Diagnosis of thin-cap fibroatheromas by a self-contained intravascular magnetic resonance imaging probe in ex vivo human aortas and in situ coronary arteries.
OBJECTIVE
We sought to correlate findings obtained from a self-contained magnetic resonance imaging (MRI) probe with plaque morphology of ex vivo human aortas and coronary arteries.


BACKGROUND
Early detection of thin-cap fibroatheromas (TCFAs) may allow for early preventive treatment of acute coronary syndromes. We developed an intravascular MRI catheter capable of imaging the arterial wall without external magnets or coils by differentiating lipid-rich and fibrotic-rich areas of the atherosclerotic plaque on the basis of differential water diffusion.


METHODS
Aortic samples (n = 16) and coronary arteries were obtained within 12 h of death. Coronary specimens were intermediate in angiographic severity (30% to 60% luminal narrowing, n = 18). Blinded histologic and immunohistochemical analyses of the tissues were performed and correlated to MRI findings.


RESULTS
The 16 aortic lesions included four ulcerated plaques, two TCFAs, two thick-cap fibrous atheromas, two intimal xanthomas, and six adaptive intimal thickenings. The MRI scan correctly correlated with the histologic diagnosis in 15 (94%) of 16 lesions. The 18 coronary lesions included one plaque rupture, three TFCAs, seven thick-cap fibrous atheromas, four fibrocalcific plaques, two intimal xanthomas, and one adaptive intimal thickening. The MRI scan correlated with the histologic diagnosis in 16 of 18 lesions (sensitivity 100%, specificity 89%).


CONCLUSIONS
The self-contained intravascular MRI catheter successfully identified TCFA and may prove to be an important diagnostic approach to determining the presence of lesions with increased risk of causing death or myocardial infarction.
Schneiderman
Jacob
J
Department of Vascular Surgery and Gottesdiener Vascular Biology Laboratory, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Wilensky
Robert L
RL
Weiss
Assaf
A
Samouha
Eitzek
E
Muchnik
Lev
L
Chen-Zion
Malca
M
Ilovitch
Mordechay
M
Golan
Erez
E
Blank
Aharon
A
Flugelman
Moshe
M
Rozenman
Yosef
Y
Virmani
Renu
R
D001011:Aorta / Q000473:pathology*; D006328:Cardiac Catheterization; D003324:Coronary Artery Disease / Q000473:pathology*; D003331:Coronary Vessels / Q000473:pathology*; D004867:Equipment Design; D005355:Fibrosis / Q000473:pathology; D006801:Humans; D007089:Image Enhancement; D066298:In Vitro Techniques; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D012680:Sensitivity and Specificity