Clinical imaging of the high-risk or vulnerable atherosclerotic plaque.
The study of atherosclerotic disease during its natural history and after therapeutic intervention will enhance our understanding of disease progression and regression and aid in selecting appropriate treatments. Several invasive and noninvasive imaging techniques are available to assess atherosclerotic vessels. Most of the standard techniques identify luminal diameter, stenosis, wall thickness, and plaque volume; however, none can characterize plaque composition and therefore identify the high-risk plaques. We will present the different imaging modalities that have been used for the direct assessment of the carotid, aortic, and coronary atherosclerotic plaques. We will review in detail the use of high-resolution, multicontrast magnetic resonance for the noninvasive imaging of vulnerable plaques and the characterization of plaques in terms of their various components (ie, lipid, fibrous, calcium, or thrombus).
Fayad
Z A
ZA
Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, NY 10029, USA. zahi.fayad@mssm.edu
Fuster
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V
D017546:Angioscopy; D000818:Animals; D001011:Aorta / Q000000981:diagnostic imaging / Q000473:pathology*; D001018:Aortic Diseases / Q000175:diagnosis; D001027:Aortography; D001161:Arteriosclerosis / Q000145:classification / Q000175:diagnosis*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D016893:Carotid Stenosis / Q000175:diagnosis; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D003952:Diagnostic Imaging / Q000295:instrumentation / Q000379:methods*; D018450:Disease Progression; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D018570:Risk Assessment; D013055:Spectrophotometry, Infrared; D013059:Spectrum Analysis, Raman; D014057:Tomography, X-Ray Computed / Q000379:methods; D014463:Ultrasonography / Q000295:instrumentation / Q000379:methods