Influence of acquired obesity on coronary vessel wall late gadolinium enhancement in discordant monozygote twins

Figures

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  Fig. 1. MRI pulse diagram for the visualization and quantification of the contrast agent in the coronary wall. a coronary navigator-gated, vector ECG-triggered, fat-suppressed T1-weighted, three-dimensional gradient-echo inversion recovery sequence (3D-IR-TFE) was performed prior to and 30 to 40 minutes after the administration of Gd-DTPA (0.2 mmol/kg). Image acquisition was performed in mid-diastole. Additionally, to compensate for breathing, navigator gating and tracking was performed

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  Fig. 2. Segmental model for the assessment of coronary enhancement. Coronary arteries were subdivided into eight segments. For an accurate identification of the segments, the segments were pre-defined according to distance from the coronary origin in the aortic root. The right coronary artery (RCA, a) was analyzed in 3 segments (1–3), the left coronary artery (LCA, b) within the left main artery (1 segment, 5), the left anterior descending (2 segments, 6, 7), and the circumflex artery (2 segments, 11, 13)

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  Fig. 3. Assessment of coronary enhancement after the administration of Gd-DTPA in monozygous twins. a–d: Fusion images (a, c) of coronary MRAs with matched vessel wall scans. Typical example of the enhancement pattern (b, d) in the left and right coronary artery in twins with a low BMI after administration of the Gd-DTPA. Only a mild signal enhancement can be appreciated in the left and right coronary artery. e–h: Example of coronary enhancement in twins with a high BMI on fused images (e, g) as well as inversion recovery images (f, h). A relatively strong coronary enhancement can be observed in the proximal right and left coronary artery (red arrow)

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  Fig. 4. Comparison of number of coronary segments with enhancement after administration of the contrast agent. The group with the high BMI showed a significantly increased number of coronary segments per subject with gadolinium enhancement compared to the twin group with the low BMI

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  Fig. 5. Comparison of coronary contrast to noise ratios (CNRs) after administration of the contrast agent. The group with the high BMI showed a significantly increased CNR following the administration of the contrast agent compared to the twin group with the low BMI. Values are shown as mean ± standard deviation