Noninvasive corollary vessel wall and plaque imaging with magnetic resonance imaging

Background-Conventional x-ray angiography frequently underestimates the tru e burden of atherosclerosis. Although intravascular ultrasound allows for i maging of coronary plaque, this invasive technique is inappropriate for scr eening or serial examinations. We therefore sought to develop a noninvasive free-breathing MR technique For coronary vessel wall imaging. We hypothesi zed that such an approach would allow for in vivo imaging of coronary ather osclerosis. Methods and Results-Ten subjects, including 5 healthy adult volunteers (age d 35+/-17 years, range 19 to 56 years) and 5 patients (aged 60+/-4 years, r ange 56 to 66 years) with x-ray-confirmed coronary artery disease (CAD), we re studied with a T2-weighted, dual-inversion, fast spin-echo MR sequence. Multiple adjacent 5-mm cross-sectional images of the proximal right coronar y artery were obtained with an in-plane resolution of 0.5x1.0 mm. A right h emidiaphragmatic navigator was used to facilitate free-breathing MR acquisi tion. Coronary vessel wall images were readily acquired in all subjects. Bo th coronary vessel wall thickness (1.5+/-0.2 versus 1.0+/-0.2 mm) and wall area (21.2+/-3.1 versus 13.7+/-4.2 mm(2)) were greater in patients with CAD (both P<0.02 versus healthy adults). Conclusions-In vivo free-breathing coronary vessel wall and plaque imaging with MR has been successfully implemented in humans. Coronary wall thicknes s and wall area were significantly greater in patients with angiographic CA D. The presented technique may have potential applications in patients with known or suspected atherosclerotic CAD or for serial evaluation after phar macological intervention.