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30 Whole body contrast enhanced MRA can quantify and monitor atherosclerosis progression
  1. JR Weir-McCall1,
  2. RD White2,
  3. SJ Gandy3,
  4. PG Ramkumar4,
  5. JJF Belch1,
  6. AD Struthers1,
  7. JG Houston1,4
  1. 1Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, DD1 9SY, UK
  2. 2Department of Clinical Radiology, University Hospital of Wales, Cardiff, CF14 4XW, UK
  3. 3Medical Physics, Ninewells Hospital, Dundee, DD1 9SY, UK
  4. 4Clinical Radiology, Ninewells Hospital, Dundee, DD1 9SY, UK

Abstract

Aim To determine the ability of whole body magnetic resonance angiography (WB-MRA) to measure global atheroma burden progression.

Methods 50 consecutive patients with symptomatic peripheral arterial disease referred for clinical MRA were recruited. WB-MRA was performed at baseline, 6 months and 3 years. WB-MRA data was analysed by dividing the vasculature into 31 anatomical arterial segments. Each segment was scored according to degree of luminal narrowing: 0=normal, 1 = <50%, 2 = 50–70%, 3 = 71–99%, 4 = vessel occlusion. From this a standardised atheroma score (SAS) was calculated with a maximum score of 100 and minimum score of 0. Progression was assessed with repeat measure ANOVA.

Results 36 patients were scanned at 0 and 6 months, with 26 patients scanned at the three year follow up. Only those who completed all 3 visits were included in the final analysis. At 3 years, n = 18 demonstrated atheroma progression while n = 8 showed stable or improved disease. Those with no progression had significantly lower baseline SAS, and were more likely to be on statin therapy (p < 0.05 for both). Baseline SAS was 15.7 ± 10.3 at baseline with no progression at 6 months (SAS=16.4 ± 10.5, p = 0.67). At 3 years there was significant progression in atheroma (SAS = 17.7 ± 11.5, p = 0.01) (Figure 1). On multiple linear regression, age (β 0.14 p = 0.014), pulse pressure (β −0.12 p = 0.005) and ankle-brachial pressure index (β −7.7 p = 0.036) were independently associated with the rate of progression.

Abstract 30 Figure 1

Comparison of atheroma score at baseline, 6 months and 3 years. Visit 1 = Baseline, Visit 2 = 6months, Visit 3 = 3 years. T-bars represent 95% confidence intervals.

Conclusion Whole body contrast enhanced MRA can quantify and monitor atherosclerosis progression at 3 year follow-up even in a small cohort.

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