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Coronary Atherosclerosis T1-Weighed Characterization With Integrated Anatomical Reference: Comparison With High-Risk Plaque Features Detected by Invasive Coronary Imaging

 Yibin Xie  ;  Young-Jin Kim  ;  Jianing Pang  ;  Jung-Sun Kim  ;  Qi Yang  ;  Janet Wei  ;  Christopher T. Nguyen  ;  Zixin Deng  ;  Byoung Wook Choi  ;  Zhaoyang Fan  ;  C. Noel Bairey Merz  ;  Prediman K. Shah  ;  Daniel S. Berman  ;  Hyuk-Jae Chang  ;  Debiao Li 
 JACC-CARDIOVASCULAR IMAGING, Vol.10(6) : 637-648, 2017 
Journal Title
Issue Date
Adult ; Aged ; Algorithms ; Cardiac-Gated Imaging Techniques ; Case-Control Studies ; Coronary Angiography/methods* ; Coronary Artery Disease/diagnostic imaging* ; Coronary Vessels/diagnostic imaging* ; Electrocardiography ; Female ; Humans ; Image Interpretation, Computer-Assisted/methods* ; Magnetic Resonance Imaging, Cine/methods* ; Male ; Middle Aged ; Plaque, Atherosclerotic* ; Predictive Value of Tests ; Tomography, Optical Coherence* ; Young Adult
atherosclerosis ; inflammation ; intraplaque hemorrhage ; magnetic resonance imaging ; optical coherence tomography
OBJECTIVES: The aim of this work is the development of coronary atherosclerosis T1-weighted characterization with integrated anatomical reference (CATCH) technique and the validation by comparison with high-risk plaque features (HRPF) observed on intracoronary optical coherence tomography (OCT) and invasive coronary angiography. BACKGROUND: T1-weighted cardiac magnetic resonance with or without contrast media has been used for characterizing coronary atherosclerosis showing promising prognostic value. Several limitations include: 1) coverage is limited to proximal coronary segments; 2) spatial resolution is low and often anisotropic; and 3) a separate magnetic resonance angiography acquisition is needed to localize lesions. METHODS: CATCH acquired dark-blood T1-weighted images and bright-blood anatomical reference images in an interleaved fashion. Retrospective motion correction with 100% respiratory gating efficiency was achieved. Reference control subjects (n = 13) completed both pre- and post-contrast scans. Stable angina patients (n = 30) completed pre-contrast scans, among whom 26 eligible patients also completed post-contrast scans. After cardiac magnetic resonance, eligible patients (n = 22) underwent invasive coronary angiography and OCT for the interrogation of coronary atherosclerosis. OCT images were assessed and scored for HRPF (lipid-richness, macrophages, cholesterol crystals, and microvessels) by 2 experienced analysts blinded to magnetic resonance results. RESULTS: Per-subject analysis showed none of the 13 reference control subjects had coronary hyperintensive plaques (CHIP) in either pre-contrast or post-contrast CATCH. Five patients had CHIP on pre-contrast CATCH and 5 patients had CHIP on post-contrast CATCH. Patients with CHIP had greater lipid abnormality than those without. Per-segment analysis showed elevated pre- and post-contrast plaque to myocardium signal ratio in the lesions with HRPF versus those without. Positive correlation was observed between plaque to myocardium signal ratio and OCT HRPF scoring. CHIP on pre-contrast CATCH were associated with significantly higher stenosis level than non-CHIP on invasive coronary angiography. CONCLUSIONS: CATCH provided accelerated whole heart coronary plaque characterization with simultaneously acquired anatomical reference. CHIP detected by CATCH showed positive association with high-risk plaque features on invasive imaging studies.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
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