Characterization of intimal changes in coronary artery specimens with MR microscopy.
OBJECTIVE
To determine if magnetic resonance (MR) microscopy can yield images sufficient for discriminating early progressive atherosclerotic lesions from nonprogressive atherosclerotic lesions in human coronary arteries.


METHODS
Institutional review board approval and informed consent were not required. Seventeen coronary artery segments (mean diameter, 2.8 mm +/- 1.0 [standard deviation]) were collected within 36 hours after death from 11 cadavers (six men, five women; age range at death, 33-65 years). Quantitative T1, T2, intensity-weighted (IW), and magnetization transfer (MT) maps were acquired with a 9.4-T vertical-bore magnet. Coronary artery lesions were classified as adaptive intimal thickening (AIT), pathologic intimal thickening (PIT), or intimal xanthoma (IXA). Internal anatomic fiducial landmarks and stains were applied to proximal and epicardial vessel surfaces and used to register histologic sections with MR images and thus enable comparison of MR images and Movat pentachrome-stained histologic specimens. Unique 0.0012-0.0287-cm(2) regions of interest were visually identified on quantitative T1, T2, MT, and IW maps of AIT, IXA, and PIT lesions. Distributions of T1, T2, MT, and IW values were compared with Student t and Wilcoxon two-sample tests.


RESULTS
MR microscopic images of nonprogressive AIT and IXA lesions revealed two intimal layers. The luminal intima had higher T1 and T2 values and lower MT values than did the medial intima; these findings were consistent with compositional differences observed in histologic sections. In the IXA lesion, T2 values of both intimal layers were markedly reduced when compared with T2 values of AIT lesions because of the accumulation of lipid-laden macrophages in both layers. Progressive PIT lesions had a typical multilayered appearance or foci with a short T2 relaxation time and low IW values; these features were not observed in AIT or IXA lesions.


CONCLUSIONS
MR microscopy enabled identification of morphologic arterial wall features that enable discrimination of progressive PIT lesions from nonprogressive AIT or IXA lesions.
Pessanha
Breno S
BS
Department of Cardiovascular Pathology and Magnetic Resonance Microscopy Facility, Armed Forces Institute of Pathology, Washington, DC, USA.
Potter
Kimberlee
K
Kolodgie
Frank D
FD
Farb
Andrew
A
Kutys
Robert
R
Mont
Erik K
EK
Burke
Allen P
AP
O'leary
Timothy J
TJ
Virmani
Renu
R
D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000473:pathology*; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008853:Microscopy / Q000379:methods*; D008875:Middle Aged; D017539:Tunica Intima / Q000473:pathology