MRI of carotid atherosclerosis: clinical implications and future directions.
Atherosclerosis is now widely recognized as a multifactorial disease with outcomes that arise from complex factors such as plaque components, blood flow, and inflammation. Despite recent advances in understanding of plaque biology, diagnosis, and treatment, atherosclerosis remains a leading cause of morbidity and mortality. Further research into the development and validation of reliable indicators of the high-risk individual is greatly needed. Carotid MRI is a histologically validated, noninvasive imaging method that can track disease progression and regression, and quantitatively evaluate a spectrum of parameters associated with in vivo plaque morphology and composition. Intraplaque hemorrhage and the lipid-rich necrotic core are the best indicators of lesion severity currently visualized by carotid MRI. However, MRI methods capable of imaging other important aspects of carotid atherosclerotic disease in vivo-including inflammation, neovascularization, and mechanical forces-are emerging and may aid in advancing our understanding of the pathophysiology of this multifactorial disease.
Underhill
Hunter R
HR
Department of Radiology, University of Washington, 815 Mercer Street, Box 358050, Seattle, WA 98109, USA. hunterru@u.washington.edu
Hatsukami
Thomas S
TS
Fayad
Zahi A
ZA
Fuster
Valentin
V
Yuan
Chun
C
D002339:Carotid Arteries / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D018450:Disease Progression; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000639:trends; D011237:Predictive Value of Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome