Abstract 12364: Hyperintense Coronary Plaque with Non-Contrast T1-Weighted Magnetic Resonance Imaging Indicates Positive Remodeling, Remarkable Low CT Density, and High Incidence of Spotty Calcification
Background: Our prior study has demonstrated that the presence of a coronary hyperintense plaque (HIP) on non-contrast T1-weighted (T1W) magnetic resonance imaging is associated with positive coronary artery remodeling, low plaque density on computed tomography (CT), and plaque attenuation on intracoronary ultrasound in a small number of patients with angina pectoris. We aimed to confirm these findings in a larger number of patients with a wider spectrum of coronary artery disease (CAD).
Method: Two hundreds sixty-seven lesions from 175 consecutive CAD patients (71 with acute coronary syndrome and 104 with stable CAD) who demonstrated > 50% coronary stenosis on CT angiography were evaluated by non-contrast T1WI using a 1.5-T MR imager. Signal intensity of coronary plaque to cardiac muscle ratio (PMR) > 1.0 was defined as HIP (Fig. A). We divided 267 lesions into the two groups, according to the presence or absence of HIP, i.e., HIP (n=171) and non-HIP (n=96) groups.
Results: In comparison with the non-HIP group, the HIP group demonstrated significantly higher PMR (1.6 ± 0.7 vs. 0.8 ± 0.2, p < 0.01), higher frequency of positive remodeling as observed by CT (91% vs. 2%, p < 0.0001), and higher frequency of spotty calcification (89 % vs. 34 %, p < 0.0001) (Fig. B). The HIP group also exhibited a significantly lower CT density (−21.7 ± 16.7 HU vs. 12.3 ± 11.5 HU, p < 0.01). In addition, PMR of HIP lesions in ACS patients was significantly higher than those in stable CAD patients (2.7 ± 0.4 vs. 1.7 ± 0.6, p < 0.05).
Conclusion: HIP in the coronary artery indicates positive remodeling, remarkable low CT density, and high incidence of spotty calcification. Non-contrast T1WI may be useful for the assessment of coronary plaque characterization in patients with CAD.
- © 2011 by American Heart Association, Inc.