Differences of plaque characterization of high-intensity and non high-intensity plaques on non-contrast T1-weighted magnetic resonance imaging using angioscopy and optical coherence tomography

Abstract

Coronary high-intensity plaques (HIPs) visualized by non-contrast T1-weighted imaging (T1WI) in cardiac magnetic resonance (CMR) were associated with coronary events. We report a case of a 68-year-old man with an old myocardial infarction. He had undergone CMR to exclude new coronary artery disease, because he sometimes had an atypical chest symptom. The moderate stenosis in the right coronary artery (RCA) showed non HIP on non-contrast T1WI. We observed HIP in the proximal left anterior descending artery (LAD) without significant stenosis. Non HIP lesion in the RCA showed fibrous and calcified plaque without thrombus by optical coherence tomography (OCT) and angioscopy. On the other hand, the HIP lesion in the LAD showed lipid plaque with thrombus by OCT, and yellow plaque with mobile mixed thrombus by angioscopy.<Learning objective: These intracoronary modalities suggested that the HIP lesion is correlated with vulnerable plaques. Invasive coronary angiography (CAG) is considered the gold standard for the diagnosis of coronary disease, but CAG is thought not to be able to predict future events. Non-contrast T1WI on CMR may be able to use for screening of vulnerable plaques.>