조직병리와 비교한 죽상경화반의 가돌리니움 조영증강 자기공명영상: 토끼 대동맥을 이용한 생체 실험 Gadolinium-Enhanced Magnetic Resonance Imaging of Atherosclerotic Plaques in Comparison with Histopathology: An In Vivo Study in Aorta of Rabbits원문보기
목적: 죽상경화반 유발 토끼 대동맥에서 자기공명영상을 이용하여 가돌리니움 조영제에 대한 경화반의 조영증강에 어떤 특징이 있는지 알아보고, 경화반 취약성의 대표적인 두 특징인 조직병리학적인 지질풍부 성분과 대식세포 풍부 성분과 비교하여 조영증강이 어떤 조직 소견에서 기인하는지 평가하고자 하였다. 대상 및 방법: 뉴질랜드 흰토끼 (4마리, 무게 3.0 $\sim$ 3.5 kg, 수컷)를 죽상경화반 모델로 사용하였다. 고콜레스테롤식이와 이중 풍선 손상을 이용하여 대동맥 죽상경화반을 유발하였다. 3-T 자기공명영상을 사용하여 가돌리니움 조영제를 투여하기 전과 후에 T1-강조영상을 얻었다. 자기공명영상과 상응하는 조직병리절편 (n=35)을 4개나 3개의 구역으로 나누었다 (n=130). 자기공명영상에서의 조영증강비 (ER, ER=SIpost/SIpre)를 각 구역마다 계산하여 조직병리의 지질풍부영역과 대식세포 풍부 영역과 비교하였다. 결과: 지질풍부 구역은 72개였고 섬유성구역은 58개였다. 대식세포풍부영역을 포함한 구역은 105개였고 포함하지 않은 구역은 25개였다. 조영증강비는 섬유성구역보다 지질풍부구역에서 높았다 (평균 조영증강비 2.25 $\pm$ 0.41 vs. 2.72 $\pm$ 0.65, p=0.013). 조영증강비는 지질성분을 제어했을 때 대식세포풍부영역과 잘 비례하지 않았다 (correlation coefficient -0.203, p=0.236). 결론: 표준 가돌리니움 기반의 세포외 조영제를 사용하였을 때 지질풍부 경화반은 섬유성 경화반보다 강한 조영증강을 보였다. 대식세포 침윤은 조영증강 정도와 비례하지 않았다. 초기부터 진행된 병기의 다양한 경화반 모델을 사용하고 조영증강과 관련된 모든 가능한 인자를 사용하여 조영제 투여 후 최적의 영상획득 시간을 결정하는 연구가 필요하다.
목적: 죽상경화반 유발 토끼 대동맥에서 자기공명영상을 이용하여 가돌리니움 조영제에 대한 경화반의 조영증강에 어떤 특징이 있는지 알아보고, 경화반 취약성의 대표적인 두 특징인 조직병리학적인 지질풍부 성분과 대식세포 풍부 성분과 비교하여 조영증강이 어떤 조직 소견에서 기인하는지 평가하고자 하였다. 대상 및 방법: 뉴질랜드 흰토끼 (4마리, 무게 3.0 $\sim$ 3.5 kg, 수컷)를 죽상경화반 모델로 사용하였다. 고콜레스테롤식이와 이중 풍선 손상을 이용하여 대동맥 죽상경화반을 유발하였다. 3-T 자기공명영상을 사용하여 가돌리니움 조영제를 투여하기 전과 후에 T1-강조영상을 얻었다. 자기공명영상과 상응하는 조직병리절편 (n=35)을 4개나 3개의 구역으로 나누었다 (n=130). 자기공명영상에서의 조영증강비 (ER, ER=SIpost/SIpre)를 각 구역마다 계산하여 조직병리의 지질풍부영역과 대식세포 풍부 영역과 비교하였다. 결과: 지질풍부 구역은 72개였고 섬유성구역은 58개였다. 대식세포풍부영역을 포함한 구역은 105개였고 포함하지 않은 구역은 25개였다. 조영증강비는 섬유성구역보다 지질풍부구역에서 높았다 (평균 조영증강비 2.25 $\pm$ 0.41 vs. 2.72 $\pm$ 0.65, p=0.013). 조영증강비는 지질성분을 제어했을 때 대식세포풍부영역과 잘 비례하지 않았다 (correlation coefficient -0.203, p=0.236). 결론: 표준 가돌리니움 기반의 세포외 조영제를 사용하였을 때 지질풍부 경화반은 섬유성 경화반보다 강한 조영증강을 보였다. 대식세포 침윤은 조영증강 정도와 비례하지 않았다. 초기부터 진행된 병기의 다양한 경화반 모델을 사용하고 조영증강과 관련된 모든 가능한 인자를 사용하여 조영제 투여 후 최적의 영상획득 시간을 결정하는 연구가 필요하다.
