI protocol to characterize arterial wall morphology and composition. Normalized wall index (wall area/total vessel area), maximum wall thickness and, if present, percentages of wall area occupied by calcification and lipid-rich necrotic core were determined. A multiple-slice CINE MR sequence was added to the multicontrast protocol to measure the distensibility coefficient (DC) at several locations spanning the bifurcation. The intraclass correlation coefficient (ICC) and the coefficient of variation were used to assess the reproducibility of DC measurements made on the healthy subjects. The DC was compared between arterial segments and between the healthy and diseased groups. Furthermore, within the diseased group, DC was correlated to plaque morphology and composition at each location as well as that averaged over the plaque.
Results:
Distensibility measurements were highly reproducible: ICC (95% confidence interval) was 0.998 (0.96–1.0) for the common carotid segment and 0.990 (0.92–1.0) for the internal carotid segment. In healthy volunteers, we found significantly higher distensibility in the common segment of the carotid artery compared to the internal carotid segment (mean ± SD = 4.56 ± 1.02 versus 3.56 ± 1.32 × 10−5/Pa; p < 0.05). However, no segmental differences were seen in the diseased group (3.25 ± 1.84 versus 3.26 ± 1.60 × 10−5/Pa; p = 0.607). Location-to-location changes in DC were not found to correlate to changes in the local plaque morphology or composition nor were average DC found to be associated with aggregate plaque features.
Conclusions:
These results demonstrate the feasibility of MRI to measure distensibility in the carotid artery and to presumably detect changes in distensibility due to age and/or disease. The results suggest that the effect of atherosclerosis on local distensibility may not strongly depend upon the specific underlying plaque features in mild to moderate stenotic carotid lesions though more diffuse or nonlocal changes in arterial distensibility could not be ruled out. |
|---|---|
| AbstractList | Purpose:
Arterial distensibility is a marker that can measure vessel wall functional and structural changes resulting from atherosclerosis with applications including estimation of mechanical properties of the wall. We sought to assess the feasibility of using magnetic resonance imaging (MRI) to include wall distensibility in the characterization of atherosclerotic carotid arteries and to analyze the relationship between distensibility and morphological and compositional plaque features.
Methods:
Five healthy volunteers were imaged with a multiple-slice CINE MR sequence twice, within 24 h, to determine the interscan reproducibility of distensibility measurements. Twenty-one subjects with >15% carotid stenosis and the five healthy volunteers were imaged using a multicontrast carotid MRI protocol to characterize arterial wall morphology and composition. Normalized wall index (wall area/total vessel area), maximum wall thickness and, if present, percentages of wall area occupied by calcification and lipid-rich necrotic core were determined. A multiple-slice CINE MR sequence was added to the multicontrast protocol to measure the distensibility coefficient (DC) at several locations spanning the bifurcation. The intraclass correlation coefficient (ICC) and the coefficient of variation were used to assess the reproducibility of DC measurements made on the healthy subjects. The DC was compared between arterial segments and between the healthy and diseased groups. Furthermore, within the diseased group, DC was correlated to plaque morphology and composition at each location as well as that averaged over the plaque.
Results:
Distensibility measurements were highly reproducible: ICC (95% confidence interval) was 0.998 (0.96–1.0) for the common carotid segment and 0.990 (0.92–1.0) for the internal carotid segment. In healthy volunteers, we found significantly higher distensibility in the common segment of the carotid artery compared to the internal carotid segment (mean ± SD = 4.56 ± 1.02 versus 3.56 ± 1.32 × 10−5/Pa; p < 0.05). However, no segmental differences were seen in the diseased group (3.25 ± 1.84 versus 3.26 ± 1.60 × 10−5/Pa; p = 0.607). Location-to-location changes in DC were not found to correlate to changes in the local plaque morphology or composition nor were average DC found to be associated with aggregate plaque features.
