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MRI Could Pinpoint Potentially Deadly Plaques

April 9, 2013
Written by: , Filed in: Cardiac Imaging
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A new study finds that MRI might noninvasively find potentially dangerous atherosclerotic plaques by detecting areas of low endothelial sheer stress (ESS)—indirect stress from the friction of blood flow over the inner blood vessel wall.

That might allow detection of unstable plaques before they rupture, disrupt blood flow, and cause heart attacks or strokes. As James A. Hamilton, PhD, senior author of an article about the research, put it:

Early identification of ‘high-risk’ plaques prior to acute cardiovascular events will provide enhanced decision-making and might improve patient management by allowing prompt, aggressive interventions that aim to stabilize plaques.

Dr. Hamilton is professor of physiology and biophysics and research professor of medicine at Boston University School of Medicine (BUSM). He was quoted in a BUSM news release. The article appeared in the March issue of Circulation: Cardiovascular Imaging.

Researchers at BUSM and King’s College London induced atherosclerosis in some hapless rabbits, used MRI to scan the blood flow in their aortas, then used drugs to trigger plaque disruption. Subsequent MRI scans showed the disrupted plaques.

The disrupted plaques were clustered at areas of low ESS. Plaques in those areas also had other high-risk features, such as positive remodeling—outward bulging of the vessel wall that can hide the plaque from detection.

“Our results indicate that using noninvasive MRI assessments of ESS together with the structural characteristics of the plaque offers a comprehensive way to identify the location of ‘high-risk’ plaque, monitor its progression, and assess the effect of interventions,” Dr. Hamilton said.

Obviously, a lot more research is needed to bridge the gap between rabbit models and human clinical use. But the study’s cautious conclusion, “Assessment of ESS by noninvasive MRI might be useful for assessing atherosclerotic risk,” does seem eminently defensible.

Related seminar: Cardiovascular & Pulmonary Imaging

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