Evaluation of the early enhancement of coronary atherosclerotic plaque by contrast-enhanced MR angiography.
OBJECTIVE
To evaluate the early enhancement of coronary atherosclerotic plaque using contrast-enhanced MR angiography (CE-MRA) and investigate the association between unstable angina pectoris (UAP) and early enhancement of the plaque.


METHODS
Forty-one patients presenting with angina pectoris and demonstrating single-vessel disease with non-calcified plaque and significant coronary stenosis (≥50%) on CTA were consecutively recruited for coronary CE-MRA. Contrast-to-noise ratio of the culprit plaque guided by CTA was measured on a cross-sectional multi-planar reconstruction image of the plaque on both pre- and post-CE-MRA. A 50% increasing of CNR was defined as plaque enhancement. The association between early enhancement of the plaques and UAP was analyzed.


RESULTS
Thirty-seven non-calcified plaques with significant coronary stenosis were detected in the 37 patients on MRA. 4 subjects were excluded because coronary atherosclerotic plaques were inadequate for identification on MRA. Of the 37 patients, 18 patients had UAP and other 19 patients presented stable angina pectoris (SAP). Of the 37 plaques on CE-MRA, 13 and 24 plaques presented early enhancement and no enhancement, respectively. Of the 13 early-enhanced plaques, 11 (85%) and 2 (15%) were found in the patients with UAP and SAP, respectively (p<0.01). Of the 37 patients, 11 (61%) with UAP and 2 (11%) with SAP had early-enhanced plaques, respectively (p<0.01).


CONCLUSIONS
CE-MRA allows detection of early enhancement of coronary atherosclerotic plaque. The early enhancement is common in unstable angina and could be a sign of vulnerability.
Li
Tao
T
Department of Radiology, The General Hospital of Chinese People's Armed Police Forces, Number 69, Yong Ding Road, Hai Dian District, Beijing, China.
Zhao
Xihai
X
Liu
Xin
X
Gao
Jianhua
J
Zhao
Shaohong
S
Li
Xin
X
Zhou
Weihua
W
Cai
Zulong
Z
Zhang
Weiguo
W
Yang
Li
L
D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000150:complications / Q000175:diagnosis; D003287:Contrast Media; D003324:Coronary Artery Disease / Q000175:diagnosis*; D023921:Coronary Stenosis / Q000175:diagnosis; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000175:diagnosis*
D003287:Contrast Media