Advanced MRI for carotid plaque imaging

Atherosclerosis is the ubiquitous underling pathological process that manifests in heart attack and stroke, cumulating in the death of one in three North American adults. High-resolution magnetic resonance imaging (MRI) is able to delineate atherosclerotic plaque components and total plaque burden w...

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Bibliographic Details
Published in:The International Journal of Cardiovascular Imaging 2016-01, Vol.32 (1), p.83-89
Main Authors: Singh, Navneet, Moody, Alan R., Roifman, Idan, Bluemke, David A., Zavodni, Anna E. H.
Format: Article
Language:English
Subjects:
Automation
Cardiac Imaging
Cardiology
Carotid Arteries - pathology
Carotid Artery Diseases - pathology
Carotid Artery Diseases - therapy
Equipment Design
Fibrosis
Humans
Image Interpretation, Computer-Assisted
Imaging
Magnetic Resonance Angiography - instrumentation
Magnetic Resonance Angiography - methods
Medicine
Medicine & Public Health
Necrosis
Neovascularization, Pathologic
Original Paper
Plaque, Atherosclerotic
Predictive Value of Tests
Prognosis
Radiology
Software
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Summary:Atherosclerosis is the ubiquitous underling pathological process that manifests in heart attack and stroke, cumulating in the death of one in three North American adults. High-resolution magnetic resonance imaging (MRI) is able to delineate atherosclerotic plaque components and total plaque burden within the carotid arteries. Using dedicated hardware, high resolution images can be obtained. Combining pre- and post-contrast T1, T2, proton-density, and magnetization-prepared rapid acquisition gradient echo weighted fat-saturation imaging, plaque components can be defined. Post-processing software allows for semi- and fully automated quantitative analysis. Imaging correlation with surgical specimens suggests that this technique accurately differentiates plaque features. Total plaque burden and specific plaque components such as a thin fibrous cap, large fatty or necrotic core and intraplaque hemorrhage are accepted markers of neuroischemic events. Given the systemic nature of atherosclerosis, emerging science suggests that the presence of carotid plaque is also an indicator of coronary artery plaque burden, although the preliminary data primarily involves patients with stable coronary disease. While the availability and cost-effectiveness of MRI will ultimately be important determinants of whether carotid MRI is adopted clinically in cardiovascular risk assessment, the high accuracy and reliability of this technique suggests that it has potential as an imaging biomarker of future risk.
ISSN:1569-5794
1573-0743
1875-8312
DOI:10.1007/s10554-015-0743-6