Purpose : We sought to evaluate enhancement of plaque with gadolinium-based contrast agent by magnetic resonance imaging (MRI) in comparison with histopathology, namely lipid-rich and macrophage-rich components that were two representative characteristics of plaque vulnerability using atheroscleroti...
Purpose : We sought to evaluate enhancement of plaque with gadolinium-based contrast agent by magnetic resonance imaging (MRI) in comparison with histopathology, namely lipid-rich and macrophage-rich components that were two representative characteristics of plaque vulnerability using atherosclerotic rabbit aorta in order to determine which histopathologic component is relevant to the enhancement. Materials and Methods : New Zealand white rabbit (n=4, weight 3.0 to 3.5 kg, all male) was used for animal model of atherosclerosis. Atherosclerotic aortic lesions were induced by high-cholesterol diet and double balloon injury. T1-weight axial images were acquired before and after gadolinium-based contrast agent using a 3-T MRI. MR images and the matched histopathological sections (n=35) were divided into 4 quadrants or 3 (n=130). Enhancement ratio (ER, ER=SIpost/SIpre) on MRI was calculated for each quadrant and compared with histopathology in regard to lipid-rich and macrophage-rich areas. Results : Lipid-rich quadrants were 72 and fibrous quadrants were 58. The number of quadrants which had macrophage-rich areas was 105 and that of quadrants which did not have macrophage-rich areas was 25. ER was significantly higher in lipid-rich quadrants than in fibrous quadrants (mean ER 2.25c$\pm$0.41 vs. 2.72$\pm$0.65, p=0.013). ER poorly correlated with macrophage-rich areas when lipid-component was controlled (correlation coefficient -0.203, p=0.236). Conclusion : Lipid-rich plaques showed stronger enhancement than fibrous plaques using a standard gadolinium-based extracellular contrast agent. Macrophage infiltration did not correlate with degree of enhancement. Further study is warranted that account for optimal time of imaging after contrast injection using various plaque models from early to advanced stages and all possible parameters associated with contrast enhancement.
Purpose : We sought to evaluate enhancement of plaque with gadolinium-based contrast agent by magnetic resonance imaging (MRI) in comparison with histopathology, namely lipid-rich and macrophage-rich components that were two representative characteristics of plaque vulnerability using atherosclerotic rabbit aorta in order to determine which histopathologic component is relevant to the enhancement. Materials and Methods : New Zealand white rabbit (n=4, weight 3.0 to 3.5 kg, all male) was used for animal model of atherosclerosis. Atherosclerotic aortic lesions were induced by high-cholesterol diet and double balloon injury. T1-weight axial images were acquired before and after gadolinium-based contrast agent using a 3-T MRI. MR images and the matched histopathological sections (n=35) were divided into 4 quadrants or 3 (n=130). Enhancement ratio (ER, ER=SIpost/SIpre) on MRI was calculated for each quadrant and compared with histopathology in regard to lipid-rich and macrophage-rich areas. Results : Lipid-rich quadrants were 72 and fibrous quadrants were 58. The number of quadrants which had macrophage-rich areas was 105 and that of quadrants which did not have macrophage-rich areas was 25. ER was significantly higher in lipid-rich quadrants than in fibrous quadrants (mean ER 2.25c$\pm$0.41 vs. 2.72$\pm$0.65, p=0.013). ER poorly correlated with macrophage-rich areas when lipid-component was controlled (correlation coefficient -0.203, p=0.236). Conclusion : Lipid-rich plaques showed stronger enhancement than fibrous plaques using a standard gadolinium-based extracellular contrast agent. Macrophage infiltration did not correlate with degree of enhancement. Further study is warranted that account for optimal time of imaging after contrast injection using various plaque models from early to advanced stages and all possible parameters associated with contrast enhancement.
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문제 정의
Multicontrast plaque imaging and contrast enhanced imaging for evaluation of atherosclerotic plaques in human coronary artery will be possible in near future. This study would be helpful to elucidate the mechanism of contrast enhancement in plaques and to predict vulnerability of plaques based on the association of enhancement and representative components of vulnerabiligy.
