Characterization of pip5k3 fleck corneal dystrophy-linked gene in zebrafish.

PIKfyve is a kinase encoded by pip5k3 involved in phosphatidylinositols (PdtIns) pathways. These lipids building cell membranes have structural functions and are involved in complex intracellular regulations. Mutations in human PIP5K3 are associated with François-Neetens mouchetée fleck corneal dystrophy [Li, S., Tiab, L., Jiao, X., Munier, F.L., Zografos, L., Frueh, B.E., Sergeev, Y., Smith, J., Rubin, B., Meallet, M.A., Forster, R.K., Hejtmancik, J.F., Schorderet, D.F., 2005. Mutations in PIP5K3 are associated with François-Neetens mouchetee fleck corneal dystrophy. Am. J. Hum. Genet. 77, 54-63]. We cloned the zebrafish pip5k3 and report its molecular characterization and expression pattern in adult fish as well as during development. The zebrafish PIKfyve was 70% similar to the human homologue. The gene encompassed 42 exons and presented four alternatively spliced variants. It had a widespread expression in the adult organs and was localized in specific cell types in the eye as the cornea, lens, ganglion cell layer, inner nuclear layer and outer limiting membrane. Pip5k3 transcripts were detected in early cleavage stage embryos. Then it was uniformly expressed at 10 somites, 18 somites and 24 hpf. Its expression was then restricted to the head region at 48 hpf, 72 hpf and 5 dpf and partial expression was found in somites at 72 hpf and 5 dpf. In situ on eye sections at 3 dpf showed a staining mainly in lens, outer limiting membrane, inner nuclear layer and ganglion cell layer. A similar expression pattern was found in the eye at 5 dpf. A temporal regulation of the spliced variants was observed at 1, 3 and 5 dpf and they were also found in the adult eye.

The zebrafish is an animal model in ophthalmic diseases : Fleck corneal dystrophy and Schorderet-Munier syndrome

RAPPORT DE SYNTHÈSE : Pip5k3 : Pip5k3 is a kinase responsible for fleck corneal dystrophy when mutated. It is a well conserved gene that has only been characterized in human and mouse. Characterization of pip5k3 in zebrafish was necessary before using it as a model. The protein is 70 % similar to the human homologue. The full coding sequence encompasses 6303 by and presented four isoforms. They were differentially expressed during development. All the analyzed organs of the adult zebrafish expressed pip5k3. The adult eye expressed pip5k3 in the cornea, lens, ganglion cell layer (GCL), inner nuclear layer (INL) and outer limiting membrane (OLM). During development, pip5k3 was first uniformly expressed before to be restricted to the head region and to the somites. The expression of pip5k3 in the cornea of the larval eye could make possible the study of fleck corneal dystrophy on this animal. NkxS-3 : NKXS-3 is a transcription factor responsible for a new oculo-auricular syndrome in human when mutated. This recessive disorder is characterized by defects in ear lobule and multiple defects in eye, including microphthalmia and cataract. During development, the zebrafish expressed nkx5-3 in the lens, in the anterior retina and in otic vesicles. Knockdown experiments partially phenocopied the human disease. Microphthalmia and cataract were reproduced, but zebrafish showed also defects in the cartilage of the jaw associated with a microcephaly and fins abnormalities. The retinal cell differentiation was delayed, possibly linked with the delayed expression of at`h5 and crx also observed in morphants. Shh, a regulator of ath5, was normally expressed in morphant. Overexpression of nkx5-3 lead to an anophthalmia, suggesting a role at the early organogenesis of the eye. All the phenotypes observed in morphants and embryos overexpressing nkx5-3 suggest a potential involvement of the FGF and hedgehog signaling pathways.

A novel PIKFYVE mutation in fleck corneal dystrophy.

