The MRI Of Carotid Plaques And Coronary Artery Disease And Its Relative Study

Background and purpose: Many clinical investigations and pathological studies have shown the atherosclerosis plaques play an important part in the procession of coronary atherosclerosis heart disease. Magnetic resonance imaging(MRI) is a better invasive technique of all techniques which detects the atherosclerosis plaques. In the past years, as to the new MRI techniques appeared, MRI has been applied to detect carotid plaques and coronary artery lesions. And MRI can be used to follow-up visit and can be a tool to guide therapy. To investigate the use of MRI in the detection of carotid plaques , its type and coronary artery stenosis. We collect data of patients of coronary heart disease. This study was divided into two parts.Methods:Part one: 43 patients including 30 men and 13 women with carotid plaques detected by carotid ultrasound were selected in this investigation. The average age of them is 66.78±10.48.With the consents of the patients, all of them accepted carotid artery MRI within one week after the detection by ultrasound. The type of the carotid plaques according to the American Heart Association carotid classification for MRI which divided into eight types Carotid atherosclerosis was evaluated by the plaque thickness which implicate the degree of the carotid atherosclerosis. All of the patients received atrovastatin therapy for six months. And all of the patients received the carotid artery MRI and carotid ultrasound in the same areas after six months. According to the results of the MRI and ultrasound, the imaging characteristics of carotid plaque were analyzed . And the effects on the type of the carotid plaques were observed. And the changes of the mean thickness of the carotid plaques were detected.Part two: 32 patients were chosen to accepted with selected coronary angiography and they also accepted coronary MRI (1.5 T) within a week before the angiography. There are 21 men, 11 women in these patients with the average age 62.26±14.78. According to the results of the coronary angiography and coronary MRI. We evaluate the exactness and effectiveness of the MRI technique in the detection of the main coronary artery branches. And we also compare the coronary angiography with Gensini scores to coronary MRI CMRA scores to detect coronary artery lesions.Results:1. Among the 43 patients, only 25 patients were complete the investigation. The average time of the follow-up visit were 182±10 days. And we see: (1)Before and after the cured with atrovastatin, the mean thickness of the carotid plaques decreased ,but not statistical significance.(2)Carotid MRI can be used to detect unstable carotid plaque ,which displayed hypointense or hyperintense signal on T1 phasing, isointense signal on T2 phasing, hypointense signal on PdW phasing.(3)After cured by atrovastatin, the typing of the 13 carotid plaques changed from unstable plaques(typingⅣ-Ⅵ) to stable plaques(Ⅶ-Ⅷ) .2. Among the 32 patients who received coronary angiography, only 28 patients received coronary MRI detection. In these patients, 7 patients was normal, 12 patients had RCA stenosis, 8 patients had left main coronary stenosis, 15 patients had LAD stenosis and 11 had LCX stenosis. The correctness of CMRA in detection of the coronary disease, RCA, LM, LAD, LCX were 90.48%,83.33%,100%,86.67%, 90.91%; the sensitivity were95.23%, 87.5% ,100%, 80%, 90.91%; the specificity were 85.71% 93.75%, 100%, 84.15%, 85.71%. And the Gensini scores and CMRA scores had no statistical significance.Conclusions1. MRI can be used in qualitatively detecting unstable carotid plaques., which can be a help for clinical follow-up visit.2. Atrovastatin can decrease lipid in the plaques and improve the type of the carotid plaques.3. MRI can be used for coronary angiography, but the correctness of the MRI would be improved.