Determination of Edema in Porcine Coronary Arteries by T2 Weighted Cardiac Magnetic Resonance

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ABSTRACT: BACKGROUND: Inflammation plays a pivotal role in all stages of atherosclerosis. Since edema is known to be an integral part of inflammation, a noninvasive technique that can identify edema in the coronary artery wall may provide unique information regarding plaque activity. In this study, we aimed to determine whether edema induced in porcine coronary arteries by balloon injury could be reliably detected using a water sensitive T2-weighted short tau inversion recovery sequence (T2-STIR). We also aimed to compare these results to those of conventional T2-weighted (T2W) imaging. METHODS: Edema was induced in the proximal left anterior descending (LAD) coronary artery wall in seven pigs by balloon injury. At baseline, and 1-10 days (average four) post injury, the proximal LAD was assessed by water sensitive T2-STIR and conventional T2W sequences in cross-sectional planes. CMR images were matched to histopathology, validated against Evans blue, and correlated with the arterial amount of fibrinogen used as an edema surrogate marker. RESULTS: Post injury, the T2-STIR images of the injured LAD vessel wall showed a significant 72%, relative signal intensity (SI) increase compared with baseline (p=0.028). Using a threshold value of 7 SD, T2-STIR detected edema in the vessel wall (i.e. enhancement) with a sensitivity of 100 and a specificity of 71. Twelve out of the 14 (86 %) T2-STIR images displaying coronary artery wall enhancement also showed Evans blue uptake in the corresponding histology. The relative signal intensity showed a linear correlation with the amount of fibrinogen detected on the corresponding histopathology (rho=0.750, p=0.05). The conventional T2W images did not show significant changes in SI post injury. CONCLUSION: T2-STIR CMR enabled detection of coronary artery wall edema and could therefore be a non-invasive diagnostic tool for evaluation of inflammatory coronary artery wall activity.
Original languageEnglish
JournalJournal of Cardiovascular Magnetic Resonance
Volume13
Issue1
Pages (from-to)52
ISSN1097-6647
DOIs
Publication statusPublished - 21 Sep 2011

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