Free-breathing, non-contrast, three-dimensional whole-heart coronary magnetic resonance imaging for the identification of culprit and vulnerable atherosclerotic plaque.

IF 4.2 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Magnetic Resonance Pub Date : 2025-04-22 DOI:10.1016/j.jocmr.2025.101898

Reza Hajhosseiny, Adam Hartley, Graham Cole, Camilla Munoz, Amarjit Sethi, Rasha Al-Lamee, Saud Khawaja, Sameer Zaman, James Howard, Deepa Gopalan, Ben Ariff, Raffi Kaprielian, Radhouene Neji, Karl P Kunze, Amit Kaura, Claudia Prieto, Ramzi Khamis, René M Botnar

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引用次数: 0

Abstract

Background: Detection of vulnerable coronary plaque can predict future myocardial infarctions. We have developed a novel, non-contrast cardiovascular magnetic resonance sequence (iT2prep-BOOST), enabling simultaneous, co-registered coronary angiography and plaque detection.

Objectives: To validate iT2prep-BOOST in patients with non-ST-segment elevation myocardial infarction (NSTEMI).

Methods: 41 patients with suspected NSTEMI were recruited. Invasive coronary angiography ± intravascular imaging was used to classify coronary segments into the following categories: normal, non-culprit and culprit segments; stenosed segments as well as segments with vulnerable plaque features (lipid, calcium, fibroatheroma, thin cap fibroatheroma (TCFA), plaque-rupture and thrombus). The plaque/myocardial signal intensity ratio (PMR) in each coronary segment was analyzed on iT2prep-BOOST.

Results: The mean ± standard deviation PMR of culprit segments was significantly higher than non-culprit segments and normal segments (1.01±0.14 vs. 0.67±0.18 vs. 0.35±0.24, P<0.001, respectively). Coronary segments with lipid, calcium, and fibroatheroma had a significantly higher PMR compared to normal coronary segments (P<0.001), but significantly lower than segments with plaque-rupture and intraluminal thrombus (P<0.05). There was a progressive increase in PMR with increasing coronary segment stenosis (P<0.001). There was a significant association on multivariable analysis between HbA1c as well as family history of coronary artery disease and mean PMR (P=0.05 and P=0.04, respectively).

Conclusion: iT2prep-BOOST has the potential to simultaneously visualize coronary artery lumen and plaque and differentiate normal segments from non-culprit and culprit plaque segments non-invasively and without contrast. The prognostic value of PMR needs to be investigated in a prospective multicenter study.

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自由呼吸、非对比、三维全心冠状动脉磁共振成像识别罪魁祸首和易损性动脉粥样硬化斑块。

背景：易损冠状动脉斑块的检测可以预测未来的心肌梗死。我们开发了一种新型的非对比心血管磁共振序列（iT2prep-BOOST），可以同时，共同注册冠状动脉造影和斑块检测。目的：验证iT2prep-BOOST对非st段抬高型心肌梗死（NSTEMI）患者的治疗效果。方法：招募41例疑似NSTEMI患者。有创冠状动脉造影±血管内显像将冠状动脉节段分为正常、非罪魁祸首和罪魁祸首节段；狭窄节段以及具有易损斑块特征的节段（脂质、钙质、纤维粥样瘤、薄帽纤维粥样瘤（TCFA）、斑块破裂和血栓）。采用iT2prep-BOOST分析各冠状动脉段斑块/心肌信号强度比（PMR）。结果：罪魁祸首段的PMR平均值±标准差明显高于非罪魁祸首段和正常段（1.01±0.14 vs. 0.67±0.18 vs. 0.35±0.24）。结论：iT2prep-BOOST具有同时显示冠状动脉管腔和斑块的潜力，可以无创、无对比地区分正常段与非罪魁祸首段和罪魁祸首斑块段。PMR的预后价值需要在前瞻性多中心研究中进行调查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cardiovascular Magnetic Resonance 医学-核医学

CiteScore

10.90

自引率

12.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.