title: Experimental evaluation of the detectability of submillimeter atherosclerotic lesions in ex vivo human iliac arteries with ultrahigh-field (7.0 T) magnetic resonance imaging.
abstract: BACKGROUND
  To evaluate the ability of ultrahigh-field magnetic resonance imaging (MRI) to accurately depict the composition of the human arterial vessel wall ex vivo and to detect early atherosclerotic lesion formation in comparison to histology.
  
  
  METHODS
  Eight iliac artery specimens with low-grade atherosclerotic lesions obtained from human organ donors were studied. Three-dimensional, high-resolution MRI (spatial resolution: 79 x 79 x 109 microm) was performed using T1-, T2- and proton density (PD)-weightings (7.0 Tesla MR system, Bruker Pharmascan). A total of 36 MR slices and corresponding histological sections were matched for comparative evaluation of area measurements of lumen, media and adventitia and--if present--plaque size. Statistical correlation between histology and MR measurements was tested and a ROC-analysis was performed to determine the plaque size being predictive of correctly identifying atherosclerotic lesions with MRI.
  
  
  RESULTS
  The areas of vessel lumen and media as measured on T1-, T2- and PD-weighted MR images showed a strong correlation with the corresponding histological measurements (r = 0.84 to r = 0.89; P < 0.01), however, a systematic overestimation of 34-41% was found. For the area of adventitia, only a moderate, though significant, correlation (r = 0.55 to r = 0.62; P < 0.01) could be demonstrated with a similar overestimation by MRI (38-43%). With T1-weighted MRI, sensitivity and specificity for the detection of plaques > 4.0 mm(2) were 79% and 91%, respectively. With T2- and PD-weighted MRI, however, sensitivity and specificity for the detection of plaques > 0.4 mm2 were 93% and 89%.
  
  
  CONCLUSIONS
  In an experimental ex vivo setting, ultrahigh-field MRI of the human arterial vessel wall resulted in an accurate visualization of vessel wall composition when compared to histology and, thus, allowed for a quantitative assessment. T2- and PD-weighted MRI proved capable of reliably detecting submillimeter atherosclerotic lesions.
authors.affiliation: Department of Internal Medicine/Cardiology, German Heart Institute Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. jahnke@dhzb.de
authors.forename: Cosima
authors.initials: C
authors.lastname: Jahnke
authors.forename: Thore
authors.initials: T
authors.lastname: Dietrich
authors.forename: Ingo
authors.initials: I
authors.lastname: Paetsch
authors.forename: Uwe
authors.initials: U
authors.lastname: Koehler
authors.forename: Kathleen
authors.initials: K
authors.lastname: Preetz
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schnackenburg
authors.forename: Eckart
authors.initials: E
authors.lastname: Fleck
authors.forename: Kristof
authors.initials: K
authors.lastname: Graf
authors.forename: Eike
authors.initials: E
authors.lastname: Nagel
mesh_terms: D050197:Atherosclerosis / Q000175:diagnosis* / Q000473:pathology; D003238:Connective Tissue / Q000473:pathology*; D006801:Humans; D007083:Iliac Artery / Q000473:pathology*; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012107:Research Design; D012680:Sensitivity and Specificity; D017540:Tunica Media / Q000473:pathology*