title: Carotid artery atherosclerosis: effect of intensive lipid therapy on the vasa vasorum--evaluation by using dynamic contrast-enhanced MR imaging.
abstract: OBJECTIVE
  To investigate whether short-term, intensive lipid therapy leads to changes in microvascular characteristics, as measured by using dynamic contrast material-enhanced (DCE) magnetic resonance (MR) imaging.
  
  
  METHODS
  Institutional review board approval and informed consent were obtained for this HIPAA-compatible study. Subjects with established coronary artery disease or carotid artery stenosis of 15% or greater determined by using ultrasonography and with levels of apolipoprotein B of 120 mg/dL (1.2 g/L) or greater were enrolled in an ongoing study (clinical trial NCT00715273). All received intensive lipid therapy to achieve targeted high- and low-density lipoprotein cholesterol levels and underwent serial serum monitoring including high-sensitivity C-reactive protein (HsCRP) level measurements. Carotid artery MR imaging examinations including morphologic and DCE MR images were obtained at baseline and 1 year after treatment. In subjects with advanced lesions (>2 mm thick), MR image analysis was performed, including measurement of lipid-rich necrotic core size and kinetic modeling of DCE MR images to assess changes in the transfer constant (K(trans)). The differences in K(trans) between baseline and 1-year follow-up were compared by using the Wilcoxon signed rank test, and associations were assessed by using the Spearman rank correlation coefficient.
  
  
  RESULTS
  Twenty-eight subjects with interpretable DCE MR imaging results at both baseline and 1-year follow-up were included. After 1 year of treatment, a significant reduction was found in mean K(trans) (0.085 min(-1) ± 0.037 [standard deviation] to 0.067 min(-1) ± 0.028, P = .02). Reduction in K(trans) was not significantly correlated with observed reductions in lipid-rich necrotic core size or reductions in HsCRP level.
  
  
  CONCLUSIONS
  These findings suggest that DCE MR imaging may be a useful imaging method for the assessment of the therapeutic response of the vasa vasorum in patients with atherosclerotic plaque.
authors.affiliation: Department of Radiology, University of Washington School of Medicine, 815 Mercer St, Seattle, WA 98109, USA.
authors.forename: Li
authors.initials: L
authors.lastname: Dong
authors.forename: Williams S
authors.initials: WS
authors.lastname: Kerwin
authors.forename: Huijun
authors.initials: H
authors.lastname: Chen
authors.forename: Baocheng
authors.initials: B
authors.lastname: Chu
authors.forename: Hunter R
authors.initials: HR
authors.lastname: Underhill
authors.forename: Moni Blazej
authors.initials: MB
authors.lastname: Neradilek
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Hatsukami
authors.forename: Chun
authors.initials: C
authors.lastname: Yuan
authors.forename: Xue-Qiao
authors.initials: XQ
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D050197:Atherosclerosis / Q000188:drug therapy* / Q000473:pathology*; D000069059:Atorvastatin; D002340:Carotid Artery Diseases / Q000188:drug therapy* / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011758:Pyrroles / Q000627:therapeutic use*; D016896:Treatment Outcome; D014651:Vasa Vasorum / Q000473:pathology*
chemical_list: D000924:Anticholesteremic Agents; D003287:Contrast Media; D006538:Heptanoic Acids; D011758:Pyrroles; C064925:gadodiamide; D000069059:Atorvastatin; D019786:Gadolinium DTPA