microcirculationРегионарное кровообращение и микроциркуляцияRegional blood circulation and microcirculation1682-66552712-9756Academician I.P. Pavlov First St. Petersburg State Medical University10.24884/1682-6655-2013-12-1-31-35microcirculation-815Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLES (CLINICAL INVESTIGATIONS)Оценка структуры атеросклеротической бляшки методом магнитно-резонансной томографии с целью определения ее стабильностиAssessment of atherosclerotic plaques by magnetic resonance imaging to determine its stabilityСтразденьЕ. Ю.StrazdenE. Yu.strazden@gmail.comШарияМ. А.ShariyaM. A.noemail@neicon.ruТараракЭ. М.TararakE. M.noemail@neicon.ruУстюжанинД. В.UstyuzhaninD. V.noemail@neicon.ruРадюхинаН. В.RadyukhinaN. V.noemail@neicon.ruИнститут клинической кардиологии им. А. Л. МясниковаРоссияCardiology Research Center Russian FederationRussian Federation2013300320131213135Copyright © Страздень Е.Ю., Шария М.А., Тарарак Э.М., Устюжанин Д.В., Радюхина Н.В., 20132013Страздень Е.Ю., Шария М.А., Тарарак Э.М., Устюжанин Д.В., Радюхина Н.В.Strazden E.Y., Shariya M.A., Tararak E.M., Ustyuzhanin D.V., Radyukhina N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.microcirc.ru/jour/article/view/815

Цель исследования: оценить возможности магнитно-резонансной томографии (МРТ) в определении стабильности атеросклеротической бляшки (АСБ) у пациентов с мультифокальным атеросклерозом в сопоставлении с данными гистологического исследования. С помощью МРТ и магнитно-резонансной ангиографии (МРА) были обследованы 37 пациентов со стенозом сонных артерий более 70 %. Исследование проводилось на высокопольном 3Т-томографе с использованием 16-тиканальной нейроваскулярной и специализированной каротидной 8-миканальной катушек. Протокол исследования включал стандартную времяпролетную ангиографию в 3D-режиме, Т1-, Т2- и протон-взвешенные (PD) последовательности в аксиальной проекции с толщиной среза 1-2 мм. Далее пациентам была выполнена каротидная эндартерэктомия с последующей гистологической обработкой полученного материала и оценкой структуры атеромы. По данным МРТ, у 23 пациентов были выявлены признаки нестабильности, такие как кровоизлияние в бляшку и/или тромбоз, большое (>40 %) богатое липидными клетками некротическое ядро. Эти результаты были подтверждены данными гистологического исследования. Полученные результаты позволяют судить о высокой эффективности данного метода в определении стабильности атеросклеротической бляшки.

To evaluate the possibility of magnetic resonance imaging (MRI) in determining the stability of atherosclerotic plaques in patients with multifocal atherosclerosis, comparing with the data of histological examination. Using magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) were examined 37 patients with carotid stenosis of more than 70 %. The study was conducted at 3T scanner using 16-channel neurovascular and carotid specialized 8-channel coils. The study protocol consisted of a standard time-of-flight angiography in 3D, T1-, T2-and proton-weighted (PD) sequence in axial projection, with a slice thickness of 1-2mm. Further, most of the patients was performed carotid endarterectomy, with subsequent histological processing and evaluation of the resulting material structure atheroma. In 23 cases the patients had signs of instability, such as hemorrhage into the plaque and/or thrombosis, a large (>40 %), lipid/necrotic core. Which was confirmed by histological findings of the study. This paper gives an indication of the high efficiency of this method in determining the stability of atherosclerotic plaques.

