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(Circulation. 1996;94:932-938.)
© 1996 American Heart Association, Inc.


Articles

Magnetic Resonance Images Lipid, Fibrous, Calcified, Hemorrhagic, and Thrombotic Components of Human Atherosclerosis In Vivo

Jean-Francois Toussaint, MD, PhD; Glenn M. LaMuraglia, MD, PhD; James F. Southern, MD, PhD; Valentin Fuster, MD, PhD; Howard L. Kantor, MD, PhD

Service de Cardiologie, Hopital Cochin, Paris, Service Hospitalier Frederic Joliot, CEA, Orsay, France (J-F.T.); the Cardiac Unit and NMR Center (J-F.T., H.L.K.), Division of Vascular Surgery (G.M.LaM.), and Pathology Department (J.F.S.), Massachusetts General Hospital, Boston; and the Cardiovascular Institute, Mount Sinai Medical Center, New York, NY (V.F.).

Correspondence to J.F. Toussaint, MD, PhD, Service Hospitalier Frederic Joliot, Groupe de RMN, CEA, 4 Place du General Leclerc, 91401 Orsay, Cedex, France. E-mail toussain@uriens.shfj.cea.fr.

Background Although MRI can discriminate the lipid core from the collagenous cap of atherosclerotic lesions in vitro with T2 contrast, it has not yet produced detailed in vivo images of these human plaque components.

Methods and Results We imaged seven lesions from six patients who required surgical carotid endarterectomy and calculated T2 in vivo before surgery in various plaque regions. Using the same acquisition parameters, we repeated these measurements in vitro on the resected fragment and compared MR images with histology. T2 values calculated in vivo correlate with in vitro measurements for each plaque component; the in vitro discrimination we demonstrated previously with T2 contrast can therefore be performed similarly in vivo.

Conclusions MRI is the first noninvasive imaging technique that allows the discrimination of lipid cores, fibrous caps, calcifications, normal media, and adventitia in human atheromatous plaques in vivo. This technique also characterizes intraplaque hemorrhage and acute thrombosis. This result may support further investigations that include MRI of plaque progression, stabilization, and rupture in human atherosclerosis.


Key Words: magnetic resonance imaging • lipids • fibrous cap • thrombosis • carotid arteries




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RadiologyHome page
B. A. Wasserman, W. I. Smith, H. H. Trout III, R. O. Cannon III, R. S. Balaban, and A. E. Arai
Carotid Artery Atherosclerosis: In Vivo Morphologic Characterization with Gadolinium-enhanced Double-oblique MR Imaging—Initial Results
Radiology, May 1, 2002; 223(2): 566 - 573.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
J. Wang, Y.-J. Geng, B. Guo, T. Klima, B. N. Lal, J. T. Willerson, and W. Casscells
Near-infrared spectroscopic characterization of human advanced atherosclerotic plaques
J. Am. Coll. Cardiol., April 17, 2002; 39(8): 1305 - 1313.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
R. Corti, J. I. Osende, Z. A. Fayad, J. T. Fallon, V. Fuster, G. Mizsei, E. Dickstein, B. Drayer, and J. J. Badimon
In vivo noninvasive detection and age definition of arterial thrombus by MRI
J. Am. Coll. Cardiol., April 17, 2002; 39(8): 1366 - 1373.
[Abstract] [Full Text] [PDF]


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StrokeHome page
L. J. Walker, A. Ismail, W. McMeekin, D. Lambert, A. D. Mendelow, and D. Birchall
Computed Tomography Angiography for the Evaluation of Carotid Atherosclerotic Plaque: Correlation With Histopathology of Endarterectomy Specimens
Stroke, April 1, 2002; 33(4): 977 - 981.
[Abstract] [Full Text] [PDF]


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Eur Heart JHome page
C. Di Mario
Vulnerable plaques: let's stop sinking on submerged icebergs?
Eur. Heart J., March 1, 2002; 23(5): 349 - 351.
[Full Text] [PDF]


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ANGIOLOGYHome page
H. Ohyama, K. Mizushige, T. Takahashi, N. Hosomi, and M. Kohno
Plaque Rupture on the Carotid Artery Observed by Doppler Ultrasonography: A Case Report
Angiology, December 1, 2001; 52(12): 867 - 869.
[Abstract] [PDF]


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StrokeHome page
B. D. Coombs, J. H. Rapp, P. C. Ursell, L. M. Reilly, and D. Saloner
Structure of Plaque at Carotid Bifurcation: High-Resolution MRI With Histological Correlation
Stroke, November 1, 2001; 32(11): 2516 - 2521.
[Abstract] [Full Text] [PDF]


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CirculationHome page
C. Yuan, L. M. Mitsumori, M. S. Ferguson, N. L. Polissar, D. Echelard, G. Ortiz, R. Small, J. W. Davies, W. S. Kerwin, and T. S. Hatsukami
In Vivo Accuracy of Multispectral Magnetic Resonance Imaging for Identifying Lipid-Rich Necrotic Cores and Intraplaque Hemorrhage in Advanced Human Carotid Plaques
Circulation, October 23, 2001; 104(17): 2051 - 2056.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
X.-Q. Zhao, C. Yuan, T. S. Hatsukami, E. H. Frechette, X.-J. Kang, K. R. Maravilla, and B. G. Brown
Effects of Prolonged Intensive Lipid-Lowering Therapy on the Characteristics of Carotid Atherosclerotic Plaques In Vivo by MRI: A Case-Control Study
Arterioscler Thromb Vasc Biol, October 1, 2001; 21(10): 1623 - 1629.
[Abstract] [Full Text] [PDF]


