Multi-modality imaging of high-intensity plaques on non-contrast T1-weighted magnetic resonance imaging: a case report.

IF 2.1 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiovascular diagnosis and therapy Pub Date : 2023-10-31 Epub Date: 2023-08-25 DOI:10.21037/cdt-23-125
Hayato Hosoda, Yu Kataoka, Fumiyuki Otsuka, Yasuhide Asaumi, Teruo Noguchi
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Abstract

Background: Non-contrast T1-weighted imaging (T1WI) with cardiac magnetic resonance enables to evaluate the intensity of coronary plaque. Plaque-to-myocardial signal intensity ratio (PMR) has been shown to associate with an elevated risk of future coronary events. Of note, PMR >1.4 is a best cut-off value to identify high-risk plaque causing future coronary events. One recent study has reported intraluminal thrombus as a contributor to PMR. However, whether plaque material itself is associated with PMR has not been fully characterized yet. We present three cases with coronary artery stenosis evaluated by non-contrast T1WI-magnetic resonance imaging, optical coherence tomography (OCT) and near-infrared spectroscopy (NIRS)-intravascular ultrasound (IVUS) imaging.

Case description: Case 1 exhibited one lesion with high PMR (2.79) at the proximal segment of left anterior descending (LAD) artery. OCT imaging did not identify any obvious intra-luminal thrombus but the presence of lipid-rich plaque harboring cholesterol crystal at the corresponding lesion. In addition, an elevated maximum 4-mm lipid-core burden index (maxLCBI4mm) (=873) was observed at this lesion by NIRS/IVUS imaging. In case 2, PMR of coronary stenosis at the middle segment of LAD artery was 1.88. This lesion harboured lipidic materials without any thrombus on OCT imaging. NIRS-derived maxLCBI4mm was 725. Case 3 had a severe stenosis at the middle segment of LAD artery. This lesion exhibited a low PMR (0.90). On OCT and NIRS/IVUS imaging, this lesion was characterized as the presence of small lipid arc with a low maxLCBI4mm (=386).

Conclusions: These cases showed the possible relationship of T1WI-derived PMR with the degree of lipidic plaque components.

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非对比T1加权磁共振成像高强度斑块的多模式成像:一例报告。
背景:心脏磁共振非对比T1加权成像(T1WI)能够评估冠状动脉斑块的强度。斑块与心肌信号强度比(PMR)已被证明与未来冠状动脉事件的风险升高有关。值得注意的是,PMR>1.4是识别导致未来冠状动脉事件的高危斑块的最佳截止值。最近的一项研究报告称,管腔内血栓是PMR的一个因素。然而,斑块材料本身是否与PMR相关还没有完全表征。我们报告了三例冠状动脉狭窄病例,通过非对比T1WI磁共振成像、光学相干断层扫描(OCT)和近红外光谱(NIRS)-血管内超声(IVUS)成像进行评估。病例描述:病例1显示左前降支(LAD)近端有一处PMR高(2.79)的病变。OCT成像没有发现任何明显的腔内血栓,但在相应的病变处存在富含脂质的斑块,其中含有胆固醇晶体。此外,通过NIRS/IVUS成像,在该病变处观察到最大4mm脂质核心负荷指数(maxLCBI4mm)升高(=873)。病例2左前降支中段冠状动脉狭窄的PMR为1.88。OCT成像显示,该病变含有脂质物质,没有任何血栓。NIRS衍生的最大LCBI4mm为725。病例3左前降支动脉中段严重狭窄。该病变表现出低PMR(0.90)。在OCT和NIRS/IVUS成像上,该病变的特征是存在小的脂质弧,最大LCBI4mm(=386)。结论:这些病例表明T1WI衍生的PMR可能与脂质斑块成分的程度有关。
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来源期刊
Cardiovascular diagnosis and therapy
Cardiovascular diagnosis and therapy Medicine-Cardiology and Cardiovascular Medicine
CiteScore
4.90
自引率
4.20%
发文量
45
期刊介绍: The journal ''Cardiovascular Diagnosis and Therapy'' (Print ISSN: 2223-3652; Online ISSN: 2223-3660) accepts basic and clinical science submissions related to Cardiovascular Medicine and Surgery. The mission of the journal is the rapid exchange of scientific information between clinicians and scientists worldwide. To reach this goal, the journal will focus on novel media, using a web-based, digital format in addition to traditional print-version. This includes on-line submission, review, publication, and distribution. The digital format will also allow submission of extensive supporting visual material, both images and video. The website www.thecdt.org will serve as the central hub and also allow posting of comments and on-line discussion. The web-site of the journal will be linked to a number of international web-sites (e.g. www.dxy.cn), which will significantly expand the distribution of its contents.
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