Conclusions:
These results demonstrate the feasibility of MRI to measure distensibility in the carotid artery and to presumably detect changes in distensibility due to age and/or disease. The results suggest that the effect of atherosclerosis on local distensibility may not strongly depend upon the specific underlying plaque features in mild to moderate stenotic carotid lesions though more diffuse or nonlocal changes in arterial distensibility could not be ruled out. Arterial distensibility is a marker that can measure vessel wall functional and structural changes resulting from atherosclerosis with applications including estimation of mechanical properties of the wall. We sought to assess the feasibility of using magnetic resonance imaging (MRI) to include wall distensibility in the characterization of atherosclerotic carotid arteries and to analyze the relationship between distensibility and morphological and compositional plaque features. Five healthy volunteers were imaged with a multiple-slice CINE MR sequence twice, within 24 h, to determine the interscan reproducibility of distensibility measurements. Twenty-one subjects with >15% carotid stenosis and the five healthy volunteers were imaged using a multicontrast carotid MRI protocol to characterize arterial wall morphology and composition. Normalized wall index (wall area∕total vessel area), maximum wall thickness and, if present, percentages of wall area occupied by calcification and lipid-rich necrotic core were determined. A multiple-slice CINE MR sequence was added to the multicontrast protocol to measure the distensibility coefficient (DC) at several locations spanning the bifurcation. The intraclass correlation coefficient (ICC) and the coefficient of variation were used to assess the reproducibility of DC measurements made on the healthy subjects. The DC was compared between arterial segments and between the healthy and diseased groups. Furthermore, within the diseased group, DC was correlated to plaque morphology and composition at each location as well as that averaged over the plaque. Distensibility measurements were highly reproducible: ICC (95% confidence interval) was 0.998 (0.96-1.0) for the common carotid segment and 0.990 (0.92-1.0) for the internal carotid segment. In healthy volunteers, we found significantly higher distensibility in the common segment of the carotid artery compared to the internal carotid segment (mean ± SD = 4.56 ± 1.02 versus 3.56 ± 1.32 × 10(-5)∕Pa; p < 0.05). However, no segmental differences were seen in the diseased group (3.25 ± 1.84 versus 3.26 ± 1.60 × 10(-5)∕Pa; p = 0.607). Location-to-location changes in DC were not found to correlate to changes in the local plaque morphology or composition nor were average DC found to be associated with aggregate plaque features. These results demonstrate the feasibility of MRI to measure distensibility in the carotid artery and to presumably detect changes in distensibility due to age and∕or disease. The results suggest that the effect of atherosclerosis on local distensibility may not strongly depend upon the specific underlying plaque features in mild to moderate stenotic carotid lesions though more diffuse or nonlocal changes in arterial distensibility could not be ruled out. Purpose: Arterial distensibility is a marker that can measure vessel wall functional and structural changes resulting from atherosclerosis with applications including estimation of mechanical properties of the wall. We sought to assess the feasibility of using magnetic resonance imaging (MRI) to include wall distensibility in the characterization of atherosclerotic carotid arteries and to analyze the relationship between distensibility and morphological and compositional plaque features. Methods: Five healthy volunteers were imaged with a multiple-slice CINE MR sequence twice, within 24 h, to determine the interscan reproducibility of distensibility measurements. Twenty-one subjects with >15% carotid stenosis and the five healthy volunteers were imaged using a multicontrast carotid MRI protocol to characterize arterial wall morphology and composition. Normalized wall index (wall area/total vessel area), maximum wall thickness and, if present, percentages of wall area occupied by calcification and lipid-rich necrotic core were determined. A multiple-slice CINE MR sequence was added to the multicontrast protocol to measure the distensibility coefficient (DC) at several locations spanning the bifurcation. The intraclass correlation coefficient (ICC) and the coefficient of variation were used to assess the reproducibility of DC measurements made on the healthy subjects. The DC was compared between arterial segments and between the healthy and diseased groups. Furthermore, within the diseased group, DC was correlated to plaque morphology and composition at each location as well as that averaged over the plaque. Results: Distensibility measurements were highly reproducible: ICC (95% confidence interval) was 0.998 (0.96–1.0) for the common carotid segment and 0.990 (0.92–1.0) for the internal carotid segment. In healthy volunteers, we found significantly higher distensibility in the common segment of the carotid artery compared to the internal carotid segment (mean ± SD = 4.56 ± 1.02 versus 3.56 ± 1.32 × 10 −5 /Pa; p < 0.05). However, no segmental differences were seen in the diseased group (3.25 ± 1.84 versus 3.26 ± 1.60 × 10 −5 /Pa; p = 0.607). Location-to-location changes in DC were not found to correlate to changes in the local plaque morphology or composition nor were average DC found to be associated with