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European Heart Journal Advance Access published online on June 20, 2006
European Heart Journal, doi:10.1093/eurheartj/ehl102
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European Heart Journal © The European Society of Cardiology 2006; all rights reserved
Received November 28, 2005
Revised May 11, 2006
Accepted May 26, 2006

Clinical research

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

David Maintz 1 *, Murat Ozgun 1, Andreas Hoffmeier 2, Roman Fischbach 1, Won Yong Kim 3, Matthias Stuber 4, Warren J. Manning 5, Walter Heindel 1, and René M. Botnar 6

1 Department of Clinical Radiology, University of Muenster, Münster 48129, Germany
2 Department of Thoracic Surgery, University of Muenster, Germany
3 Institute of Clinical Medicine and Department of Cardiology, MR Center, Aarhus University Hospital, Skejby Sygehus, Aarhus, Denmark
4 Department of Radiology, Division of MR Research, Johns Hopkins Hospital, Baltimore, MD, USA
5 Cardiac MR Center, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
6 Department of Nuclear Medicine, Technical University Munich, Munich, Germany

* To whom correspondence should be addressed.
David Maintz, E-mail: maintz{at}uni-muenster.de


  Abstract

Aims We sought to evaluate the utility of contrast-enhanced coronary magnetic resonance imaging (CE-MRI) for selective visualization and non-invasive differentiation of atherosclerotic coronary plaque in humans.

Methods and results Nine patients with coronary artery disease (CAD) as confirmed by X-ray angiography and multidetector computed tomography (MDCT) were studied by T1-weighted black blood inversion recovery coronary MRI before (N-IR) and after administration of Gd-DTPA (CE-IR). Plaques were categorized as calcified, non-calcified, and mixed based on their Hounsfield number derived from MDCT. With MDCT, a total of 29 plaques were identified, including calcified (n=6), non-calcified (n=6), and mixed calcified/non-calcified (n=17). On N-IR MRI, 26 plaques (90%) were dark, whereas three plaques (two non-calcified and one mixed) appeared bright. On CE-MRI, 13/29 (45%) plaques, 11 of which were mixed, one non-calcified, and one calcified showed contrast uptake. All others remained dark.

Conclusion In this preliminary study, we demonstrate the potential utility of CE-IR MRI for selective plaque visualization and differentiation of plaque types. The observed contrast uptake may be associated with endothelial dysfunction, neovascularization, inflammation, and/or fibrosis.

Keywords: Magnetic resonance imaging; Coronary plaque; Contrast enhancement; Plaque characterization.
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