Ehara Shoichi, Matsumoto Kenji, Shimada Kenei
Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan.
Int J Mol Sci. 2016 Jul 21;17(7):1187. doi: 10.3390/ijms17071187.
Over the past several decades, significant progress has been made in the pathohistological assessment of vulnerable plaques and in invasive intravascular imaging techniques. However, the assessment of plaque morphology by invasive modalities is of limited value for the detection of subclinical coronary atherosclerosis and the subsequent prediction or prevention of acute cardiovascular events. Recently, magnetic resonance (MR) imaging technology has reached a sufficient level of spatial resolution, which allowed the plaque visualization of large and static arteries such as the carotids and aorta. However, coronary wall imaging by MR is still challenging due to the small size of coronary arteries, cardiac and respiratory motion, and the low contrast-to-noise ratio between the coronary artery wall and the surrounding structures. Following the introduction of carotid plaque imaging with noncontrast T1-weighted imaging (T1WI), some investigators have reported that coronary artery high-intensity signals on T1WI are associated with vulnerable plaque morphology and an increased risk of future cardiac events. Although there are several limitations and issues that need to be resolved, this novel MR technique for coronary plaque imaging could influence treatment strategies for atherothrombotic disease and may be useful for understanding the pathophysiological mechanisms of atherothrombotic plaque formation.
在过去几十年里，在易损斑块的病理组织学评估和侵入性血管内成像技术方面取得了重大进展。然而，通过侵入性方式评估斑块形态对于检测亚临床冠状动脉粥样硬化以及随后预测或预防急性心血管事件的价值有限。最近，磁共振（MR）成像技术已达到足够的空间分辨率水平，这使得能够对诸如颈动脉和主动脉等大型静态动脉的斑块进行可视化。然而，由于冠状动脉尺寸小、心脏和呼吸运动以及冠状动脉壁与周围结构之间的低对比度噪声比，通过MR进行冠状动脉壁成像仍然具有挑战性。在引入非对比T1加权成像（T1WI）进行颈动脉斑块成像后，一些研究人员报告称，T1WI上的冠状动脉高强度信号与易损斑块形态以及未来心脏事件风险增加有关。尽管存在一些需要解决的局限性和问题，但这种用于冠状动脉斑块成像的新型MR技术可能会影响动脉粥样硬化血栓形成疾病的治疗策略，并且可能有助于理解动脉粥样硬化血栓形成斑块形成的病理生理机制。
