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J Am Coll Cardiol, 2001; 37:2031-2035 © 2001 by the American College of Cardiology Foundation |
* Division of Cardiology of the Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Manuscript received December 31, 2000; revised manuscript received February 27, 2001, accepted March 14, 2001.
Reprint requests and correspondence: Dr. João A. C. Lima, Division of Cardiology, Blalock 569, The Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, Maryland 21287-6568
jlima{at}mri.jhu.edu
OBJECTIVES
We sought to determine the feasibility and potential of transesophageal magnetic resonance imaging (TEMRI) for quantifying atherosclerotic plaque burden in the aortic arch and descending thoracic aorta in comparison with transesophageal echocardiography (TEE).
BACKGROUND
Improved morphologic assessment of atherosclerotic plaque features in vivo is of interest because of the potential for improved understanding of the pathophysiology of plaque vulnerability to rupture and progression to clinical events. Magnetic resonance imaging (MRI) is well suited for atherosclerotic plaque imaging. Performing MRI using a radio frequency (RF) receiver probe placed near the region of interest improves the signal-to-noise ratio (SNR).
METHODS
High-resolution images of the thoracic aortic wall were obtained by TEMRI in 22 subjects (8 normals, 14 with aortic atherosclerosis). In nine subjects, we compared aortic wall thickness and circumferential extent of atherosclerotic plaque measured by TEMRI versus TEE using a Bland-Altman analysis. Additional studies were performed in a human cadaver with pathology as an independent gold standard for assessment of atherosclerosis.
RESULTS
In clinical and experimental studies, we found similar measurements for aortic plaque thickness but a relative underestimation of circumferential extent of atherosclerosis by TEE (p = 0.001), due in large part to the lower SNR in the near field.
CONCLUSIONS
Using TEMRI allows for quantitative assessment of thoracic aortic atherosclerotic plaque burden. This technique provides good SNR in the near field, which makes it a promising approach for detailed characterization of aortic plaque burden.
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