Imaging of carotid atherosclerosis

Abstract

Growing interest in the in vivo characterization of plaque pathology has furthered the development of vessel wall imaging approaches beyond traditional techniques of luminal imaging. By leveraging histopathological information from carotid endarterectomy specimens, magnetic resonance imaging has been proven capable of providing qualitative and quantitative information on a number of morphological and pathological features of carotid atherosclerosis, including fibrous cap and necrotic core, intraplaque hemorrhage, plaque neovascularization, and inflammation. These technical advancements present new opportunities to expand the understanding of the pathophysiology of ischemic stroke and devise more efficient diagnostic and prognostic tools to address contemporary clinical problems in the management of carotid atherosclerosis. From a clinical perspective, this article introduces the various magnetic resonance techniques for carotid atherosclerosis imaging. The background and pathological basis of direct plaque imaging in carotid arteries are discussed, followed by available solutions and key technical considerations, as well as promising applications that have arisen from these techniques.