Inflammation contributes importantly to atherosclerosis, but detection in humans is limited to surrogate inflammatory markers in blood. We assessed whether 1.5 T cardiac MRI using a double inversion recovery fast spin echo sequence could detect vascular inflammation in vivo, by means of 3 potential imaging characteristics of vascular inflammation : 1)arterial wall contrast agent enhancement with gadolinium-DTPA (0.1 mmol/kg) as an index of intramural vasovasorum dilation and increased capillary permeability, 2) increased T2 values as an index of arterial wall edema, and 3) increased wall thickness as an index of arterial wall edema and infiltration. Twenty-seven subjects >40 years of age underwent carotid artery and infrarenal aorta MRI: 10 had coronary artery disease (CAD), 6 had LDL cholesterol >160 mg/dL, and 11 had no conventional risk factors for CAD (normals). The following surrogate inflammatory markers were measured in serum: vascular cell adhesion molecule (VCAM-1), intercellular adhesion molecule (ICAM-1), E-selectin (E-S), interleukin-6 (IL-6), and C-reactive protein (CRP). Results: Fifteen subjects (including 7 CAD patients and 5 normals) had 1 or more MRI indices of vascular inflammation (>1 S.D. above group mean values) in carotid and/or aortic walls: 8 had increased T2 values or contrast enhancement without increased wall thickness, 4 had increased wall thickness only, and 3 had combinations of indices. Compared with remaining subjects, the 15 subjects with MRI indices of inflammation had higher levels of VCAM-1 (510+/-128 vs. 385+/-84 ng/mL, p<0.01), ICAM-1 (246+/-80 vs. 186+/-24 ng/mL, p<0.01), and IL-6 (3.1+/-2.0 vs. 1.5+/-0.6 pg/mL, p<0.01); and had nonsignificant elevations in E-S (48+/-18 vs. 43+/-14 ng/mL), and CRP (0.31+/-0.27 vs. 0.20+/-0.41 mg/dL). We conclude that MRI characteristics of large arteries may permit in vivo noninvasive detection of vascular inflammation, even in apparently healthy middle-aged and older subjects without conventional risk factors for CAD. - atherosclerosis, inflammation, magnetic resonance imaging - Human Subjects
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