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1. MR Imaging of Atherosclerosis:MR Imaging of Atherosclerosis:
The Seattle ExperienceThe Seattle Experience
University of Washington
Chun Yuan, Ph.D.
Thomas S. Hatsukami, M.D.
3. The First High Resolution CarotidThe First High Resolution Carotid
ImagingImaging by a 3T MRIby a 3T MRI
Fine structures like plaque cap now can be imaged.
May 2003
4. 1.5 T; 2 NEX; resolution 0.63x0.63 mm 3 T; 2 NEX; resolution 0.63x0.63 mm
3 T; 1 NEX; resolution 0.27x0.55 mm1.5 T; 1 NEX; resolution 0.27x0.55 mm
Comparing 1.5 and 3TComparing 1.5 and 3T
without Software Enhancementwithout Software Enhancement
GE 3T and 1.5T Scanners with Identical Phased-array Design
11. Blood Vessel Volume MeasurementBlood Vessel Volume Measurement
• Precision of MRI
for Measuring
Plaque Volume
• 3.8 – 4.6% for T1W,
PDW, & T2W imaging
• Possible to detect a >
13% change in plaque
volume with 95%
confidence
• IQ – most important
factor
13. MRI Based Lesion TypeMRI Based Lesion Type
TOF T1WI
PDWI T2WI
H&E
Type VIII: Fibrous Lesion
14. Fibrous Cap CharacteristicsFibrous Cap Characteristics
Gross
Specimen
Masson’s
Trichrome
In Vivo 3D-MOTSA Image
1 32
3
1 = Fibrous Cap Rupture
2 = Intraplaque Hemorrhage
3 = Thick Fibrous Cap
Thick fibrous cap appears as dark band
between lumen and plaque core.
Recent plaque hemorrhage appears
hyperintense.
15. Risk of Symptoms by Cap Status onRisk of Symptoms by Cap Status on
MRIMRI
95% CI
3, 210
1, 104
---
23
10
1
OR for Sx
70%
50%
9%
% w/ Sx
Ruptured Cap
Thin Cap
Thick Cap
Cap Status
p = 0.001 Mann-Whitney test for cap status vs. symptoms
16. DCE-MRI ProtocolDCE-MRI Protocol
• MRI: 2DSPGR (TR / TE = 100 / 3.5 msec)
• Contrast agent: 20 ml Omniscan (Gadolinium-based)
administered at 2ml/sec
time
~15 sec
Dynamic
MRI
Contrast injection
Pre-contrast
MRI
Post-contrast
MRI
t = 1 t = nt = 3t = 2
...
17. DCE- Kinetic Model ResultsDCE- Kinetic Model Results
0
5
10
15
20
25
30
0 0.5 1 1.5 2 2.5 3
fVA (%) by histology
fBV(%)byMRI
R = 0.80
p < 0.001
19. Grant support provided by: NIH
and AstraZeneca
Pharmaceuticals, Pfizer, and
Esperion Therapeutics
vil.rad.washington.edu
Department of Radiology
Niranjan Balu Tobias Saam
Baocheng Chu Dongxiang Xu
William S. Kerwin Annette Kampshulte
Zachary E. Miller Vasily Yarnykh
Department of Pathology
Russell Ross Steve Schwartz
Randy Small Marina S. Ferguson
Department of E. E.
Jenq Neng Hwang Ying Luo
Mountain Whisper Light
Nayak Polissar
C. Yuan, T.S. Hatsukami