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The pathophysiology of the initiation and progression of abdominal aortic aneurysms (AAAs) and aortic dissections (AADs) is still unclear. However, there is strong evidence that monocytes and macrophages are of crucial importance in these processes. Here, we utilized a molecular imaging approach based on background-free  19 F MRI and employed perfluorocarbon nanoemulsions (PFCs) for  in situ   19 F labeling of monocytes/macrophages to monitor vascular inflammation and AAA/AAD formation in angiotensin II (angII)-treated apolipoproteinE-deficient (apoE −/− ) mice. In parallel, we used conventional  1 H MRI for the characterization of aortic flow patterns and morphology. AngII (1 μg/kg/min) was infused into apoE −/−  mice  via  osmotic minipumps for 10 days and mice were monitored by multiparametric  1 H/ 19 F MRI. PFCs were intravenously injected directly after pump implantation followed by additional applications on day 2 and 4 to allow an efficient  19 F loading of circulating monocytes. The combination of angiographic, hemodynamic, and anatomical measurements allowed an unequivocal classification of mice in groups with developing AAAs, AADs or without any obvious aortic vessel alterations despite the exposure to angII. Maximal luminal and external diameters of the aorta were enlarged in AAAs, whereas AADs showed either a slight decrease of the luminal diameter or no alteration.  1 H/ 19 F MRI after intravenous PFC application demonstrated significantly higher  19 F signals in aortae of mice that developed AAAs or AADs as compared to mice in which no aortic disorders were detected. High resolution  1 H/ 19 F MRI of excised aortae revealed a patchy pattern of the  19 F signals predominantly in the adventitia of the aorta. Histological analysis confirmed the presence of macrophages in this area and flow cytometry revealed higher numbers of immune cells in aortae of mice that have developed AAA/AAD. Importantly, there was a linear correlation of the  19 F signal with the total number of infiltrated macrophages. In conclusion, our approach enables a precise differentiation between AAA and AAD as well as visualization and quantitative assessment of inflammatory active vascular lesions, and therefore may help to unravel the complex interplay between macrophage accumulation, vascular inflammation, and the development and progression of AAAs and AADs.

frontiers in cardiovascular medicine

Beyond Vessel Diameters: Non-invasive Monitoring of Flow Patterns and Immune Cell Recruitment in Murine Abdominal Aortic Disorders by Multiparametric MRI