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Role of Magnetic Resonance and Intravascular Magnetic Resonance in the Detection of Vulnerable Plaques

Robert L. Wilensky, MD^_*,a,_*, Hee Kwon Song, PhD and Victor A. Ferrari, MD^_*,,b

^_* Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

Manuscript received June 16, 2005; revised manuscript received November 8, 2005, accepted November 12, 2005.

^_* Reprint requests and correspondence: Dr. Robert L. Wilensky, Hospital of the University of Pennsylvania, 3400 Spruce Street, 9 Gates, Philadelphia, Pennsylvania 19104. (Email: Robert.Wilensky{at}uphs.upenn.edu).

Noninvasive magnetic resonance imaging (MRI) has been used to determine vascular three-dimensional structure, detect the presence of subclinical atherosclerotic disease in high-risk patient subgroups, and optimize and follow therapy in individual patients. The outstanding soft-tissue–characterizing capabilities of MRI permit depiction of various components of atherothrombotic plaque, including lipid, fibrous tissue, calcium, and thrombus formation. However, noninvasive MRI visualization of coronary arteries is currently limited by the small size of the coronary arteries, the deep arterial location, and arterial motion. The combination of MR imaging and molecular probes offers exciting possibilities of direct visualization of biologic processes within atherosclerotic tissue. The self-contained intravascular MRI probe appears to hold promise in the identification of high-risk coronary atherosclerotic lesions with increased superficial lipid content.

Abbreviations and Acronyms   HDL = high-density lipoprotein   IVMRI = intravascular magnetic resonance imaging   LDL = low-density lipoprotein   MRI = magnetic resonance imaging   PD = proton density   RF = radiofrequency   SNR = signal-to-noise ratio   TE-MRI = transesophageal magnetic resonance imaging   TOF = time of flight   USPIO = ultra-small particles of iron oxide

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