Luigi Natale MD, Presenter: Nothing to Disclose

Antonio Bernardini MD, Abstract Co-Author: Nothing to Disclose

Alessandra Porcelli MD, Abstract Co-Author: Nothing to Disclose

Agostino Meduri MD, Abstract Co-Author: Nothing to Disclose

Antonella Lombardo MD, Abstract Co-Author: Nothing to Disclose

Lorenzo Bonomo MD, Abstract Co-Author: Nothing to Disclose

Inflammation may contribute to destabilize vulnerable plaques in acute coronary syndromes by promoting rupture and erosion. This premise led to the hypothesis that systemic inflammatory factors could be related with widespread plaque activity in many vascular districts and to the development of a variety of techniques for detection of vulnerable plaques. The purpose of our study was to evaluate, with contrast enhanced-MRI (CE-MRI) plaque inflammation signs in carotid arteries of pts with unstable angina (UA) and to relate them to serum levels of C-reactive protein (CRP), used as a marker of systemic inflammation.

32 pts with carotid plaques, 19 with UA (mean age: 62) and 13 with stable angina (mean age: 67) underwent carotid arteries MRI (1.5 T GE scanner), with SE, FSE and black blood FSE sequences, before and 10 to 15 minutes after Gadolinium-DTPA (Gd) iv. administration (0.2 mmol/Kg). We considered 3 markers: 1) wall thickening, index of arterial wall edema or infiltration; 2) increased T2 or FSE-STIR signal intensity (SI), index of arterial wall or plaque edema; 3) arterial wall or plaque enhancement, index of increased capillary permeability. Totally 44 plaques were evaluated (20 patients with monolateral and 12 with bilateral stenosis). CRP levels were determined with the ELISA essay.

24 plaques showed wall thickening and/or increased T2 and/or FSE-STIR SI and Gd enhancement, 5 plaques showed only contrast enhancement, whereas 15 plaques had no inflammation signs. CRP levels of patients with enhanced plaques were significantly higher than those of patients without enhancement (median values: 12.4 vs 3.4, p < 0.05).

Pts with UA showed plaque inflammation signs more frequently than controls; patients with UA and inflammation signs showed higher CRP levels than pts with UA and no inflammation signs. Our results suggest a widespread plaque activity, possibly mediated by systemic inflammation, in acute coronary syndromes.

Natale, L, Bernardini, A, Porcelli, A, Meduri, A, Lombardo, A, Bonomo, L, MRI Signs of Carotid Plaque Inflammation in Patients with Unstable Angina.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4417766.html