Imaging Features of Vulnerable Carotid Atherosclerotic Plaque and the Associated Clinical Implications

AbstractPurpose of reviewCarotid atherosclerotic plaque composition influences plaque rupture risk and may be used to better stratify patients based on ischemic stroke risk than degree of luminal stenosis alone. The goal of this review is to critically evaluate the ability of both conventional and advanced noninvasive vascular imaging techniques to identify and characterize vulnerable carotid plaques.Recent findingsAdvanced noninvasive vascular imaging techniques include contrast-enhanced vascular ultrasound, dual-energy CT, and MR vessel wall imaging (VWI). Each of these modalities has unique strengths with the ability to evaluate the degree of luminal stenosis and provide insight into carotid atherosclerotic plaque composition. MR VWI has proven superior to other imaging modalities in terms of its ability to accurately characterize and quantify components of carotid plaque including intraplaque hemorrhage, lipid-rich necrotic core, dystrophic calcification, and the integrity of the plaque fibrous cap.SummaryAdvanced noninvasive vascular imaging techniques such as MR VWI offer important insights into carotid atherosclerotic plaque composition and have the potential to dramatically improve the quality of care delivered to patients with carotid atherosclerosis.

Source: Current Treatment Options in Cardiovascular Medicine - July 13, 2020 Category: Cardiology Source Type: research