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Intra-individual comparison of carotid and femoral atherosclerotic plaque features with in vivo MR plaque imaging

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Abstract

The purpose of this study was to evaluate differences of plaque composition and morphology within the same patient in different vascular beds using non-invasive MR-plaque imaging. 28 patients (67.8 ± 7.4 years, 8 females) with high Framingham general cardiovascular disease 10-year risk score and mild-to-moderate atherosclerosis were consecutively included in the study. All subjects underwent a dedicated MRI-plaque imaging protocol using TOF and T1w and T2w black-blood-sequences with fat suppression at 1.5 T. The scan was centered on the carotid bulb of the carotid arteries and on the most stenotic lesion of the ipsilateral femoral artery, respectively. Plaques were classified according to the American Heart Association (AHA) lesion type classification and area measurements of lumen, wall and the major plaque components, such as calcification, necrotic core and hemorrhage were determined in consensus by two blinded reviewers using dedicated software (Cascade, Seattle, USA). Plaque components were recorded as maximum percentages of the wall area. Carotid arteries had larger maximum wall and smaller minimum lumen areas (p < 0.001) than femoral arteries, whereas no significant difference was find with respect to the max. NWI (p = 0.87). Prevalence of lipid-rich AHA lesion type IV/V and complicated AHA lesion type VI with hemorrhage/thrombus/fibrous cap rupture was significantly higher in the carotid arteries compared to the femoral arteries. Plaque composition as percentage of the vessel wall differed significantly between carotid and femoral arteries: Max. %necrotic core and max. %hemorrhage were significantly higher in the carotid arteries compared to the femoral arteries (p = 0.001 and p = 0.02, respectively). Max. %calcification did not differ significantly. Average stenotic degree of carotid arteries at duplex was 49.7 ± 12.5 (%). Non-invasive MR plaque-imaging is able to visualize differences in plaque composition across the vascular tree. We observed significant differences in quantitative and qualitative plaque features between carotid and femoral arteries within the same patient, which in the future could help to improve risk stratification in patients with atherosclerosis.

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Acknowledgement

This study was supported by DAAD (German Academic Exchange Program).

Author’s contribution

A.H. and T.S. planned the study. B.N., G.A., and R.W. were involved in the patient recruitment. D.S.H. prepared the statistics and G.C. prepared the figures. A.H. and C.Y. drafted the manuscript. M.R., T.S., G.C. and R.W. critically reviewed the manuscript. All authors read and approved the final version of the manuscript.

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Authors and Affiliations

  1. Institute for Clinical Radiology, Ludwig Maximilians University Hospital Munich, Marchioninistr. 15, 81377, Munich, Germany

    Andreas Helck, Maximilian F. Reiser & Tobias Saam

  2. Department of Radiology, Ospedale San Giovanni Bellinzona (EOC), 6500, Bellinzona, Switzerland

    Rolf Wyttenbach

  3. Department of Radiology, University of Washington, Seattle, WA, USA

    Gador Canton, Chun Yuan & Daniel S. Hippe

  4. Division of Cardiology and Vascular Medicine, Department of Internal Medicine, Ospedale San Giovanni Bellinzona (EOC), 6500, Bellinzona, Switzerland

    Nicola Bianda & Augusto Gallino

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  1. Andreas Helck
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  2. Nicola Bianda
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  3. Gador Canton
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  4. Chun Yuan
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  9. Tobias Saam
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Correspondence to Andreas Helck.

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Helck, A., Bianda, N., Canton, G. et al. Intra-individual comparison of carotid and femoral atherosclerotic plaque features with in vivo MR plaque imaging. Int J Cardiovasc Imaging 31, 1611–1618 (2015). https://doi.org/10.1007/s10554-015-0737-4

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  • DOI: https://doi.org/10.1007/s10554-015-0737-4

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