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, and plaque composition. This work was a natural support for what was at the time a new concept: that certain atherosclerotic plaque types were at high risk for rupture, the concept of the so-called “vulnerable plaque” first pioneered by pathologist Dr. Valentin Fuster. This led to an NIH R01 and several other grants to study the vulnerable plaque with MRI.
Now, over a decade later, the concept of the vulnerable plaque and the ability of MRI to detect and differentiate atherosclerosis is widely accepted, but questions of how best to transition our knowledge of MRI into clinical practice remain. The paper “Geometric and Compositional Appearance of Atheroma in an Angiographically Normal Carotid Artery in Patients with Atherosclerosis,” originally published in AJNR, offers a partial answer to the question—by comparing current clinical findings of stenosis levels by MRA with the technologies we have developed with MRI, we can see that stenosis measured by MRA may underestimate the presence of carotid atherosclerosis, demonstrating the need for improved methods for accurately identifying carotid atherosclerotic plaque severity.