September 2013

Introduction

Carotid Vulnerable Plaque Imaging

Mahmud Mossa-Basha

Mahmud Mossa-Basha

Extracranial carotid vulnerable plaque imaging is a maturing field in both the clinical and research realms, providing information that goes beyond standard luminal imaging techniques. The North American Symptomatic Carotid Endarterectomy Trial and the European Carotid Surgery Trial have formed the basis of reliance on carotid luminal stenosis measurements to determine the risk for future … more »

Review Articles

Vascular Wall Imaging of Vulnerable Atherosclerotic Carotid Plaques: Current State of the Art and Potential Future of Endovascular Optical Coherence Tomography

Victor X.D. Yang

Victor X.D. Yang

The current standard of care for the assessment of carotid plaques has been the use of ultrasonography, MR imaging, and CT to identify key features of atherosclerosis. Fundamental markers such as intimal morphology, presence of macrophages, and lipid content in the plaque are attributed to the classification of the lesion, as well as assessment of stroke … more »

Interventional

Geometric and Compositional Appearance of Atheroma in an Angiographically Normal Carotid Artery in Patients with Atherosclerosis

Chun Yuan

Chun Yuan

My initial interest in carotid plaque MR imaging began while working as an Assistant Professor. The work of Drs. Eugene Strandness, Russell Ross, and James Nelson was instrumental in introducing me to the field of atherosclerosis imaging, and Dr.  Thomas Hatsukami and I began to investigate MRI’s unique ability to assess and differentiate size, morphology, … more »

Head & Neck

A Noninvasive Imaging Approach to Assess Plaque Severity: The Carotid Atherosclerosis Score

Hunter R. Underhill

Hunter R. Underhill

Carotid atherosclerotic disease is a principal cause of stroke. Advances in MRI have afforded the opportunity to study the in vivo evolution of plaque progression, monitor response to therapy during clinical trials, and identify features associated with future ischemic events such as fibrous cap rupture (FCR) and intraplaque hemorrhage (IPH). While carotid MRI … more »

Extracranial Vascular

Carotid Plaque Neovascularization and Hemorrhage Detected by MR Imaging are Associated with Recent Cerebrovascular Ischemic Events

Bruce Wasserman

Bruce Wasserman

High-resolution contrast-enhanced MRI has been shown to reliably and accurately depict features of atherosclerotic plaque that are considered risk markers for stroke. In fact, we now recognize that these features seem to be as important as angiographic measures of stenosis for determining stroke risk.1 Intraplaque hemorrhage (IPH) is one such feature and the target of several … more »

Head & Neck

MR Carotid Plaque Imaging and Contrast-Enhanced MR Angiography Identifies Lesions Associated with Recent Ipsilateral Thromboembolic Symptoms: An In Vivo Study at 3T

J. Kevin DeMarco

J. Kevin DeMarco

Carotid plaque MRI has the ability to noninvasively detect “vulnerable plaque” features such as intraplaque hemorrhage, thin/ruptured fibrous cap, and large lipid-rich necrotic core, which may offer improved prediction of ispilateral carotid stroke or TIA compared with simple carotid stenosis measurements. Our work at Michigan State University has confirmed the ability of carotid … more »

Head & Neck

High-Resolution CT Imaging of Carotid Artery Atherosclerotic Plaques

Max Wintermark

Max Wintermark

Carotid atherosclerotic disease is considered to be responsible for 30% of all ischemic stroke. Luminal narrowing is the standard parameter used to report the severity of carotid atherosclerosis, and a luminal stenosis of ≥70% is typically considered a hallmark of increased stroke risk. However, even if they have a higher individual risk of developing a … more »