Abstract 11191: Coronary Hyperintense Plaques Detected by Cardiac Magnetic Resonance Related to Atherosclerotic Plaque Components but Not to Intraluminal Thrombus; Imaging Evaluation Cooperative with Optical Coherence Tomography

Abstract

Background: It remains unsettled whether coronary hyperintense plaques (HIPs) detected by non-contrast T1 weighted imaging (T1WI) reflect intra-luminal thrombosis or atherosclerotic plaque components in patients with coronary artery disease. To address this issue, we have focused on stable effort angina pectoris (EAP) in whom the pathological role of intraluminal thrombosis is likely to be minimized.

Methods: We examined the signal intensity of coronary plaques in 55 lesions from 20 patients with stable EAP using non-contrast T1WI on cardiac magnetic resonance (CMR), muti-detector row computed tomography (MDCT), optical coherence tomography (OCT) imaging, and coronary angiography (CAG). All patients underwent T1WI and MDCT within 24 hours of coronary intervention, and pre-interventional OCT was performed for HIP and non-HIP lesions. HIP was defined as present when the signal intensity of plaque to myocardium ratio (PMR) was greater than 1.0.

Results: Of the 55 lesions studied, 67% were HIPs and 33% were non-HIPs. There were no significant differences in prevalence of plaque rupture and calcification between the HIP and non-HIP groups. In the HIP group, no intraluminal thrombosis was detected by OCT and the frequency of lipid-rich core and thin-cap fibroatheroma were significantly higher than those in the non-HIP group (89% vs. 21%, P<0.001, 83% vs. 5%, P<0.0001, respectively).

Conclusions: The present cooperative imaging analysis of EAP patients demonstrates that HIPs are more likely to be related to coronary plaques composed of lipid-rich core than intraluminal thrombosis.