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Circ. Res.Home page
S. M. Schwartz, T. S. Hatsukami, and C. Yuan
Molecular Markers, Fibrous Cap Rupture, and the Vulnerable Plaque: New Experimental Opportunities
Circ. Res., September 14, 2001; 89(6): 471 - 473.
[Full Text] [PDF]


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CirculationHome page
S. Flacke, S. Fischer, M. J. Scott, R. J. Fuhrhop, J. S. Allen, M. McLean, P. Winter, G. A. Sicard, P. J. Gaffney, S. A. Wickline, et al.
Novel MRI Contrast Agent for Molecular Imaging of Fibrin: Implications for Detecting Vulnerable Plaques
Circulation, September 11, 2001; 104(11): 1280 - 1285.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
M. T. Johnstone, R. M. Botnar, A. S. Perez, R. Stewart, W. C. Quist, J. A. Hamilton, and W. J. Manning
In Vivo Magnetic Resonance Imaging of Experimental Thrombosis in a Rabbit Model
Arterioscler Thromb Vasc Biol, September 1, 2001; 21(9): 1556 - 1560.
[Abstract] [Full Text] [PDF]


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Circ. Res.Home page
Z. A. Fayad and V. Fuster
Clinical Imaging of the High-Risk or Vulnerable Atherosclerotic Plaque
Circ. Res., August 17, 2001; 89(4): 305 - 316.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
M. Kawasaki, H. Takatsu, T. Noda, Y. Ito, A. Kunishima, M. Arai, K. Nishigaki, G. Takemura, N. Morita, S. Minatoguchi, et al.
Noninvasive quantitative tissue characterization and two-dimensional color-coded map of human atherosclerotic lesions using ultrasound integrated backscatter: Comparison between histology and integrated backscatter images
J. Am. Coll. Cardiol., August 1, 2001; 38(2): 486 - 492.
[Abstract] [Full Text] [PDF]


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CirculationHome page
R. Corti, Z. A. Fayad, V. Fuster, S. G. Worthley, G. Helft, J. Chesebro, M. Mercuri, and J. J. Badimon
Effects of Lipid-Lowering by Simvastatin on Human Atherosclerotic Lesions: A Longitudinal Study by High-Resolution, Noninvasive Magnetic Resonance Imaging
Circulation, July 17, 2001; 104(3): 249 - 252.
[Abstract] [Full Text] [PDF]


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CirculationHome page
M.-L. M. Gronholdt, B. G. Nordestgaard, T. V. Schroeder, S. Vorstrup, and H. Sillesen
Ultrasonic Echolucent Carotid Plaques Predict Future Strokes
Circulation, July 3, 2001; 104(1): 68 - 73.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
K. A. Shunk, J.e. Garot, E. Atalar, and J. A. C. Lima
Transesophageal magnetic resonance imaging of the aortic arch and descending thoracic aorta in patients with aortic atherosclerosis
J. Am. Coll. Cardiol., June 15, 2001; 37(8): 2031 - 2035.
[Abstract] [Full Text] [PDF]


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StrokeHome page
K. J. Hunt, G. W. Evans, A. R. Folsom, A. R. Sharrett, L. E. Chambless, C. H. Tegeler, and G. Heiss
Acoustic Shadowing on B-Mode Ultrasound of the Carotid Artery Predicts Ischemic Stroke : The Atherosclerosis Risk in Communities (ARIC) Study
Stroke, May 1, 2001; 32(5): 1120 - 1126.
[Abstract] [Full Text] [PDF]


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RadiologyHome page
M. Stuber, R. M. Botnar, K. V. Kissinger, and W. J. Manning
Free-Breathing Black-Blood Coronary MR Angiography: Initial Results
Radiology, April 1, 2001; 219(1): 278 - 283.
[Abstract] [Full Text]


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J Am Coll CardiolHome page
G.e. Helft, S. G. Worthley, V. Fuster, A. G. Zaman, C. Schechter, J. I. Osende, O. J. Rodriguez, Z. A. Fayad, J. T. Fallon, and J. J. Badimon
Atherosclerotic aortic component quantification by noninvasive magnetic resonance imaging: an in vivo study in rabbits
J. Am. Coll. Cardiol., March 15, 2001; 37(4): 1149 - 1154.
[Abstract] [Full Text] [PDF]


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CirculationHome page
S. G. Ruehm, C. Corot, P. Vogt, S. Kolb, and J. F. Debatin
Magnetic Resonance Imaging of Atherosclerotic Plaque With Ultrasmall Superparamagnetic Particles of Iron Oxide in Hyperlipidemic Rabbits
Circulation, January 23, 2001; 103(3): 415 - 422.
[Abstract] [Full Text] [PDF]