Purpose: To report the findings of the clinical and molecular evaluation in a Greek family with fleck corneal dystrophy (CFD).Methods: A 58-year-old woman was seen on routine ophthalmic examination and diagnosed as having CFD. All available family members were examined to evaluate the clinical findings and inheritance of the disease. Twenty members of the family in five generations underwent slit-lamp examination. Eleven were females and nine males, aged from two years to 85 years old. Blood samples were available from four patients with CFD and seven unaffected relatives, and the DNAs were subjected to molecular screening of the phosphoinositide kinase, five finger-containing (PIKFYVE) gene by direct sequencing or denaturing high performance liquid chromatography (DHPLC).Results: The clinical evaluation revealed six family members (five females and one male) with CFD. In two CFD patients early cataract formation was noticed. All patients affected with the corneal dystrophy were asymptomatic. The molecular analyses demonstrated the existence of a novel c. 3060-3063delCCTT (p.P968Vfs23) mutation in PIKFYVE in all CFD patients tested but in none of the six unaffected family members. No molecular screening was performed in the seventh unaffected member as the causative mutation was clearly transmitted from his affected wife to his affected son.Conclusions: We report on the clinical and molecular findings of a five generation Greek family with CFD and we conclude that the novel c. 3060-3063delCCTT (p. P968Vfs23) mutation in PIKFYVE, which segregated with the disease, was the causative mutation in this family.

Gadolinium Enhanced MR Coronary Vessel Wall Imaging at 3.0 Tesla.

Purpose. We evaluated the influence of the time between low-dose gadolinium (Gd) contrast administration and coronary vessel wall enhancement (LGE) detected by 3T magnetic resonance imaging (MRI) in healthy subjects and patients with coronary artery disease (CAD). Materials and Methods. Four healthy subjects (4 men, mean age 29 ± 3 years and eleven CAD patients (6 women, mean age 61 ± 10 years) were studied on a commercial 3.0 Tesla (T) whole-body MR imaging system (Achieva 3.0 T; Philips, Best, The Netherlands). T1-weighted inversion-recovery coronary magnetic resonance imaging (MRI) was repeated up to 75 minutes after administration of low-dose Gadolinium (Gd) (0.1 mmol/kg Gd-DTPA). Results. LGE was seen in none of the healthy subjects, however in all of the CAD patients. In CAD patients, fifty-six of 62 (90.3%) segments showed LGE of the coronary artery vessel wall at time-interval 1 after contrast. At time-interval 2, 34 of 42 (81.0%) and at time-interval 3, 29 of 39 evaluable segments (74.4%) were enhanced. Conclusion. In this work, we demonstrate LGE of the coronary artery vessel wall using 3.0 T MRI after a single, low-dose Gd contrast injection in CAD patients but not in healthy subjects. In the majority of the evaluated coronary segments in CAD patients, LGE of the coronary vessel wall was already detectable 30-45 minutes after administration of the contrast agent.

Detection of coronary stenoses with contrast enhanced, three-dimensional free breathing coronary MR angiography using the gadolinium-based intravascular contrast agent gadocoletic acid (B-22956).

PURPOSE: To determine the diagnostic value of the intravascular contrast agent gadocoletic acid (B-22956) in three-dimensional, free breathing coronary magnetic resonance angiography (MRA) for stenosis detection in patients with suspected or known coronary artery disease. METHODS: Eighteen patients underwent three-dimensional, free breathing coronary MRA of the left and right coronary system before and after intravenous application of a single dose of gadocoletic acid (B-22956) using three different dose regimens (group A 0.050 mmol/kg; group B 0.075 mmol/kg; group C 0.100 mmol/kg). Precontrast scanning followed a coronary MRA standard non-contrast T2 preparation/turbo-gradient echo sequence (T2Prep); for postcontrast scanning an inversion-recovery gradient echo sequence was used (real-time navigator correction for both scans). In pre- and postcontrast scans quantitative analysis of coronary MRA data was performed to determine the number of visible side branches, vessel length and vessel sharpness of each of the three coronary arteries (LAD, LCX, RCA). The number of assessable coronary artery segments was determined to calculate sensitivity and specificity for detection of stenosis > or = 50% on a segment-to-segment basis (16-segment-model) in pre- and postcontrast scans with x-ray coronary angiography as the standard of reference. RESULTS: Dose group B (0.075 mmol/kg) was preferable with regard to improvement of MR angiographic parameters: in postcontrast scans all MR angiographic parameters increased significantly except for the number of visible side branches of the left circumflex artery. In addition, assessability of coronary artery segments significantly improved postcontrast in this dose group (67 versus 88%, p < 0.01). Diagnostic performance (sensitivity, specificity, accuracy) was 83, 77 and 78% for precontrast and 86, 95 and 94% for postcontrast scans. CONCLUSIONS: The use of gadocoletic acid (B-22956) results in an improvement of MR angiographic parameters, asssessability of coronary segments and detection of coronary stenoses > or = 50%.

