Contrast-enhanced magnetic resonance imaging for the detection of ruptured coronary plaques in patients with acute myocardial infarction

Christian H.P. Jansen; Divaka Perera; Andrea J. Wiethoff; Alkystis Phinikaridou; Reza M. Razavi; Aldo Rinaldi; Mike S. Marber; Gerald F. Greil; Eike Nagel; David Maintz; Simon Redwood; Rene M. Botnar; Marcus R. Makowski

doi:10.1371/journal.pone.0188292

Contrast-enhanced magnetic resonance imaging for the detection of ruptured coronary plaques in patients with acute myocardial infarction

Christian H.P. Jansen, Divaka Perera, Andrea J. Wiethoff, Alkystis Phinikaridou, Reza M. Razavi, Aldo Rinaldi, Mike S. Marber, Gerald F. Greil, Eike Nagel, David Maintz, Simon Redwood, Rene M. Botnar, Marcus R. Makowski

Research output: Contribution to journal › Article

3 Scopus citations

Abstract

Purpose: X-ray coronary angiography (XCA) is the current gold standard for the assessment of lumen encroaching coronary stenosis but XCA does not allow for early detection of rupture-prone vulnerable plaques, which are thought to be the precursor lesions of most acute myocardial infarctions (AMI) and sudden death. The aim of this study was to investigate the potential of delayed contrast-enhanced magnetic resonance coronary vessel wall imaging (CE-MRCVI) for the detection of culprit lesions in the coronary arteries. Methods: 16 patients (13 male, age 61.9±8.6 years) presenting with sub-acute MI underwent CE-MRCVI within 24-72h prior to invasive XCA. CE-MRCVI was performed using a T1-weighted 3D gradient echo inversion recovery sequence (3D IR TFE) 40±4 minutes following the administration of 0.2 mmol/kg gadolinium-diethylenetriamine-pentaacetic acid (DTPA) on a 3T MRI scanner equipped with a 32-channel cardiac coil. Results: 14 patients were found to have culprit lesions (7x LAD, 1xLCX, 6xRCA) as identified by XCA. Quantitative CE-MRCVI correctly identified the culprit lesion location with a sensitivity of 79% and excluded culprit lesion formation with a specificity of 99%. The contrast to noise ratio (CNR) of culprit lesions (9.7±4.1) significantly exceeded CNR values of segments without culprit lesions (2.9±1.9, p<0.001). Conclusion: CE-MRCVI allows the selective visualization of culprit lesions in patients immediately after myocardial infarction (MI). The pronounced contrast uptake in ruptured plaques may represent a surrogate biomarker of plaque activity and/or vulnerability.

Original language	English (US)
Article number	e0188292
Journal	PloS one
Volume	12
Issue number	11
DOIs	https://doi.org/10.1371/journal.pone.0188292
State	Published - Nov 2017

ASJC Scopus subject areas

Biochemistry, Genetics and Molecular Biology(all)
Agricultural and Biological Sciences(all)
General

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Jansen, C. H. P., Perera, D., Wiethoff, A. J., Phinikaridou, A., Razavi, R. M., Rinaldi, A., Marber, M. S., Greil, G. F., Nagel, E., Maintz, D., Redwood, S., Botnar, R. M., & Makowski, M. R. (2017). Contrast-enhanced magnetic resonance imaging for the detection of ruptured coronary plaques in patients with acute myocardial infarction. PloS one, 12(11), [e0188292]. https://doi.org/10.1371/journal.pone.0188292

Contrast-enhanced magnetic resonance imaging for the detection of ruptured coronary plaques in patients with acute myocardial infarction. / Jansen, Christian H.P.; Perera, Divaka; Wiethoff, Andrea J.; Phinikaridou, Alkystis; Razavi, Reza M.; Rinaldi, Aldo; Marber, Mike S.; Greil, Gerald F.; Nagel, Eike; Maintz, David; Redwood, Simon; Botnar, Rene M.; Makowski, Marcus R.

In: PloS one, Vol. 12, No. 11, e0188292, 11.2017.

Research output: Contribution to journal › Article

Jansen, CHP, Perera, D, Wiethoff, AJ, Phinikaridou, A, Razavi, RM, Rinaldi, A, Marber, MS, Greil, GF, Nagel, E, Maintz, D, Redwood, S, Botnar, RM & Makowski, MR 2017, 'Contrast-enhanced magnetic resonance imaging for the detection of ruptured coronary plaques in patients with acute myocardial infarction', PloS one, vol. 12, no. 11, e0188292. https://doi.org/10.1371/journal.pone.0188292

Jansen, Christian H.P. ; Perera, Divaka ; Wiethoff, Andrea J. ; Phinikaridou, Alkystis ; Razavi, Reza M. ; Rinaldi, Aldo ; Marber, Mike S. ; Greil, Gerald F. ; Nagel, Eike ; Maintz, David ; Redwood, Simon ; Botnar, Rene M. ; Makowski, Marcus R. / Contrast-enhanced magnetic resonance imaging for the detection of ruptured coronary plaques in patients with acute myocardial infarction. In: PloS one. 2017 ; Vol. 12, No. 11.