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CirculationHome page
R. M. Botnar, M. Stuber, K. V. Kissinger, W. Y. Kim, E. Spuentrup, and W. J. Manning
Noninvasive Coronary Vessel Wall and Plaque Imaging With Magnetic Resonance Imaging
Circulation, November 21, 2000; 102(21): 2582 - 2587.
[Abstract] [Full Text] [PDF]


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RadiologyHome page
X. Yang and E. Atalar
Intravascular MR Imaging-guided Balloon Angioplasty With an MR Imaging Guide Wire: Feasibility Study in Rabbits
Radiology, November 1, 2000; 217(2): 501 - 506.
[Abstract] [Full Text]


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CirculationHome page
T. S. Hatsukami, R. Ross, N. L. Polissar, and C. Yuan
Visualization of Fibrous Cap Thickness and Rupture in Human Atherosclerotic Carotid Plaque In Vivo With High-Resolution Magnetic Resonance Imaging
Circulation, August 29, 2000; 102(9): 959 - 964.
[Abstract] [Full Text] [PDF]


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CirculationHome page
Z. A. Fayad, V. Fuster, J. T. Fallon, T. Jayasundera, S. G. Worthley, G. Helft, J. G. Aguinaldo, J. J. Badimon, and S. K. Sharma
Noninvasive In Vivo Human Coronary Artery Lumen and Wall Imaging Using Black-Blood Magnetic Resonance Imaging
Circulation, August 1, 2000; 102(5): 506 - 510.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
G. Pasterkamp, E. Falk, H. Woutman, and C. Borst
Techniques characterizing the coronary atherosclerotic plaque: influence on clinical decision making?
J. Am. Coll. Cardiol., July 1, 2000; 36(1): 13 - 21.
[Abstract] [Full Text] [PDF]


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VASC ENDOVASCULAR SURGHome page
B. Axisa, A. R. Naylor, N. London, P. R. F. Bell, and M. M. Thompson
The Influence of Carotid Plaque Morphology on the Development of Cerebral Symptoms
Vascular and Endovascular Surgery, July 1, 2000; 34(4): 309 - 318.
[Abstract] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
W. J. Rogers, J. W. Prichard, Y.-L. Hu, P. R. Olson, D. H. Benckart, C. M. Kramer, D. A. Vido, and N. Reichek
Characterization of Signal Properties in Atherosclerotic Plaque Components by Intravascular MRI
Arterioscler Thromb Vasc Biol, July 1, 2000; 20(7): 1824 - 1830.
[Abstract] [Full Text] [PDF]


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CirculationHome page
S. G. Worthley, G. Helft, V. Fuster, Z. A. Fayad, O. J. Rodriguez, A. G. Zaman, J. T. Fallon, and J. J. Badimon
Noninvasive In Vivo Magnetic Resonance Imaging of Experimental Coronary Artery Lesions in a Porcine Model
Circulation, June 27, 2000; 101(25): 2956 - 2961.
[Abstract] [Full Text] [PDF]


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CirculationHome page
Z. A. Fayad, T. Nahar, J. T. Fallon, M. Goldman, J. G. Aguinaldo, J. J. Badimon, M. Shinnar, J. H. Chesebro, and V. Fuster
In Vivo Magnetic Resonance Evaluation of Atherosclerotic Plaques in the Human Thoracic Aorta : A Comparison With Transesophageal Echocardiography
Circulation, May 30, 2000; 101(21): 2503 - 2509.
[Abstract] [Full Text] [PDF]


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Eur Heart JHome page
R Erbel, A Schmermund, S Mohlenkamp, S Sack, and D Baumgart
Electron-beam computed tomography for detection of early signs of coronary arteriosclerosis
Eur. Heart J., May 1, 2000; 21(9): 720 - 732.
[PDF]


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Am. J. Roentgenol.Home page
P. A. Tunick, G. A. Krinsky, V. S. Lee, and I. Kronzon
Diagnostic Imaging of Thoracic Aortic Atherosclerosis
Am. J. Roentgenol., April 1, 2000; 174(4): 1119 - 1125.
[Full Text] [PDF]


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LupusHome page
S Manzi, L H Kuller, D Edmundowicz, and K Sutton-Tyrrell
Vascular imaging: changing the face of cardiovascular research
Lupus, March 1, 2000; 9(3): 176 - 182.
[Abstract] [PDF]


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Am. J. Neuroradiol.Home page
S. Aoki, H. Nakajima, H. Kumagai, and T. Araki
Dynamic Contrast-Enhanced MR Angiography and MR Imaging of the Carotid Artery: High-Resolution Sequences in Different Acquisition Planes
AJNR Am. J. Neuroradiol., February 1, 2000; 21(2): 381 - 385.
[Abstract] [Full Text]


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HeartHome page
R A Coulden, H Moss, M J Graves, D J Lomas, D S Appleton, and P L Weissberg
High resolution magnetic resonance imaging of atherosclerosis and the response to balloon angioplasty
Heart, February 1, 2000; 83(2): 188 - 191.
[Abstract] [Full Text]