제안 방법
Aortic injury was performed 3 times from the aortic arch to the iliac bifurcation with use of a 4F Fogarty embolectomy catheter introduced through the iliac artery. All procedures were performed under general anesthesia by intramuscular ketamine injection (30 mg/kg) and xylazine (10 mg/kg). The study protocol was approved by our Animal Care and Use Committee.
The histopathologic sections were digitized from a camera attached to a light microscope then transferred to another computer. An independent pathologist blinded to the results of MRI performed the histopathology analysis.
Macrophage infiltration did not correlate with degree of enhancement. Further study is warranted that account for optimal time of imaging after contrast injection using various plaque models from early to advanced stages and all possible parameters associated with contrast enhancement.
In this study, we sought to evaluate enhancement of plaque with gadolinium-based contrast agent by MRI in comparison with histopathology, namely lipid-rich and macrophage-rich components that were two representative characteristics of plaque vulnerability using atherosclerotic rabbit aorta in order to determine which histopathologic component is relevant to the enhancement.
43 mm. Two minutes after administration of 0.1mmol/kg of gadolinium-based contrast agent (Gadodiamide, OmniscanTM, 0.5 mmol/ml, GE Healthcare) via the ear vein, axial T1-weighted imaging was repeated with the same protocol as pre-contrast scan. Each T1-weighted imaging typically took 15 minutes.
데이터처리
Correlations of ER and macrophage-rich areas were performed using Pearson’ s correlation coefficient.
The statistical significance of differences in ER of plaques according to different plaque types determined by histopathology was assessed using Student’s t test for independent samples.
성능/효과
In this study, more distributable space was associated with strong enhancement because contrast-enhanced MRI protocol allowed sufficient time for contrast agent molecules to diffuse into lipid-rich areas. In addition, macrophage existed in most quadrants including fibrous quadrant as well as lipid-rich quadrants.
후속연구
As loose matrix is associated with delayed hyperenhancement using extracellular contrast agents and neovasculature is associated with perfusion parameters, further studies are warranted that account for optimal timing of MRI after contrast administration. Recently, high resolution wall imaging has been tried in human coronary artery with a 3-T MR unit and a 32- channel receiver coil.
참고문헌 (16)
Virmani R, Burke AP, Farb A, Kolodgie FD. Pathology of the vulnerable plaque. J Am Coll Cardiol 2006;47:C13-18.
Yuan C, Kerwin WS, Marina S, et al. Contrast-enhanced high resolution MRI for atherosclerotic carotid artery tissue characterization. J Magn Reson Imaging 2002;15:52-67.
Cai J, Hatsukami TS, Ferguson MS, et al. In vivo quantitative measurement of intact fibrous cap and lipid-rich necrotic core size in atherosclerotic carotid plaque; comparison of high-resolution, contrast-enhanced magnetic resonance imaging and histology. Circulation 2005;112:3437-3444.
Kerwin W, Hooker A, Spilker M, et al. Quantitative magnetic resonance imaging analysis of neovesculature volume in carotid atherosclerotic plaque. Circulation 2003;107:851-856.
Calcagno C, Cornily JC, Hyafil F, et al. Detection of neovessels in atherosclerotic plaques of rabbits using dynamic contrast enhanced MRI and 18F-FDG PET. Arterioscler Thromb Vasc Biol 2008;28:1311-1317.
Ibrahim T, Makowski MR, Jankauskas A, et al. Serial contrast-enhanced cardiac magnetic resonance imaging demonstrates regression of hyperenhancement within the coronary artery wall in patients after acute myocardial infarction. J Am Coll Cardiol Img 2009;2:580-588.
Lobbes MB, Miserus RJJHM, Heeneman S, et al. Atherosclerosis: contrast-enhanced MR imaging of vessel wall in rabbit model-comparison of gadofosveset and gadopentetate dimeglumine. Radiology 2009;250:682-691.
Ogawa M Ishino S, Mukai T, et al. F-FDG accumulation in atherosclerotic plaques: immunohistochemical and PET imaging study. J Nucl Med 2004;45:1245-1250.
Wasserman BA, Smith WI, Trout HH III, Cannon RO III, Balaban RS, Arai AE. Carotid artery atherosclerosis: in vivo morphologic characterization with gadolinium-enhanced double-oblique MR imaging-initial results. Radiology 2002;223:566-573.
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