In vivo magnetic resonance imaging of coronary thrombosis using a fibrin-binding molecular magnetic resonance contrast agent

被引:132
作者
Botnar, RM
Buecker, A
Wiethoff, AJ
Parsons, EC
Katoh, M
Katsimaglis, G
Weisskoff, RM
Lauffer, RB
Graham, PB
Gunther, RW
Manning, WJ
Spuentrup, E
机构
[1] Beth Israel Deaconess Med Ctr, Div Cardiovasc, Cardiac MR Ctr, Dept Med, Boston, MA 02215 USA
[2] Beth Israel Deaconess Med Ctr, Dept Radiol, Boston, MA 02215 USA
[3] Harvard Univ, Sch Med, Boston, MA USA
[4] Rhein Westfal TH Aachen, Dept Radiol, Aachen, Germany
[5] EPIX Med Inc, Cambridge, MA USA
关键词
thrombosis; coronary disease; magnetic resonance imaging;
D O I
10.1161/01.CIR.0000134960.31304.87
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background-The advent of fibrin-binding molecular magnetic resonance (MR) contrast agents and advances in coronary MRI techniques offers the potential for direct imaging of coronary thrombosis. We tested the feasibility of this approach using a gadolinium (Gd)-based fibrin-binding contrast agent, EP-2104R (EPIX Medical Inc), in a swine model of coronary thrombus and in-stent thrombosis. Methods and Results-Ex vivo and in vivo sensitivity of coronary MR thrombus imaging was tested by use of intracoronarily delivered Gd-DTPA-labeled fibrinogen thrombi (n=6). After successful demonstration, in-stent coronary thrombosis was induced by x-ray-guided placement of thrombogenic-coated, MR- lucent stents (n=5). After stent placement, 60 mumol of EP-2104R was injected via the left main coronary artery. Free-breathing, navigator-gated 3D coronary MR angiography and thrombus imaging were performed (1) before and after stent placement and (2) before and after EP-2104R. Thrombi were confirmed by x-ray angiography and autopsy. Fibrinogen thrombi: 5 of 6 intracoronarily delivered Gd-labeled fibrinogen clots (approximate to250 mumol/L Gd) were visible on MRI and subsequently confirmed by x-ray angiography. In-stent thrombi: in-stent thrombosis was observed in all stents after EP-2104R. Four of 5 thrombi were confirmed by x-ray angiography. Chemical analysis of 2 thrombi demonstrated 99 to 147 mumol/L Gd. Conclusions-We demonstrate the feasibility of MRI of coronary thrombus and in-stent thrombosis using a novel fibrin-binding molecular MR contrast agent. Potential applications include detection of coronary in-stent thrombosis or thrombus burden in patients with acute coronary syndromes.
引用
收藏
页码:1463 / 1466
页数:4
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