title: Hyperintense plaque identified by magnetic resonance imaging relates to intracoronary thrombus as detected by optical coherence tomography in patients with angina pectoris.
abstract: OBJECTIVE
  Many investigators have speculated that hyperintense plaques (HIPs) of the carotid artery on non-contrast T1-weighted imaging (T1WI) in magnetic resonance indicate the presence of mural or intraplaque haemorrhage containing methemoglobin. Coronary plaque imaging with T1WI is challenging, and the clinical significance of coronary HIP on T1WI remains unknown. The aim of this study was to compare HIPs on T1WI with coronary plaque morphology assessed by optical coherence tomography (OCT), which allows us to identify not only plaque rupture, but also fibrous cap thickness and intracoronary thrombus in vivo, in patients with angina pectoris.
  
  
  RESULTS
  Twenty-six lesions from 26 patients with either stable or unstable angina pectoris were examined in this study. All patients underwent T1WI within 24 h before the day on which invasive coronary angiography was performed, and pre-interventional OCT was performed on a native atherosclerotic lesion, considered to be the culprit lesion. Of the 26 lesions studied, 16 (62%) were HIPs and 10 (38%) were non-HIPs. The signal intensity of the coronary plaque to cardiac muscle ratio in HIPs was significantly higher than that in non-HIPs. There were no significant differences in the frequency of lipid-rich plaque, thin-cap fibroatheroma, plaque rupture, and calcification between HIPs and non-HIPs. In contrast, the frequency of thrombus was significantly higher in HIPs than in non-HIPs (P = 0.004).
  
  
  CONCLUSIONS
  This study shows that the HIPs on T1WI in angina patients relate to the presence of intracoronary thrombus as detected by OCT imaging.
authors.affiliation: Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan. ehara@med.osaka-cu.ac.jp
authors.forename: Shoichi
authors.initials: S
authors.lastname: Ehara
authors.forename: Takao
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Nakata
authors.forename: Kenji
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nishimura
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Iguchi
authors.forename: Toru
authors.initials: T
authors.lastname: Kataoka
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis* / Q000473:pathology; D017023:Coronary Angiography / Q000295:instrumentation; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000473:pathology; D003328:Coronary Thrombosis / Q000175:diagnosis* / Q000473:pathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000295:instrumentation*; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment; D013223:Statistics as Topic / Q000295:instrumentation; D018709:Statistics, Nonparametric; D041623:Tomography, Optical Coherence / Q000295:instrumentation*; D014463:Ultrasonography