магнитно-резонансная томографияатеросклерозкровоизлияние в бляшкуmagnetic resonance imagingatherosclerosisplaque hemorrhageReferencesCai J. M. et al. Classification of Human Carotid Atherosclerotic Lesion using In Vivo Multi-Contrast MR Imaging // Circulation. 2002. № 106. Р. 1368-1373.Cai J. M. et al. Classification of Human Carotid Atherosclerotic Lesion using In Vivo Multi-Contrast MR Imaging // Circulation. 2002. № 106. Р. 1368-1373.Choudhury R. P. et al. MRI and characterization of atherosclerotic plaque: emerging applications and molecular imaging // Arterioscler. Thromb. Vasc. Biol. 2002. № 22. Р. 1065-1074.Choudhury R. P. et al. MRI and characterization of atherosclerotic plaque: emerging applications and molecular imaging // Arterioscler. Thromb. Vasc. Biol. 2002. № 22. Р. 1065-1074.Demer L. L., Watson K. E., Bostrom K. Mechanism of calcification in atherosclerosis // Trends Cardiovasc. Med. 1994. Vol. 4. P. 45-49.Demer L. L., Watson K. E., Bostrom K. Mechanism of calcification in atherosclerosis // Trends Cardiovasc. Med. 1994. Vol. 4. P. 45-49.Fayad Z. A. et al. Noninvasive in vivo high-resolution magnetic resonance imaging of atherosclerotic lesions in genetically ingineered mice [see comments] // Circulation. 1998.Fayad Z. A. et al. Noninvasive in vivo high-resolution magnetic resonance imaging of atherosclerotic lesions in genetically ingineered mice [see comments] // Circulation. 1998.Fayad Z. A. , Fuster V. Characterization of atherosclerotic plaques by magnetic resonance imaging // Ann N.-Y. Acad Sci. 2000. № 902. Р. 173-186.Fayad Z. A. , Fuster V. Characterization of atherosclerotic plaques by magnetic resonance imaging // Ann N.-Y. Acad Sci. 2000. № 902. Р. 173-186.Fuster V. et al. The pathogenesis of coronary artery disease and the acute coronary syndromes // New Engl. J. Med. 1992. Vol. 326. P. 242-250; 310-318.Fuster V. et al. The pathogenesis of coronary artery disease and the acute coronary syndromes // New Engl. J. Med. 1992. Vol. 326. P. 242-250; 310-318.Johnson-Tidey R. R. et al. Increase in the adhesion molecule P-selectin in endothelium overlying atherosclerotic plaques // Am. J. Pathology. 1994. Vol. 144. P. 952-961.Johnson-Tidey R. R. et al. Increase in the adhesion molecule P-selectin in endothelium overlying atherosclerotic plaques // Am. J. Pathology. 1994. Vol. 144. P. 952-961.Milner J. S. et al. Hemodynamics of human carotid artery bifurcations: computational studies with models reconstructed from magnetic resonance imaging of normal subjects // J. Vasc. Surg. 1998. № 28 (1). Р. 143-156.Milner J. S. et al. Hemodynamics of human carotid artery bifurcations: computational studies with models reconstructed from magnetic resonance imaging of normal subjects // J. Vasc. Surg. 1998. № 28 (1). Р. 143-156.Mitsumori L. M. et al. In vivo identification of lipid cores in advanced carotid atherosclerotic plaques by high resolution MR imaging // Circulation. 2000. № 102 (18). Р. II252.Mitsumori L. M. et al. In vivo identification of lipid cores in advanced carotid atherosclerotic plaques by high resolution MR imaging // Circulation. 2000. № 102 (18). Р. II252.Shinnar M. et al. The diagnostic accuracy of ex vivo MRI for human atherosclerotic plaque characterization // Arterioscler. Thromb Vasc. Biol. 1999. № 19 (11). Р. 2756-2761.Shinnar M. et al. The diagnostic accuracy of ex vivo MRI for human atherosclerotic plaque characterization // Arterioscler. Thromb Vasc. Biol. 1999. № 19 (11). Р. 2756-2761.Stary H. C. et al. A Definition of Advanced Types of Atherosclerotic Lesions and Classification of Atherosclerosis a report from the Committee on Vascular Lesions of the Council on Atherosclerosis, American-Heart-Assosiation // Circulation. 