Use of Contrast Enhancement and High-Resolution 3D Black-Blood MRI to Identify Inflammation in Atherosclerosis

Jin Hur, Jaeseok Park, Young Jin Kim, Hye Jeong Lee, Hyo Sup Shim, Kyu Ok Choe, Byoung Wook Choi

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)


Objectives We investigated the contributing factors for plaque enhancement and examined the relationships between regional contrast enhancement and the inflammatory activity of atherosclerotic plaques in an experimental rabbit model using contrast-enhanced high-resolution 3-dimensional (3D) black-blood magnetic resonance imaging (MRI) in comparison with histopathologic analysis. Background Inflammation plays a critical role in plaque initiation, progression, and disruption. As such, inflammation represents an emerging target for the treatment of atherosclerosis. MRI findings suggest that contrast agentinduced signal enhancement is associated with the degree of macrophage infiltration and neovessels that can be detected in plaque. Methods Ten atherosclerotic rabbits and 3 normal control rabbits underwent high-resolution 3D contrast-enhanced black-blood MRI. Magnetic resonance images and the corresponding histopathologic sections were divided into 4 quadrants. Plaque composition was analyzed for each quadrant according to histopathologic criteria (percent of lipid-rich, fibrous, macrophage area and microvessel density) and imaging criteria (enhancement ratio [ER], ER = signal intensitypost/signal intensitypre). Multiple linear regression analysis was performed to determine independent factors for plaque enhancement. Results A total of 62 noncalcified plaques (n = 248; 156 lipid-rich quadrants and 92 fibrous quadrants) were identified based on histopathologic analysis. Mean ER values were significantly higher in atherosclerotic vessel walls than in normal vessel walls (2.03 ± 0.25 vs. 1.58 ± 0.15; p = 0.017). The mean ER values were significantly higher in lipid-rich quadrants compared with the fibrous quadrants (2.14 ± 0.31 vs. 1.84 ± 0.21; p = 0.001). Mean ER values were significantly higher in macrophage-rich plaques compared with the macrophage-poor plaques (2.21 ± 0.28 vs. 1.81 ± 0.22; p = 0.001). Using multiple regression analysis, macrophage area and microvessel density were associated independently with ER values that reflected plaque enhancement (p < 0.001). Conclusions Contrast-enhanced high-resolution 3D black-blood MRI may be an efficient method to detect plaque inflammation.

Original languageEnglish
Pages (from-to)1127-1135
Number of pages9
JournalJACC: Cardiovascular Imaging
Issue number11
Publication statusPublished - 2010 Nov

Bibliographical note

Funding Information:
This work was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs , Republic of Korea ( A090358 ). The authors have reported that they have no relationships to disclose.


  • 2-dimensional
  • 2D
  • 3-dimensional
  • 3D
  • Abbreviations and Acronyms
  • DCE
  • ER
  • Gd-DTPA
  • MRI
  • SI
  • dynamic contrast enhanced
  • enhancement ratio
  • gadolinium- diethylenetriaminepentaacetic acid
  • magnetic resonance imaging
  • signal intensities

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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