Time-resolved Contrast-Enhanced Coronary Vessel Wall Imaging

Introduction: Most acute coronary syndromes result from rupture of vulnerable plaques [1]. As a result, it’s clinically very important to assess the vulnerability of coronary plaque. While studies have shown that inflammation plays a major role in plaque rupture, it is crucial to be able to evaluate the extent of inflammation of coronary vessel wall plaque. Contrast-enhanced studies have shown delayed-enhancement in several inflammatory vessel wall diseases, such as giant cell arteritis [2] and myocarditis [3]. Also strong associations between histological markers of inflammation and quantitative indices generated from dynamic contrast-enhanced carotid images in patients were demonstrated [4]. It is highly likely that the same mechanism will work in coronary wall. Delayed-enhancement and characterization of plaque component were successfully observed in coronary arteries after a delay time of one hour [5]. However, there have been no studies to demonstrate whether enhancement or characterization can be observed in very early-enhancement stage or to link the quantitative indices from dynamic contrast-enhanced images to inflammation in coronary artery. This is not a trivial task given the need for TI-independent black blood vessel wall imaging with high spatial resolution and temporal resolution. In this work, we modified the method proposed by Khaled Z [6] for dynamic contrast-enhanced coronary vessel wall imaging.