1995. № 95 (5). Р. 1355-1374.Stary H. C. et al. A Definition of Advanced Types of Atherosclerotic Lesions and Classification of Atherosclerosis a report from the Committee on Vascular Lesions of the Council on Atherosclerosis, American-Heart-Assosiation // Circulation. 1995. № 95 (5). Р. 1355-1374.Steinman D. A., Rutt B. K. On the nature and reduction of plaque-mimicking flow artifacts in black blood MRI of the carotid bifurcation // Magn. Reson. Med. 1998. № 39 (4). Р. 635-641.Steinman D. A., Rutt B. K. On the nature and reduction of plaque-mimicking flow artifacts in black blood MRI of the carotid bifurcation // Magn. Reson. Med. 1998. № 39 (4). Р. 635-641.Sukhova G. et al. Evidence of increased collagenolysis by interstitial collagenases-1 and -3 in vulnerable human atheromatous plaques // Circulation. 1999. Vol. 99. P. 2503-2509.Sukhova G. et al. Evidence of increased collagenolysis by interstitial collagenases-1 and -3 in vulnerable human atheromatous plaques // Circulation. 1999. Vol. 99. P. 2503-2509.Toussaint J. F. et al. Magneticresonance images lipid, fibrous, calcified, hemorrhagic, and thrombotic components of human atherosclerosis in vivo // Circulation. 1996. № 94 (5). Р. 932-938.Toussaint J. F. et al. Magneticresonance images lipid, fibrous, calcified, hemorrhagic, and thrombotic components of human atherosclerosis in vivo // Circulation. 1996. № 94 (5). Р. 932-938.Toussaint J. F. et al. T2-weighted contrast for NMR characterization of human atherosclerosis // Arterioscler. Thromb Vasc. Biol. 1995. № 15 (10). Р. 1533-1542.Toussaint J. F. et al. T2-weighted contrast for NMR characterization of human atherosclerosis // Arterioscler. Thromb Vasc. Biol. 1995. № 15 (10). Р. 1533-1542.Yla-Herttuala S. et al. Expression of monocyte chemoattractant protein 1 in macrophage-rich areas of human and rabbit atherosclerotic lesions // Proc. Natl. Acad. Sci. USA. 1991. Vol. 88. P. 5252-5256.Yla-Herttuala S. et al. Expression of monocyte chemoattractant protein 1 in macrophage-rich areas of human and rabbit atherosclerotic lesions // Proc. Natl. Acad. Sci. USA. 1991. Vol. 88. P. 5252-5256.Yuan C. et al. Carotid atherosclerotic plaque: noninvasive MR characterization and identification of vulnerable lesions // Radiology. 2001. № 221. Р. 285-299.Yuan C. et al. Carotid atherosclerotic plaque: noninvasive MR characterization and identification of vulnerable lesions // Radiology. 2001. № 221. Р. 285-299.Yuan C. et al. Phased-array magnetic resonance imaging of the carotid artery bifurcation: preliminary results in healthy volunteers and a patient with atherosclerotic disease // J. Magn. Reson. Imaging. 1995. № 5 (5). Р. 561-565.Yuan C. et al. Phased-array magnetic resonance imaging of the carotid artery bifurcation: preliminary results in healthy volunteers and a patient with atherosclerotic disease // J. Magn. Reson. Imaging. 1995. № 5 (5). Р. 561-565.Yuan C. et al. In vivo accuracy of multispectral magnetic resonance imaging for identifying lipid-rich necrotic cores and intraplaque hemorrhage in advanced human carotid plaques // Circulation. 2001. № 104 (17). Р. 2051-2056.Yuan C. et al. In vivo accuracy of multispectral magnetic resonance imaging for identifying lipid-rich necrotic cores and intraplaque hemorrhage in advanced human carotid plaques // Circulation. 2001. № 104 (17). Р. 2051-2056.

The authors declare that there are no conflicts of interest present.