aggregate plaque features. Conclusions: These results demonstrate the feasibility of MRI to measure distensibility in the carotid artery and to presumably detect changes in distensibility due to age and/or disease. The results suggest that the effect of atherosclerosis on local distensibility may not strongly depend upon the specific underlying plaque features in mild to moderate stenotic carotid lesions though more diffuse or nonlocal changes in arterial distensibility could not be ruled out. Arterial distensibility is a marker that can measure vessel wall functional and structural changes resulting from atherosclerosis with applications including estimation of mechanical properties of the wall. We sought to assess the feasibility of using magnetic resonance imaging (MRI) to include wall distensibility in the characterization of atherosclerotic carotid arteries and to analyze the relationship between distensibility and morphological and compositional plaque features.PURPOSEArterial distensibility is a marker that can measure vessel wall functional and structural changes resulting from atherosclerosis with applications including estimation of mechanical properties of the wall. We sought to assess the feasibility of using magnetic resonance imaging (MRI) to include wall distensibility in the characterization of atherosclerotic carotid arteries and to analyze the relationship between distensibility and morphological and compositional plaque features.Five healthy volunteers were imaged with a multiple-slice CINE MR sequence twice, within 24 h, to determine the interscan reproducibility of distensibility measurements. Twenty-one subjects with >15% carotid stenosis and the five healthy volunteers were imaged using a multicontrast carotid MRI protocol to characterize arterial wall morphology and composition. Normalized wall index (wall area∕total vessel area), maximum wall thickness and, if present, percentages of wall area occupied by calcification and lipid-rich necrotic core were determined. A multiple-slice CINE MR sequence was added to the multicontrast protocol to measure the distensibility coefficient (DC) at several locations spanning the bifurcation. The intraclass correlation coefficient (ICC) and the coefficient of variation were used to assess the reproducibility of DC measurements made on the healthy subjects. The DC was compared between arterial segments and between the healthy and diseased groups. Furthermore, within the diseased group, DC was correlated to plaque morphology and composition at each location as well as that averaged over the plaque.METHODSFive healthy volunteers were imaged with a multiple-slice CINE MR sequence twice, within 24 h, to determine the interscan reproducibility of distensibility measurements. Twenty-one subjects with >15% carotid stenosis and the five healthy volunteers were imaged using a multicontrast carotid MRI protocol to characterize arterial wall morphology and composition. Normalized wall index (wall area∕total vessel area), maximum wall thickness and, if present, percentages of wall area occupied by calcification and lipid-rich necrotic core were determined. A multiple-slice CINE MR sequence was added to the multicontrast protocol to measure the distensibility coefficient (DC) at several locations spanning the bifurcation. The intraclass correlation coefficient (ICC) and the coefficient of variation were used to assess the reproducibility of DC measurements made on the healthy subjects. The DC was compared between arterial segments and between the healthy and diseased groups. Furthermore, within the diseased group, DC was correlated to plaque morphology and composition at each location as well as that averaged over the plaque.Distensibility measurements were highly reproducible: ICC (95% confidence interval) was 0.998 (0.96-1.0) for the common carotid segment and 0.990 (0.92-1.0) for the internal carotid segment. In healthy volunteers, we found significantly higher distensibility in the common segment of the carotid artery compared to the internal carotid segment (mean ± SD = 4.56 ± 1.02 versus 3.56 ± 1.32 × 10(-5)∕Pa; p < 0.05). However, no segmental differences were seen in the diseased group (3.25 ± 1.84 versus 3.26 ± 1.60 × 10(-5)∕Pa; p = 0.607). Location-to-location changes in DC were not found to correlate to changes in the local plaque morphology or composition nor were average DC found to be associated with aggregate plaque features.RESULTSDistensibility measurements were highly reproducible: ICC (95% confidence interval) was 0.998 (0.96-1.0) for the common carotid segment and 0.990 (0.92-1.0) for the internal carotid segment. In healthy volunteers, we found significantly higher distensibility in the common segment of the carotid artery compared to the internal carotid segment (mean ± SD = 4.56 ± 1.02 versus 3.56 ± 1.32 × 10(-5)∕Pa; p < 0.05). However, no segmental differences were seen in the diseased group (3.25 ± 1.84 versus 3.26 ± 1.60 × 10(-5)∕Pa; p = 0.607). Location-to-location changes in DC were not found to correlate to changes in the local plaque morphology or composition nor were average DC found to be associated with aggregate plaque features.These results demonstrate the feasibility of MRI to measure distensibility in the carotid artery and to presumably detect changes in distensibility due to age and∕or disease. The results suggest that the effect of atherosclerosis on local distensibility may not strongly depend upon the specific underlying plaque features in mild to moderate stenotic carotid lesions though more diffuse or nonlocal changes in arterial distensibility could not be ruled out.CONCLUSIONSThese results demonstrate the feasibility of MRI to measure distensibility in the carotid artery and to presumably detect changes in distensibility due to age and∕or disease. The results suggest that the effect of atherosclerosis on local distensibility may not strongly depend upon the specific underlying plaque features in mild to moderate stenotic carotid lesions though more diffuse or nonlocal changes in arterial distensibility could not be ruled out. |
