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Detection of coronary plaques using MR coronary vessel wall imaging: validation of findings with intravascular ultrasound

  • Cardiac
  • Published:
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Abstract

Objectives

Compared with X-ray coronary angiography (CAG), magnetic resonance imaging of the coronary vessel wall (MR-CVW) may provide more information about plaque burden and coronary remodelling. We compared MR-CVW with intravascular ultrasound (IVUS), the standard of reference for coronary vessel wall imaging, with regard to plaque detection and wall thickness measurements.

Methods

In this study 17 patients with chest pain, who had been referred for CAG, were included. Patients underwent IVUS and MR-CVW imaging of the right coronary artery (RCA). Subsequently, the coronary vessel wall was analysed for the presence and location of coronary plaques.

Results

Fifty-two matching RCA regions of interest were available for comparison. There was good agreement between IVUS and MR-CVW for qualitative assessment of presence of disease, with a sensitivity of 94% and specificity of 76%. Wall thickness measurements demonstrated a significant difference between mean wall thickness on IVUS and MR-CVW (0.48 vs 1.24 mm, P < 0.001), but great heterogeneity between wall thickness measurements, resulting in a low correlation between IVUS and MR-CVW.

Conclusions

MR-CVW has high sensitivity for the detection of coronary vessel wall thickening in the RCA compared with IVUS. However, the use of MRI for accurate absolute wall thickness measurements is not supported when a longitudinal acquisition orientation is used.

Key Points

• Both MRI and IVUS can assess coronary vessels

• Both MRI and IVUS can identify coronary vessel wall thickening.

• MRI provides more information about the coronary plaque burden than conventional angiography.

• However, MRI overestimates absolute coronary wall thickness when compared with IVUS.

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Abbreviations

AUC:

Area under the curve

BSSFP:

Balanced steady state free precession

CAD:

Coronary artery disease

CAG:

X-ray coronary angiography

CMRA:

Coronary MR angiography

CT:

Computed tomography

DIR:

Double inversion recovery

FFR:

Fractional flow reserve

FWHM:

Full width at half maximum

IVUS:

Intravascular ultrasound

MESA:

Multi-Ethnic Study of Atherosclerosis

MRI:

Magnetic resonance imaging

MR-CVW:

Magnetic resonance coronary vessel wall imaging

NPV:

Negative predictive value

PCI:

Percutaneous coronary intervention

PPV:

Positive predictive value

PROCAM:

Prospective Cardiovascular Münster Heart Study

RCA:

Right coronary artery

ROC:

Receiver operating characteristic curve

ROI:

Region of interest

SPIR:

Spectral presaturation with inversion recovery

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Acknowledgements

The authors would like to thank Boston Scientific Benelux B.V. for their training in and assistance with acquiring the IVUS-images. Furthermore, we would like to thank all interventional cardiologists working in the Maastricht University Medical Centre, for their assistance with IVUS procedures.

This study was supported by BayerSchering Pharma. The sponsor had no influence on study design, data collection or analysis of the data.

Trial registration:www.clinicaltrials.gov ID: NCT00984776

Author information

Author notes

  1. Tim Leiner

    Present address: Department of Radiology, Utrecht University Medical Centre, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands

Authors and Affiliations

  1. Department of Radiology, Maastricht University Medical Centre, P. Debyelaan 25, 6229HX, Maastricht, The Netherlands

    Suzanne Gerretsen, Jos M. A. van Engelshoven, M. Eline Kooi & Tim Leiner

  2. Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands

    Suzanne Gerretsen, Jos M. A. van Engelshoven, M. Eline Kooi & Tim Leiner

  3. Department of Clinical Epidemiology and Medical Technical Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands

    Alfons G. Kessels

  4. Department of Epidemiology, Maastricht University, Maastricht, The Netherlands

    Patty J. Nelemans

  5. Department of Radiology, Division of image processing (LKEB), Leiden University Medical Centre, Leiden, The Netherlands

    Jouke Dijkstra, Johan H. C. Reiber & Rob J. van der Geest

  6. Department of Diagnostic and Interventional Radiology, HELIOS Clinic, Krefeld, Germany

    Marcus Katoh

  7. Department of Cardiology and Angiology, University of Münster, Münster, Germany

    Johannes Waltenberger

  8. Imaging Sciences Division, King’s College, London, UK

    Rene M. Botnar

Authors
  1. Suzanne Gerretsen
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  2. Alfons G. Kessels
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Corresponding author

Correspondence to Tim Leiner.

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Gerretsen, S., Kessels, A.G., Nelemans, P.J. et al. Detection of coronary plaques using MR coronary vessel wall imaging: validation of findings with intravascular ultrasound. Eur Radiol 23, 115–124 (2013). https://doi.org/10.1007/s00330-012-2576-1

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  • DOI: https://doi.org/10.1007/s00330-012-2576-1

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