Localization of Coronary High-Intensity Signals on T1-Weighted MR Imaging: Relation to Plaque Morphology and Clinical Severity of聽Angina聽Pectoris

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• 作者：Kenji Matsumoto ; MD ; PhD^&lowast ; ; Shoichi Ehara ; MD ; PhD^&lowast ; ; ^{ehara@med.osaka-cu.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Takao Hasegawa ; MD ; PhD^&lowast ; ; Mikumo Sakaguchi ; MD^&lowast ; ; Kenichiro Otsuka ; MD ; PhD^&lowast ; ; Junichi Yoshikawa ; MD ; PhD^&dagger ; ; Kenei Shimada ; MD ; PhD^&lowast ;
• 关键词：angina pectoris ; atherosclerosis ; intraplaque hemorrhage ; magnetic resonance imaging ; optical coherence tomography ; thrombosis
• 刊名：JACC: Cardiovascular Imaging
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：8
• 期：10
• 页码：1143-1152
• 全文大小：1203 K

文摘

This study sought to investigate the relationship between localization of high-intensity signals (HISs) on T1-weighted imaging (T1WI) with the noncontrast magnetic resonance technique and plaque morphology detected on optical coherence tomography, and the clinical severity of angina pectoris.

Background

Since the introduction of the T1WI noncontrast magnetic resonance technique for plaque imaging, some groups have reported that HISs in the coronary artery on T1WI are associated with a vulnerable morphology and future cardiac events. However, the association between the localization of HISs, such as coronary intrawall or intraluminal, and plaque morphology has not been investigated.

Methods

One hundred lesions with either stable or unstable angina were included and divided into 3 groups according to the following criteria using T1WI. First, the plaques with the ratio between the signal intensities of coronary plaque and cardiac muscle ≤1.0 were classified as non-HISs (n = 39). Then, HISs with the ratio between the signal intensities of coronary plaque and cardiac muscle >1.0 were classified into 2 types by using cross-sectional T1WI. Those localized within the coronary wall when the lumen was identified were defined as intrawall HISs (n = 37), whereas those occupying the lumen when the lumen was not, or even if only partly, identified, were defined as intraluminal HISs (n = 24).

Results

Multivariate analysis revealed that intrawall HISs were associated with macrophage accumulation and the absence of calcification assessed by using optical coherence tomography. In contrast, thrombus and intimal vasculature were independent factors associated with intraluminal HISs. Furthermore, 50% of patients with intraluminal HISs experienced rest angina, such as Braunwald class II or III.

Conclusions

This study shows that intrawall and intraluminal HISs on T1WI in patients with angina are related to the different types of vulnerable plaque morphology and the clinical severity.