Magnetic resonance stress tagging in ischemic heart disease.

High-dose dobutamine magnetic resonance stress testing has been shown to be superior to dobutamine stress echocardiography for diagnosis of coronary artery disease (CAD). We determined the feasibility of quantitative myocardial tagging during low- and high-dose dobutamine stress and tested the ability of global systolic and diastolic quantitative parameters to identify patients with significant CAD. Twenty-five patients suspected of having significant CAD were examined with a standard high-dose dobutamine/atropine stress magnetic resonance protocol (1.5-T scanner, Philips). All patients underwent invasive coronary angiography as the standard of reference for the presence (n = 13) or absence (n = 12) of significant CAD. During low-dose dobutamine stress, systolic (circumferential shortening, systolic rotation, and systolic rotation velocity) and diastolic (velocity of circumferential lengthening and diastolic rotation velocity) parameters changed significantly in patients without CAD (all P < 0.05 vs. rest) but not in patients with CAD. Identification of patients without and with CAD during low-dose stress was possible using the diastolic parameter of "time to peak untwist." At high-dose stress, none of the global systolic or diastolic parameters showed the potential to identify the presence of significant CAD. With myocardial tagging, a quantitative analysis of systolic and diastolic function was feasible during low- and high-dose dobutamine stress. In our study, the diastolic parameter of time to peak untwist as assessed during low-dose dobutamine stress was the most promising global parameter for identification of patients with significant CAD. Thus quantitative myocardial tagging may become a tool that reduces the need for high-dose dobutamine stress.

Neurobiologia, coscienza e neuroetica. Ricerche filosofiche in margine al dialogo tra G.P. CHANGEUX e P. RICOEUR

