title: Intra-individual comparison of carotid and femoral atherosclerotic plaque features with in vivo MR plaque imaging.
abstract: The purpose of this study was to evaluate differences of plaque composition and morphology within the same patient in different vascular beds using non-invasive MR-plaque imaging. 28 patients (67.8 ± 7.4 years, 8 females) with high Framingham general cardiovascular disease 10-year risk score and mild-to-moderate atherosclerosis were consecutively included in the study. All subjects underwent a dedicated MRI-plaque imaging protocol using TOF and T1w and T2w black-blood-sequences with fat suppression at 1.5 T. The scan was centered on the carotid bulb of the carotid arteries and on the most stenotic lesion of the ipsilateral femoral artery, respectively. Plaques were classified according to the American Heart Association (AHA) lesion type classification and area measurements of lumen, wall and the major plaque components, such as calcification, necrotic core and hemorrhage were determined in consensus by two blinded reviewers using dedicated software (Cascade, Seattle, USA). Plaque components were recorded as maximum percentages of the wall area. Carotid arteries had larger maximum wall and smaller minimum lumen areas (p < 0.001) than femoral arteries, whereas no significant difference was find with respect to the max. NWI (p = 0.87). Prevalence of lipid-rich AHA lesion type IV/V and complicated AHA lesion type VI with hemorrhage/thrombus/fibrous cap rupture was significantly higher in the carotid arteries compared to the femoral arteries. Plaque composition as percentage of the vessel wall differed significantly between carotid and femoral arteries: Max. %necrotic core and max. %hemorrhage were significantly higher in the carotid arteries compared to the femoral arteries (p = 0.001 and p = 0.02, respectively). Max. %calcification did not differ significantly. Average stenotic degree of carotid arteries at duplex was 49.7 ± 12.5 (%). Non-invasive MR plaque-imaging is able to visualize differences in plaque composition across the vascular tree. We observed significant differences in quantitative and qualitative plaque features between carotid and femoral arteries within the same patient, which in the future could help to improve risk stratification in patients with atherosclerosis.
authors: Institute for Clinical Radiology, Ludwig Maximilians University Hospital Munich, Marchioninistr. 15, 81377, Munich, Germany. andreas.helck@med.uni-muenchen.de.
authors: Andreas
authors: A
authors: Helck
authors: Division of Cardiology and Vascular Medicine, Department of Internal Medicine, Ospedale San Giovanni Bellinzona (EOC), 6500, Bellinzona, Switzerland.
authors: Nicola
authors: N
authors: Bianda
authors: Department of Radiology, University of Washington, Seattle, WA, USA.
authors: Gador
authors: G
authors: Canton
authors: Department of Radiology, University of Washington, Seattle, WA, USA.
authors: Chun
authors: C
authors: Yuan
authors: Department of Radiology, University of Washington, Seattle, WA, USA.
authors: Daniel S
authors: DS
authors: Hippe
authors: Institute for Clinical Radiology, Ludwig Maximilians University Hospital Munich, Marchioninistr. 15, 81377, Munich, Germany.
authors: Maximilian F
authors: MF
authors: Reiser
authors: Division of Cardiology and Vascular Medicine, Department of Internal Medicine, Ospedale San Giovanni Bellinzona (EOC), 6500, Bellinzona, Switzerland.
authors: Augusto
authors: A
authors: Gallino
authors: Department of Radiology, Ospedale San Giovanni Bellinzona (EOC), 6500, Bellinzona, Switzerland.
authors: Rolf
authors: R
authors: Wyttenbach
authors: Institute for Clinical Radiology, Ludwig Maximilians University Hospital Munich, Marchioninistr. 15, 81377, Munich, Germany. tobias.saam@med.lmu.de.
authors: Tobias
authors: T
authors: Saam
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000473:pathology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D003251:Constriction, Pathologic; D005260:Female; D005263:Femoral Artery / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012984:Software; D018616:Ultrasonography, Doppler, Duplex
keywords: Atherosclerosis; MR-plaque imaging; Peripheral artery disease; Plaque composition; Risk stratification