Correlation of carotid atheromatous plaque inflammation with biomechanical stress: Utility of USPIO enhanced MR imaging and finite element analysis

Objective: The aim of this study was to explore whether there is a relationship between the degree of MR-defined inflammation using ultra small super-paramagnetic iron oxide (USPIO) particles, and biomechanical stress using finite element analysis (FEA) techniques, in carotid atheromatous plaques. Methods and Results: 18 patients with angiographically proven carotid stenoses underwent multi-sequence MR imaging before and 36 h after USPIO infusion. T2 * weighted images were manually segmented into quadrants and the signal change in each quadrant normalised to adjacent muscle was calculated after USPIO administration. Plaque geometry was obtained from the rest of the multi-sequence dataset and used within a FEA model to predict maximal stress concentration within each slice. Subsequently, a new statistical model was developed to explicitly investigate the form of the relationship between biomechanical stress and signal change. The Spearman's rank correlation coefficient for USPIO enhanced signal change and maximal biomechanical stress was -0.60 (p = 0.009). Conclusions: There is an association between biomechanical stress and USPIO enhanced MR-defined inflammation within carotid atheroma, both known risk factors for plaque vulnerability. This underlines the complex interaction between physiological processes and biomechanical mechanisms in the development of carotid atheroma. However, this is preliminary data that will need validation in a larger cohort of patients.

In vivo positive contrast IRON sequence and quantitative T2* measurement confirms inflammatory burden in a patient with asymptomatic carotid atheroma after USPIO-enhanced MR Imaging

The authors report an in vivo human examination of carotid atheroma by using the inversion-recovery ON resonance (IRON) sequence, which is able to produce positive contrast after the infusion of an ultrasmall super paramagnetic iron oxide (USPIO) contrast medium. This technique provides a method of potentially identifying inflammatory burden within carotid atheroma. This may be particularly useful in patients who currently do not meet criteria for intervention (ie, moderate symptomatic stenosis or <70% asymptomatic stenosis) to further risk-stratify this important patient cohort. A 63-year-old man was imaged at 1.5 T before and 36 hours after USPIO infusion by using the IRON sequence. Regions of interest showing profound signal loss at T2*-weighted imaging corresponded well with regions of positive contrast at IRON imaging after the administration of USPIO. These regions also showed a profound decrease in T2* measurements after USPIO infusion, whereas surrounding tissue did not. It has been shown that such strong signal loss on T2*-weighted images after USPIO infusion is indicative of USPIO uptake.

Non-invasive MR imaging of inflammation in a patient with both asymptomatic carotid atheroma and an abdominal aortic aneurysm: A case report

Inflammation is a recognized risk factor for the vulnerable atherosclerotic plaque. USPIO-enhanced MRI imaging is a promising non-i nvasive method to identify high-risk atheromatous plaque inflammation in vivo in humans, in which areas of focal signal loss on MR images have been shown to correspond to the location of activated macrophages, typically at the shoulder regions of the plaque. This is the first report in humans describing simultaneous USPIO uptake within atheroma in two different arterial territories and again emphasises that atherosclerosis is a truly systemic disease. With further work, USPIO-enhanced MR imaging may be useful in identifying inflamed vulnerable atheromatous plaques in vivo, so refining patient selection for intervention and allowing appropriate early aggressive pharmacotherapy to prevent plaque rupture.

Mr. and Mrs. Fuerst Berlin, Hans Frankenbach, Wronker Slogau? and Lilienthal Berlin seated at an outdoor table; Brambach, Germany Portraits Goups

Digital Image

Eine Erinnerung an den 67. Geburtstag des Herrn Sobernheim (in memory of the 67th birthday of Mr. Sobernheim); Wiesbaden Portraits Groups

Participants include Erna Hirsch, Else Giesenow, Marta Nachmann, Erna Goldschmidt (Goldi), Lotte Strauss, Marta Bruchfeld, Toni Eichenberg, Grete Guthmann, Flora Goldschmidt, Hedwig Trum, Hedel Korhmann, Paula Arendt, Erna Behr and Frl. Minka Friedmann

Albert and Elsa Einstein at the Shanghai home of Chinese painter and calligrapher Wang Yiting; with Shanghai University President Yu Youren, former Beijing University professor Zhang Junmai, the Einstein's Japanese hosts Mr. and Mrs. Inagaki, and Einstein's colleague Mr. Pfister and his wife (and daughter?) Portraits Groups

Dedication: Freundlichste Erinnerung an Herrn Prof. Einstein und seine Frau Gemahlin. I-Jing Wang, Shanghai, China

Studio portrait of the sister of Max Rieser with her husband Mr. Karpf; Krakow Portraits Couples

Max Rieser's sister and her husband died in a concentration camp in Poland during the Holocaust

Albert and Elsa Einstein at the Shanghai home of Chinese painter and calligrapher Wang Yiting; with Shanghai University President Yu Youren, former Beijing University professor Zhang Junmai, the Einstein's Japanese hosts Mr. and Mrs. Inagaki, and Einstein's colleague Mr. Pfister and his wife (and daughter?) Portraits Groups

Dedication: Freundlichste Erinnerung an Herrn Prof. Einstein und seine Frau Gemahlin. I-Jing Wang, Shanghai, China

Optimum design of a Lanchester damper for a viscously damped single degree of freedom system subjected to inertial excitation

The problem of designing an optimum Lanchester damper for a viscously damped single degree of freedom system subjected to inertial harmonic excitation is investigated. Two criteria are used for optimizing the performance of the damper: (i) minimum motion transmissibility; (ii) minimum force transmissibility. Explicit expressions are developed for determining the absorber parameters.