Le neuroscienze occupano oggi un ruolo essenziale nel dibattito scientifico e filosofico, nonché in quello delle scienze umane. Esse costituiscono la sfida più seria al sapere fin qui elaborato intorno ai fondamenti dell'esperienza di coscienza, poiché si propongono come capaci di rispondere alla domanda di origine e funzionamento della coscienza. Le neuroscienze cognitive stanno, oggi, rivoluzionando la nostra concezione della mente e delle sue funzioni. Ci forniscono nuovi dati sulla natura delle sensazioni, della memoria, della percezione e dei processi di astrazione. L'epistemologia è rientrata così pienamente nell'ambito di una disciplina sperimentale, come diversi filosofi (da Hume a Quine) hanno auspicato. È, alla fine, evoluta nell'esperienza odierna della cosiddetta "epistemologia sperimentale", luogo che coniuga il rigore sperimentale della scienza con la profondità e la sofisticazione argomentativa della tradizione filosofica. Come arriviamo a conoscere? Quali vincoli poniamo a quello che deve essere conosciuto? Perché seguiamo certe vie invece di altre? Come arriviamo a formulare giudizi e a prendere decisioni? Che valore ha la conoscenza già acquisita nell'elaborazione di nuove esperienze? In particolare, che peso hanno le aspettative e i ricordi in questo processo? Qual è il rapporto fra esperienza, conoscenza e memoria? Come si fissano e come si richiamano i ricordi? Qual è il rapporto fra coscienza e memoria? Sono alcune delle domande che l'autore si pone in questa ottica e alle quali cerca di rispondere, a partire dall'analisi e valutazione del dialogo-dibattito fra J.-P. Changeux e P. Ricoeur, per apprenderne il linguaggio, capire i problemi sollevati, adattarsi alla complessità della materia. Nel contesto della filosofia della mente, la "lettura" della discussione ripercorre i relativi percorsi attraverso l'analisi delle loro opere, da un lato quelle dello scienziato (sulla struttura e dinamica del cervello, la teoria dell'epigenesi e stabilizzazione selettiva, le speculazioni sull'uomo neuronale e i rilievi antropologici, le teorie della conoscenza e della coscienza, oltre che sulla conoscenza matematica, gli argomenti di estetica ed etica); dall'altro lato quelle del filosofo (dal Cogito riflessivo alla scoperta dell'ermeneutica, dalle eterogenee riflessioni sul Conflitto delle interpretazioni alla grande teoria sulla creatività del linguaggio, le conclusioni teoriche sull'ermeneutica del sé e l'ontologia dell'agire). Il punto di arrivo è la determinazione delle relative posizioni: quella di Changeux tra i neuroscienziati che si occupano di questioni filosofiche, epistemologiche ed etiche, e quella di Ricoeur tra i filosofi che si occupano di neuroscienze. La conclusione della tesi si svolge in un approfondimento teoretico che dalla nozione di "traccia" porta all'esperienza della "memoria", al fine di intrecciare i fili della discussione ripercorsa ed offrire una sponda non forzata al dibattito più ampio. Il tema della memoria è privilegiato per ragioni intrinseche, poiché si tratta di uno dei temi precipui delle neuroscienze, della filosofia della mente e della fenomenologia. A un primo livello viene instaurato su questo punto un confronto epistemologico tra la proposta della neurofenomenologia (Varala, ad esempio) e la posizione tenuta in particolare da Ricoeur rispetto ad essa e al suo "progetto unificante", posizione defilata e, per certi aspetti, criticamente dubbiosa sul fatto che si possa davvero giungere a un "terzo discorso". Si riferisce poi del largo interesse e dei risultati più significativi della riflessione fenomenologica antica e moderna sulla memoria. A un secondo livello vengono illustrati i programmi di ricerca recenti della neurofenomenologia su questo argomento all'interno delle scienze cognitive e si dà conto dei risultati più significativi. Ad un terzo e conclusivo livello, si approfondisce il significato teologico della memoria. Les neurosciences ont aujourd'hui un rôle essentiel dans le débat scientifique et philosophique, ainsi que dans celui des sciences