Visualization of fibrous cap thickness and rupture in human atherosclerotic carotid plaque in vivo with high-resolution magnetic resonance imaging

Citation
Ts. Hatsukami et al., Visualization of fibrous cap thickness and rupture in human atherosclerotic carotid plaque in vivo with high-resolution magnetic resonance imaging, CIRCULATION, 102(9), 2000, pp. 959-964
Citations number
41
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
CIRCULATION
ISSN journal
0009-7322 → ACNP
Volume
102
Issue
9
Year of publication
2000
Pages
959 - 964
Database
ISI
SICI code
0009-7322(20000829)102:9<959:VOFCTA>2.0.ZU;2-6
Abstract
Background-The results of studies of advanced lesions of atherosclerosis su ggest that the thickness of the fibrous cap that overlies the necrotic core distinguishes the stable lesion from one that is at high risk for rupture and thromboembolic events. We have developed a high-resolution MRI techniqu e that can identify the fine structure of the lesion, including the fibrous cap, in vivo. The aim of the present study was to determine the agreement between in vivo MRI and lesion architecture as seen on histology and gross tissue examination to identify fibrous cap thickness and rupture. Methods and Results-Twenty-two subjects who were scheduled for carotid enda rterectomy underwent MRI with a 3-dimensional multiple overlapping thin sla b angiography protocol. The appearance of the fibrous cap was categorized a s (1) an intact, thick, (2) an intact, thin, or (3) a ruptured fibrous cap on MRI, gross, and histological sections. Thirty-six sites were available f or comparison between MRI and histology. There was a high level of agreemen t between MRI and histological findings: 89% agreement, kappa (95% CI) = 0. 83 (0.67 to 1.0), weighted kappa = 0.87. Spearman's correlation coefficient was 0.88 (significant to the 0.01 level). Conclusions-These findings indicate that high-resolution MRI with a 3-dimen sional multiple overlapping thin slab angiography protocol is capable of di stinguishing intact, thick fibrous caps from intact thin and disrupted caps in atherosclerotic human carotid arteries in vivo. This noninvasive techni que has the potential to permit studies that examine the relationship betwe en fibrous cap changes and clinical outcome and to permit trials that evalu ate therapy intended to "stabilize" the fibrous cap.