Okamura Homare, Pisani Laura J, Dalal Alex R, Emrich Fabian, Dake Benjamin A, Arakawa Mamoru, Onthank David C, Cesati Richard R, Robinson Simon P, Milanesi Matteo, Kotek Gyula, Smit Henk, Connolly Andrew J, Adachi Hideo, McConnell Michael V, Fischbein Michael P
From the Departments of Cardiothoracic Surgery (H.O., A.R.D., F.E., B.A.D., M.A., M.P.F.), Radiology (L.J.P.), and Pathology (A.J.C.), Stanford University, CA; Department of Cardiovascular Surgery, Jichi Medical University, Saitama Medical Center, Saitama, Japan (H.O., M.A., H.A.); Lantheus Medical Imaging, North Billerica, MA (D.C.O., R.R.C., S.P.R.); Agilent Technologies, Yarnton, Oxford, United Kingdom (M.M.); Departments of Radiology (G.K.) and Medical Informatics and Radiology (H.S.), Erasmus MC, Rotterdam, The Netherlands; and Division of Cardiovascular Medicine, Stanford University, CA (M.V.M.).
Circ Cardiovasc Imaging. 2014 Jul;7(4):690-6. doi: 10.1161/CIRCIMAGING.114.001658. Epub 2014 May 9.
Ascending aortic dissection and rupture remain a life-threatening complication in patients with Marfan syndrome. The extracellular matrix provides strength and elastic recoil to the aortic wall, thereby preventing radial expansion. We have previously shown that ascending aortic aneurysm formation in Marfan mice (Fbn1(C1039G/+)) is associated with decreased aortic wall elastogenesis and increased elastin breakdown. In this study, we test the feasibility of quantifying aortic wall elastin content using MRI with a gadolinium-based elastin-specific magnetic resonance contrast agent in Fbn1(C1039G/+) mice.
Ascending aorta elastin content was measured in 32-week-old Fbn1(C1039G/+) mice and wild-type (n=9 and n=10, respectively) using 7-T MRI with a T1 mapping sequence. Significantly lower enhancement (ie, lower R1 values, where R1=1/T1) was detected post-elastin-specific magnetic resonance contrast agent in Fbn1(C1039G/+) compared with wild-type ascending aortas (1.15±0.07 versus 1.36±0.05; P<0.05). Post-elastin-specific magnetic resonance contrast agent R1 values correlated with ascending aortic wall gadolinium content directly measured by inductively coupled mass spectroscopy (P=0.006).
Herein, we demonstrate that MRI with elastin-specific magnetic resonance contrast agent accurately measures elastin bound gadolinium within the aortic wall and detects a decrease in aortic wall elastin in Marfan mice compared with wild-type controls. This approach has translational potential for noninvasively assessing aneurysm tissue changes and risk, as well as monitoring elastin content in response to therapeutic interventions.
升主动脉夹层和破裂仍然是马凡综合征患者危及生命的并发症。细胞外基质为主动脉壁提供强度和弹性回缩力,从而防止径向扩张。我们之前已经表明,马凡小鼠(Fbn1(C1039G/+))升主动脉瘤的形成与主动脉壁弹性生成减少和弹性蛋白分解增加有关。在本研究中,我们测试了使用基于钆的弹性蛋白特异性磁共振造影剂通过MRI定量Fbn1(C1039G/+)小鼠主动脉壁弹性蛋白含量的可行性。
使用具有T1映射序列的7-T MRI测量32周龄Fbn1(C1039G/+)小鼠和野生型小鼠(分别为n = 9和n = 10)的升主动脉弹性蛋白含量。与野生型升主动脉相比,Fbn1(C1039G/+)小鼠在注射弹性蛋白特异性磁共振造影剂后检测到明显较低的增强(即较低的R1值,其中R1 = 1/T1)(1.15±0.07对1.36±0.05;P<0.05)。注射弹性蛋白特异性磁共振造影剂后的R1值与通过电感耦合质谱直接测量的升主动脉壁钆含量相关(P = 0.006)。
在此,我们证明使用弹性蛋白特异性磁共振造影剂的MRI能够准确测量主动脉壁内与弹性蛋白结合的钆,并检测到与野生型对照相比马凡小鼠主动脉壁弹性蛋白的减少。这种方法具有转化潜力,可用于无创评估动脉瘤组织变化和风险,以及监测弹性蛋白含量以响应治疗干预。