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abstract = "Purpose: X-ray coronary angiography (XCA) is the current gold standard for the assessment of lumen encroaching coronary stenosis but XCA does not allow for early detection of rupture-prone vulnerable plaques, which are thought to be the precursor lesions of most acute myocardial infarctions (AMI) and sudden death. The aim of this study was to investigate the potential of delayed contrast-enhanced magnetic resonance coronary vessel wall imaging (CE-MRCVI) for the detection of culprit lesions in the coronary arteries. Methods: 16 patients (13 male, age 61.9±8.6 years) presenting with sub-acute MI underwent CE-MRCVI within 24-72h prior to invasive XCA. CE-MRCVI was performed using a T1-weighted 3D gradient echo inversion recovery sequence (3D IR TFE) 40±4 minutes following the administration of 0.2 mmol/kg gadolinium-diethylenetriamine-pentaacetic acid (DTPA) on a 3T MRI scanner equipped with a 32-channel cardiac coil. Results: 14 patients were found to have culprit lesions (7x LAD, 1xLCX, 6xRCA) as identified by XCA. Quantitative CE-MRCVI correctly identified the culprit lesion location with a sensitivity of 79% and excluded culprit lesion formation with a specificity of 99%. The contrast to noise ratio (CNR) of culprit lesions (9.7±4.1) significantly exceeded CNR values of segments without culprit lesions (2.9±1.9, p<0.001). Conclusion: CE-MRCVI allows the selective visualization of culprit lesions in patients immediately after myocardial infarction (MI). The pronounced contrast uptake in ruptured plaques may represent a surrogate biomarker of plaque activity and/or vulnerability.",

author = "Jansen, {Christian H.P.} and Divaka Perera and Wiethoff, {Andrea J.} and Alkystis Phinikaridou and Razavi, {Reza M.} and Aldo Rinaldi and Marber, {Mike S.} and Greil, {Gerald F.} and Eike Nagel and David Maintz and Simon Redwood and Botnar, {Rene M.} and Makowski, {Marcus R.}",

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AU - Jansen, Christian H.P.

AU - Perera, Divaka

AU - Wiethoff, Andrea J.

AU - Phinikaridou, Alkystis

AU - Razavi, Reza M.

AU - Rinaldi, Aldo

AU - Marber, Mike S.

AU - Greil, Gerald F.

AU - Nagel, Eike

AU - Maintz, David

AU - Redwood, Simon

AU - Botnar, Rene M.

AU - Makowski, Marcus R.

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N2 - Purpose: X-ray coronary angiography (XCA) is the current gold standard for the assessment of lumen encroaching coronary stenosis but XCA does not allow for early detection of rupture-prone vulnerable plaques, which are thought to be the precursor lesions of most acute myocardial infarctions (AMI) and sudden death. The aim of this study was to investigate the potential of delayed contrast-enhanced magnetic resonance coronary vessel wall imaging (CE-MRCVI) for the detection of culprit lesions in the coronary arteries. Methods: 16 patients (13 male, age 61.9±8.6 years) presenting with sub-acute MI underwent CE-MRCVI within 24-72h prior to invasive XCA. CE-MRCVI was performed using a T1-weighted 3D gradient echo inversion recovery sequence (3D IR TFE) 40±4 minutes following the administration of 0.2 mmol/kg gadolinium-diethylenetriamine-pentaacetic acid (DTPA) on a 3T MRI scanner equipped with a 32-channel cardiac coil. Results: 14 patients were found to have culprit lesions (7x LAD, 1xLCX, 6xRCA) as identified by XCA. Quantitative CE-MRCVI correctly identified the culprit lesion location with a sensitivity of 79% and excluded culprit lesion formation with a specificity of 99%. The contrast to noise ratio (CNR) of culprit lesions (9.7±4.1) significantly exceeded CNR values of segments without culprit lesions (2.9±1.9, p<0.001). Conclusion: CE-MRCVI allows the selective visualization of culprit lesions in patients immediately after myocardial infarction (MI). The pronounced contrast uptake in ruptured plaques may represent a surrogate biomarker of plaque activity and/or vulnerability.

AB - Purpose: X-ray coronary angiography (XCA) is the current gold standard for the assessment of lumen encroaching coronary stenosis but XCA does not allow for early detection of rupture-prone vulnerable plaques, which are thought to be the precursor lesions of most acute myocardial infarctions (AMI) and sudden death. The aim of this study was to investigate the potential of delayed contrast-enhanced magnetic resonance coronary vessel wall imaging (CE-MRCVI) for the detection of culprit lesions in the coronary arteries. Methods: 16 patients (13 male, age 61.9±8.6 years) presenting with sub-acute MI underwent CE-MRCVI within 24-72h prior to invasive XCA. CE-MRCVI was performed using a T1-weighted 3D gradient echo inversion recovery sequence (3D IR TFE) 40±4 minutes following the administration of 0.2 mmol/kg gadolinium-diethylenetriamine-pentaacetic acid (DTPA) on a 3T MRI scanner equipped with a 32-channel cardiac coil. Results: 14 patients were found to have culprit lesions (7x LAD, 1xLCX, 6xRCA) as identified by XCA. Quantitative CE-MRCVI correctly identified the culprit lesion location with a sensitivity of 79% and excluded culprit lesion formation with a specificity of 99%. The contrast to noise ratio (CNR) of culprit lesions (9.7±4.1) significantly exceeded CNR values of segments without culprit lesions (2.9±1.9, p<0.001). Conclusion: CE-MRCVI allows the selective visualization of culprit lesions in patients immediately after myocardial infarction (MI). The pronounced contrast uptake in ruptured plaques may represent a surrogate biomarker of plaque activity and/or vulnerability.

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