humaines. Elles constituent le défi le plus sérieux aux savoir qu'on a construit jusqu'ici sur les fondements de l'expérience de conscience, attendu qu'elles-mêmes se considèrent capables de répondre à la demande sur l'origine e le fonctionnement de la conscience. Les neurosciences cognitives sont aujourd'hui en train de révolutionner notre conception de l'esprit et des ses fonctions. Elles nous offrent des nouvelles données au sujet de la nature de nos sensations, mémoire, perception et procédés d'abstraction. Aussi l'épistémologie est rentrée pleinement dans le domaine d'une discipline expérimentale, comme plusieurs philosophes (de Hume à Quine) l'ont souhaité. Elle s'est enfin adressée, dans l'expérience actuelle, vers la soi-disant "épistémologie expérimentale", lieu qui met en accord la rigueur expérimentale de la science avec la profondeur et la sophistiquée finesse argumentative de la tradition philosophique. Comment en arrivons-nous à connaître? Quels liens mettons-nous à ce qu'on doit être connu? Pourquoi suivons-nous certaines vois au lieu d'autres? Comment en arrivons-nous à formuler des opinions et à prendre des décisions? Quelle valeur a la connaissance qu'on a déjà acquise par l'élaboration des nouvelles expériences? En particulier, quelle est l'importance des attentes et des souvenirs dans cette évolution? Quel est le rapport entre expérience, connaissance e mémoire? Comment fixons et rappelons-nous nos souvenirs? Quel est le rapport entre conscience et mémoire? Ces sont quelques-unes des questions que l'auteur se pose dans cette perspective et aux quelles essaie de répondre a partir de l'analyse et l'évaluation du dialogue-débat entre fra J.-P. Changeux et P. Ricoeur, pour en apprendre le langage, comprendre les problèmes soulevés, s'adapter à la complexité du sujet. Dans le contexte de la philosophie du cerveau, la "lecture" du dialogue reparcourt les parcours des deux interlocuteurs par l'analyse de leur ouvrages, d'une part celles du savant (sur la structure et la dynamique du cerveau, la théorie de l'épigenèse et stabilisation sélective; les spéculations sur l'homme neuronal et les commentaires anthropologiques; les théories de la connaissance et de la conscience, de même que sur la connaissance de la mathématique, les sujets d'esthétique et étique; d'autre part celles du philosophe (du Cogito réflexif à la découverte de l'herméneutique, de les hétérogènes réflexions sur le Conflit des interprétations à la grande théorie sur la créativité du langage, les conclusions théoriques sur l'herméneutique du soi et l'ontologie de l'agir). L'issue est la determination des relatives positions: celle de Changeux parmi les neuro-scientifiques qui s'occupent de questions philosophiques, épistémologiques et éthiques, et celle de Ricoeur parmi les philosophes qui s'occupent de neurosciences. La conclusion de la thèse se développe dans un approfondissement théorétique que de la notion de "trace" à l'expérience de la "mémoire", à l'effet de nouer les fils de la discussion passée en revue et d'assurer un appui pas forcé au débat plus vaste. Le thème de la mémoire a été choisi pour des raisons intrinsèques, puisqu'il est un des thèmes principaux des neurosciences, de la philosophie de l'esprit et de la phénoménologie. Sur un premier plan épistémologique il est établi une comparaison entre la proposition de la neurophénoménologie (Varala, par exemple) et la position soutenue en particulier par Ricoeur au sujet de ce courant phénoménologique et de son "projet unifiant", position défilée et, à certains égards, critiquement hésitante sur le fait qu'on puisse vraiment en venir à un "troisième discours". On rend compte du grand intérêt et des résultats les plus significatifs de la réflexion phénoménologique ancienne et moderne sur la mémoire. Sur un second plan neurophénoménologique on illustre des plans de recherche récents sur cet argument au-dedans des sciences cognitives et on rend compte des résultats les plus distinctives. Sur un troisième et conclusif plan on approfondit le sens théologique de la mémoire.