| Author | Cantón, Gádor Tang, Dalin Kerwin, William S. Hippe, Daniel S. Underhill, Hunter R. Sun, Jie Yuan, Chun |
| Author_xml | – sequence: 1 givenname: Gádor surname: Cantón fullname: Cantón, Gádor email: gcanton@uw.edu organization: Mechanical Engineering Department, University of Washington, Box 352600, Stevens Way, Seattle, Washington 98195 – sequence: 2 givenname: Daniel S. surname: Hippe fullname: Hippe, Daniel S. organization: Vascular Imaging Laboratory, Department of Radiology, University of Washington, Box 358050, 850 Republican Street, Seattle, Washington 98109 – sequence: 3 givenname: Jie surname: Sun fullname: Sun, Jie organization: Vascular Imaging Laboratory, Department of Radiology, University of Washington, Box 358050, 850 Republican Street, Seattle, Washington 98109 – sequence: 4 givenname: Hunter R. surname: Underhill fullname: Underhill, Hunter R. organization: Division of Medical Genetics, Department of Medicine, University of Washington, Box 357720, 1959 NE Pacific Street, Seattle, Washington 98195 – sequence: 5 givenname: William S. surname: Kerwin fullname: Kerwin, William S. organization: Vascular Imaging Laboratory, Department of Radiology, University of Washington, Box 358050, 850 Republican Street, Seattle, Washington 98109 – sequence: 6 givenname: Dalin surname: Tang fullname: Tang, Dalin organization: Mathematical Sciences, Worcester Polytechnic Institute, 100 Institute Road, Worcester, Massachusetts 01609 – sequence: 7 givenname: Chun surname: Yuan fullname: Yuan, Chun organization: Vascular Imaging Laboratory, Department of Radiology, University of Washington, Box 358050, 850 Republican Street, Seattle, Washington 98109 |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/23039660$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1016_j_atherosclerosis_2015_09_008 crossref_primary_10_1016_j_jbiomech_2014_01_012 crossref_primary_10_2174_1381612825666190830175424 crossref_primary_10_1002_mrm_25494 crossref_primary_10_1080_07853890_2016_1204468 crossref_primary_10_3389_fphar_2017_00183 crossref_primary_10_1016_j_pharep_2015_05_007 crossref_primary_10_1002_jmri_28062 crossref_primary_10_1161_ATVBAHA_113_302603 crossref_primary_10_1118_1_4944500 crossref_primary_10_1161_HYPERTENSIONAHA_116_07698 crossref_primary_10_1002_nbm_3567 crossref_primary_10_1113_EP087232 crossref_primary_10_1152_japplphysiol_01011_2017 crossref_primary_10_1113_EP086585 |
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| Copyright | American Association of Physicists in Medicine 2012 American Association of Physicists in Medicine Copyright © 2012 American Association of Physicists in Medicine 2012 American Association of Physicists in Medicine |
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| Keywords | carotid atherosclerosis distensibility MRI compliance |
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| Notes | gcanton@uw.edu Author to whom correspondence should be addressed. Electronic mail Telephone: (206) 8971315; Fax: (206) 6169354. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Author to whom correspondence should be addressed. Electronic mail: gcanton@uw.edu; Telephone: (206) 8971315; Fax: (206) 6169354. |
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| Snippet | Purpose:
Arterial distensibility is a marker that can measure vessel wall functional and structural changes resulting from atherosclerosis with applications... Arterial distensibility is a marker that can measure vessel wall functional and structural changes resulting from atherosclerosis with applications including... |
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| SubjectTerms | Aged Aged, 80 and over bifurcation Bifurcations biomechanics biomedical MRI blood vessels Carotid Artery Diseases - diagnosis Carotid Artery Diseases - pathology carotid atherosclerosis Case-Control Studies compliance Contrast Digital computing or data processing equipment or methods, specially adapted for specific applications Diseases distensibility estimation theory Female Flow visualization Humans Image analysis Image data processing or generation, in general image registration image segmentation image sequences Involving electronic [emr] or nuclear [nmr] magnetic resonance, e.g. magnetic resonance imaging Magnetic Resonance Imaging Magnetic Resonance Physics Male Mechanical properties medical image processing Medical image segmentation Medical imaging Middle Aged MRI MRI: anatomic, functional, spectral, diffusion Plaque, Atherosclerotic - diagnosis Plaque, Atherosclerotic - pathology Registration Reproducibility of Results Segmentation Sequence analysis Ultrasonography Vascular system |
| Title | Characterization of distensibility, plaque burden, and composition of the atherosclerotic carotid artery using magnetic resonance imaging |
| URI | http://dx.doi.org/10.1118/1.4754302 https://onlinelibrary.wiley.com/doi/abs/10.1118%2F1.4754302 https://www.ncbi.nlm.nih.gov/pubmed/23039660 https://www.proquest.com/docview/1151037453 https://pubmed.ncbi.nlm.nih.gov/PMC3470611 |
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