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(Stroke. 2004;35:1631.)
© 2004 American Heart Association, Inc.

Original Contributions

In Vivo Detection of Macrophages in Human Carotid Atheroma

Temporal Dependence of Ultrasmall Superparamagnetic Particles of Iron Oxide-Enhanced MRI

Rikin A. Trivedi, MRCS; Jean-Marie U-King-Im, MRCS; Martin J. Graves, MSc; Justin J. Cross, FRCR; Jo Horsley, MSc; Martin J. Goddard, MRCPath; Jeremy N. Skepper, PhD; George Quartey, PhD; Elizabeth Warburton, MRCP; Ilse Joubert; Liqun Wang, PhD; Peter J. Kirkpatrick, FRCS(SN); John Brown, FMedSci Jonathan H. Gillard, FRCR

From the University Department of Radiology (R.A.T., J.-M.U., E.W., I.J., J.H.G.), Addenbrooke’s Hospital, Cambridge, UK; the Department of Pathology (J.H., M.J.G.), Papworth Hospital, Cambridge, UK; GlaxoSmithKline (G.Q., L.W., J.B.), Translational Medicine and Technology, Addenbrooke’s Centre for Clinical Investigation, Addenbrooke’s Hospital, Cambridge, UK; the Multi-Imaging Centre (J.N.S.), University Department of Anatomy, Cambridge, UK; and the Academic Department of Neurosurgery (P.J.K.), Addenbrooke’s Hospital, Cambridge, UK.

Correspondence to Dr Jonathan H. Gillard, University Department of Radiology, Addenbrooke’s Hospital, Box 219, Hills Road, Cambridge CB22QQ, UK. E-mail jhg21{at}cam.ac.uk

Background— It has been suggested that inflammatory cells within vulnerable plaques may be visualized by superparamagnetic iron oxide particle-enhanced MRI. The purpose of this study was to determine the time course for macrophage visualization with in vivo contrast-enhanced MRI using an ultrasmall superparamagnetic iron oxide (USPIO) agent in symptomatic human carotid disease.

Methods— Eight patients scheduled for carotid endarterectomy underwent multisequence MRI of the carotid bifurcation before and 24, 36, 48, and 72 hours after Sinerem (2.6 mg/kg) infusion.

Results— USPIO particles accumulated in macrophages in 7 of 8 patients given Sinerem. Areas of signal intensity reduction, corresponding to USPIO/macrophage-positive histological sections, were visualized in all 7 of these patients, optimally between 24 and 36 hours, decreasing after 48 hours, but still evident up to 96 hours after infusion.

Conclusions— USPIO-enhanced MRI of carotid atheroma can be used to identify macrophages in vivo. The temporal change in the resultant signal intensity reduction on MRI suggests an optimal time window for the detection of macrophages on postinfusion imaging.

Key Words: magnetic resonance imaging • carotid arteries • atherosclerosis • macrophages

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