Use of 2D Sensitivity Encoding for Slow-Infusion Contrast-Enhanced Isotropic 3-T Whole-Heart Coronary MR Angiography.

OBJECTIVE. The purpose of this study was to improve the blood-pool signal-to-noise ratio (SNR) and blood-myocardium contrast-to-noise ratio (CNR) of slow-infusion 3-T whole-heart coronary MR angiography (MRA).SUBJECTS AND METHODS. In 2D sensitivity encoding (SENSE), the number of acquired k-space lines is reduced, allowing less radiofrequency excitation per cardiac cycle and a longer TR. The former can be exploited for signal enhancement with a higher radiofrequency excitation angle, and the latter leads to noise reduction due to lower data-sampling bandwidth. Both effects contribute to SNR gain in coronary MRA when spatial and temporal resolution and acquisition time remain identical. Numeric simulation was performed to select the optimal 2D SENSE pulse sequence parameters and predict the SNR gain. Eleven patients underwent conventional unenhanced and the proposed 2D SENSE contrast-enhanced coronary MRA acquisition. Blood-pool SNR, blood-myocardium CNR, visible vessel length, vessel sharpness, and number of side branches were evaluated.RESULTS. Consistent with the numeric simulation, using 2D SENSE in contrast-enhanced coronary MRA resulted in significant improvement in aortic blood-pool SNR (unenhanced vs contrast-enhanced, 37.5 +/- 14.7 vs 121.3 +/- 44.0; p < 0.05) and CNR (14.4 +/- 6.9 vs 101.5 +/- 40.8; p < 0.05) in the patient sample. A longer length of left anterior descending coronary artery was visualized, but vessel sharpness, coronary artery coverage, and image quality score were not improved with the proposed approach.CONCLUSION. In combination with contrast administration, 2D SENSE was found effective in improving SNR and CNR in 3-T whole-heart coronary MRA. Further investigation of cardiac motion compensation is necessary to exploit the SNR and CNR advantages and to achieve submillimeter spatial resolution.

Performance of a new gadolinium-based intravascular contrast agent in free-breathing inversion-recovery 3D coronary MRA.

In three-dimensional (3D) coronary magnetic resonance angiography (MRA), the in-flow contrast between the coronary blood and the surrounding myocardium is attenuated as compared to thin-slab two-dimensional (2D) techniques. The application of a gadolinium (Gd)-based intravascular contrast agent may provide an additional source of signal and contrast by reducing T(1blood) and supporting the visualization of more distal or branching segments of the coronary arterial tree. In six healthy adults, the left coronary artery (LCA) system was imaged pre- and postcontrast with a 0.075-mmol/kg bodyweight dose of the intravascular contrast agent B-22956. For imaging, an optimized free-breathing, navigator-gated and -corrected 3D inversion recovery (IR) sequence was used. For comparison, state-of-the-art baseline 3D coronary MRA with T(2) preparation for non-exogenous contrast enhancement was acquired. The combination of IR 3D coronary MRA, sophisticated navigator technology, and B-22956 allowed for an extensive visualization of the LCA system. Postcontrast, a significant increase in both the signal-to-noise ratio (SNR; 46%, P < 0.05) and contrast-to-noise ratio (CNR; 160%, P < 0.01) was observed, while vessel sharpness of the left anterior descending (LAD) artery and the left coronary circumflex (LCX) were improved by 20% (P < 0.05) and 18% (P < 0.05), respectively.

Life design: Un paradigma per la costruzione della vita professionale nel XXI secolo

In questo inizio di secolo, la nuova organizzazione sociale del lavoro pone una serie di domande e di sfide ai ricercatori che intendono aiutare le persone a progettare la loro vita lavorativa. Nell'era della globalizzazione anche per quanto riguarda il career counseling, abbiamo deciso di affrontare queste problematiche e di dare delle risposte che si caratterizzassero come innovative attraverso la costituzione di un forum di discussione internazionale. Si è proceduto in questo modo per evitare le difficoltà che generalmente si incontrano quando si mettono a punto dei modelli e dei metodi in un Paese e poi si esportano in altre culture con l'intento di adattarli alle stesse. Questo articolo presenta i primi risultati della collaborazione che si è registrata - un modello e dei metodi per la consulenza di orientamento. Il modello per l'intervento nell'ambito dell'approccio Life Design si caratterizza per cinque presupposti relativi al modo di vedere le persone e la loro vita lavorativa. Essi riguardano le possibilità contestuali, i processi dinamici, i progressi non-lineari, le molteplici prospettive e la presenza di pattern personali. Partendo da questi cinque presupposti abbiamo messo a punto un modello basato sull'epistemologia del costruzionismo sociale, che sostiene che la conoscenza e l'identità di un individuo sono i prodotti dell'interazione sociale e che il significato è costruito attraverso il discorso. Questo approccio fa riferimento anche alla teoria della costruzione di sé di Guichard (2005) e della costruzione della vita professionale di Savickas (2005), che descrivono le azioni utili a facilitare la progettazione del proprio futuro. Particolare attenzione viene data agli interventi nel corso dell'arco di vita, olistici, contestuali e preventivi.

