Department of Diagnostic Radiology, Technische Universitaet Muenchen, Ismaninger Str. 22, 81675, Munich, Germany.
Int J Cardiovasc Imaging. 2011 Jul;27(6):901-12. doi: 10.1007/s10554-010-9736-7. Epub 2010 Oct 24.
To evaluate ultra small superparamagnetic iron oxide particles (USPIO) enhanced magnetic resonance (MR) imaging for characterization of atherosclerotic carotid plaques by assessing vascularity and plaque inflammation, besides contrast-enhanced MR angiography (CE-MRA) of the carotid artery stenosis. Twelve patients with severe carotid artery stenosis, scheduled for endarterectomy, underwent MRI of the carotid artery bifurcation using SHU 555 C at a dose of 40 μmol Fe/kg BW. The MR imaging protocol comprised pre- and post-contrast T2*-w, a first-pass CE-MRA and dynamic T1-w sequences. For quantitative data analysis, the signal intensities (SI) were measured and SNR-data (SNR = SI(blood/plaque/bone marrow)/standard deviation(noise)) as well as ΔSI-data (SNR(post)-SNR(pre)) were calculated. In addition, two radiologists rated the diagnostic performance of first-pass MRA according to a four level decision scale. Staining of anti-dextran (SHU 555 C) and anti-CD68 (macrophages) was performed for immunohistological confirmation. Plaque sections with a T2*-w signal decline (intracellular USPIO accumulation in macrophages) showed significantly changes (mean -14%, 95% CI, -5 to -20%; P < 0.01) and corresponding plaque regions had significantly higher (15.15 ± 1.76 vs. 5.22 ± 1.50; P < 0.01) T1-w enhancement data (global estimation of vascularity). The first-pass MRA of the supra-aortal vessels provided images of diagnostic quality. Representative immunohistology sections revealed colocalization of dextran- and CD68-immunoreactive cells. USPIO-enhanced MRI is feasible for in vivo assessment of vascularity and macrophage content in atherosclerotic carotid plaques, determining an association of these potential imaging biomarkers of plaque vulnerability. Diagnostic MRA of the supra-aortal vessels can be imaged additionally with a single administration of SHU 555 C.
评估超小超顺磁性氧化铁颗粒 (USPIO) 增强磁共振成像 (MR) 通过评估血管生成和斑块炎症对动脉粥样硬化颈动脉斑块的特征，除了颈动脉狭窄的对比增强磁共振血管造影 (CE-MRA)。12 名严重颈动脉狭窄患者，计划行颈动脉内膜切除术，接受了剂量为 40 μmol Fe/kg BW 的 SHU 555 C 的颈动脉分叉磁共振成像。MR 成像方案包括对比前和对比后 T2*-w、第一通过 CE-MRA 和动态 T1-w 序列。为了进行定量数据分析，测量了信号强度 (SI)，并计算了 SNR 数据 (SNR=SI(血液/斑块/骨髓)/标准偏差(噪声)) 和 ΔSI 数据 (SNR(post)-SNR(pre))。此外，两名放射科医生根据四级决策量表评估了第一通过 MRA 的诊断性能。进行了抗葡聚糖 (SHU 555 C) 和抗 CD68 (巨噬细胞) 染色以进行免疫组织化学确认。具有 T2*-w 信号下降 (细胞内 USPIO 积累在巨噬细胞中) 的斑块切片显示出明显的变化 (平均值 -14%，95%CI，-5 至-20%；P<0.01)，并且相应的斑块区域具有明显更高的 T1-w 增强数据 (血管化的全局估计值) (15.15±1.76 与 5.22±1.50；P<0.01)。主动脉以上血管的第一通过 MRA 提供了具有诊断质量的图像。代表性的免疫组织学切片显示了葡聚糖和 CD68 免疫反应性细胞的共定位。USPIO 增强 MRI 可行用于体内评估动脉粥样硬化颈动脉斑块的血管生成和巨噬细胞含量，确定这些斑块易损性的潜在成像生物标志物之间的关联。主动脉以上血管的诊断性 MRA 可以通过单次给予 SHU 555 C 来额外成像。
