Bao Cui, Presenter: Nothing to Disclose

Lu Ma, Abstract Co-Author: Nothing to Disclose

Ruixue Du, Abstract Co-Author: Nothing to Disclose

Xu Han, Abstract Co-Author: Nothing to Disclose

Ping Ye, Abstract Co-Author: Nothing to Disclose

Jianming Cai, Abstract Co-Author: Nothing to Disclose

To evaluate whether the intensive lipid therapy could reduce the intraplaque vasa vasorum perfusion in the carotid plaque overlaid thin fibrous caps by the dynamic contrast-enhanced (DCE) MRI.

Study Population: Between March 2009 and March 2012, the prospective study, Rosuvastatin Evaluation of Atherosclerotic Chinese Patients (REACH Study, NCT 00885872), recruited 32 subjects with advanced lesions(≥3 mm thickness without >50% calcification), matched MRI scans and acceptable image quality. All subjects received rosuvastatin 5~20 mg/d to lower low-density lipoprotein cholesterol levels to < 80 mg/dl over the 24-month follow-up period. MR Imaging Protocol: Carotid standardized protocol and DCE-MRI were underwent at baseline and 3, 12 , 24 months at a 3.0T MR scanner. DCE-MRI using double inversion recovery technique was performed on six selected axial slices chosen from T1W imaging set at 15 times separated by a repetition interval of 16 seconds. The acquisition of the forth time was coincident with the initiation of the intravenous injection of 0.2 mmol/kg gadolinium-based contrast agent at a rate of 2 ml/sec through a power injector. Data analysis: The analysis of intraplaque vasa vasorum perfusion was performed using the population arterial input function and Patlak model to calculate pharmacokinetic parameters Ktrans and Vp based on its temporal changes in intensity on the ≥3 mm thick slice.

In total, 6 cases had thin fibrous caps without intraplaque hemorrhage. After 12 and 24 months of treatment, there was a obvious reduction was found in mean plaque Ktrans (0.0486 ± 0.0289[standard deviation] to 0.0422 ± 0.0166, 0.0370 ± 0.0179), no statistically significant trend between baseline and 3 months(0.0486 ± 0.0149). The thinning of fibrous caps might be gradually thickening within the first one year after treatment.

In conclusion, evaluation of effects of lipid-lowering therapy on atherosclerotic plaque with thinning fibrous caps should be focused on inflammatory activity rather than plaque burden. Intraplaque pharmacokinetic parameters of DCE-MRI has the most possibility to become the biomarker in vivo, noninvasively.

Imaging markers of inflammation by the DCE-MRI may monitor the early response of the beneficial therapy to carotid plaque overlaid thin fibrous caps, in vivo.

Cui, B, Ma, L, Du, R, Han, X, Ye, P, Cai, J, MR Imaging of Intraplaque Vasa Vasorum during Lipid-Lowering Therapy to Carotid Plaque with Thin Fibrous Caps: A Prospective Study in Chinese Patients.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006499.html