Department of Radiology, The General Hospital of Chinese People's Armed Police Forces, Beijing, China.
AJR Am J Roentgenol. 2012 May;198(5):1069-75. doi: 10.2214/AJR.11.6496.
The objective of our study was to evaluate the feasibility of ex vivo high-resolution multicontrast-weighted MRI to accurately classify human coronary atherosclerotic plaques according to the American Heart Association classification.
Thirteen human cadaver heart specimens were imaged using high-resolution multicontrast-weighted MR technique (T1-weighted, proton density-weighted, and T2-weighted). All MR images were matched with histopathologic sections according to the landmark of the bifurcation of the left main coronary artery. The sensitivity and specificity of MRI for the classification of plaques were determined, and Cohen's kappa analysis was applied to evaluate the agreement between MRI and histopathology in the classification of atherosclerotic plaques.
One hundred eleven MR cross-sectional images obtained perpendicular to the long axis of the proximal left anterior descending artery were successfully matched with the histopathologic sections. For the classification of plaques, the sensitivity and specificity of MRI were as follows: type I-II (near normal), 60% and 100%; type III (focal lipid pool), 80% and 100%; type IV-V (lipid, necrosis, fibrosis), 96.2% and 88.2%; type VI (hemorrhage), 100% and 99.0%; type VII (calcification), 93% and 100%; and type VIII (fibrosis without lipid core), 100% and 99.1%, respectively. Isointensity, which indicates lipid composition on histopathology, was detected on MRI in 48.8% of calcified plaques. Agreement between MRI and histopathology for plaque classification was 0.86 (p < 0.001).
Ex vivo high-resolution multicontrast-weighted MRI can accurately classify advanced atherosclerotic plaques in human coronary arteries.
本研究旨在评估离体高分辨率多对比加权 MRI 准确分类人类冠状动脉粥样硬化斑块的可行性，依据美国心脏协会（AHA）分类。
使用高分辨率多对比加权 MR 技术（T1 加权、质子密度加权和 T2 加权）对 13 个人体心脏标本进行成像。所有 MR 图像均根据左主干冠状动脉分叉的标志与组织病理学切片匹配。确定 MRI 对斑块分类的灵敏度和特异性，并应用 Cohen's kappa 分析评估 MRI 和组织病理学在动脉粥样硬化斑块分类中的一致性。
成功匹配 111 个垂直于左前降支近端长轴的 MR 横断面图像与组织病理学切片。对于斑块分类，MRI 的灵敏度和特异性如下：I 型-II 型（接近正常），60%和 100%；III 型（局灶性脂质池），80%和 100%；IV-V 型（脂质、坏死、纤维化），96.2%和 88.2%；VI 型（出血），100%和 99.0%；VII 型（钙化），93%和 100%；和 VIII 型（无脂质核心纤维化），100%和 99.1%。组织病理学上显示脂质成分的等信号强度在 48.8%的钙化斑块中在 MRI 上被检测到。MRI 和组织病理学对斑块分类的一致性为 0.86（p<0.001）。
离体高分辨率多对比加权 MRI 可准确分类人类冠状动脉中的晚期动脉粥样硬化斑块。