Improved three-dimensional free-breathing coronary magnetic resonance angiography using gadocoletic acid (B-22956) for intravascular contrast enhancement.

PURPOSE: To evaluate gadocoletic acid (B-22956), a gadolinium-based paramagnetic blood pool agent, for contrast-enhanced coronary magnetic resonance angiography (MRA) in a Phase I clinical trial, and to compare the findings with those obtained using a standard noncontrast T2 preparation sequence. MATERIALS AND METHODS: The left coronary system was imaged in 12 healthy volunteers before B-22956 application and 5 (N = 11) and 45 (N = 7) minutes after application of 0.075 mmol/kg of body weight (BW) of B-22956. Additionally, imaging of the right coronary system was performed 23 minutes after B-22956 application (N = 6). A three-dimensional gradient echo sequence with T2 preparation (precontrast) or inversion recovery (IR) pulse (postcontrast) with real-time navigator correction was used. Assessment of the left and right coronary systems was performed qualitatively (a 4-point visual score for image quality) and quantitatively in terms of signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), vessel sharpness, visible vessel length, maximal luminal diameter, and the number of visible side branches. RESULTS: Significant (P < 0.01) increases in SNR (+42%) and CNR (+86%) were noted five minutes after B-22956 application, compared to precontrast T2 preparation values. A significant increase in CNR (+40%, P < 0.05) was also noted 45 minutes postcontrast. Vessels (left anterior descending artery (LAD), left coronary circumflex (LCx), and right coronary artery (RCA)) were also significantly (P < 0.05) sharper on postcontrast images. Significant increases in vessel length were noted for the LAD (P < 0.05) and LCx and RCA (both P < 0.01), while significantly more side branches were noted for the LAD and RCA (both P < 0.05) when compared to precontrast T2 preparation values. CONCLUSION: The use of the intravascular contrast agent B-22956 substantially improves both objective and subjective parameters of image quality on high-resolution three-dimensional coronary MRA. The increase in SNR, CNR, and vessel sharpness minimizes current limitations of coronary artery visualization with high-resolution coronary MRA.

Delayed contrast-enhanced MRI of the coronary artery wall in takayasu arteritis.

BACKGROUND: Takayasu arteritis (TA) is a rare form of chronic inflammatory granulomatous arteritis of the aorta and its major branches. Late gadolinium enhancement (LGE) with magnetic resonance imaging (MRI) has demonstrated its value for the detection of vessel wall alterations in TA. The aim of this study was to assess LGE of the coronary artery wall in patients with TA compared to patients with stable CAD. METHODS: We enrolled 9 patients (8 female, average age 46±13 years) with proven TA. In the CAD group 9 patients participated (8 male, average age 65±10 years). Studies were performed on a commercial 3T whole-body MR imaging system (Achieva; Philips, Best, The Netherlands) using a 3D inversion prepared navigator gated spoiled gradient-echo sequence, which was repeated 34-45 minutes after low-dose gadolinium administration. RESULTS: No coronary vessel wall enhancement was observed prior to contrast in either group. Post contrast, coronary LGE on IR scans was detected in 28 of 50 segments (56%) seen on T2-Prep scans in TA and in 25 of 57 segments (44%) in CAD patients. LGE quantitative assessment of coronary artery vessel wall CNR post contrast revealed no significant differences between the two groups (CNR in TA: 6.0±2.4 and 7.3±2.5 in CAD; p = 0.474). CONCLUSION: Our findings suggest that LGE of the coronary artery wall seems to be common in patients with TA and similarly pronounced as in CAD patients. The observed coronary LGE seems to be rather unspecific, and differentiation between coronary vessel wall fibrosis and inflammation still remains unclear.