title: MRI of carotid atherosclerosis: clinical implications and future directions.
abstract: 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.
authors.affiliation: Department of Radiology, University of Washington, 815 Mercer Street, Box 358050, Seattle, WA 98109, USA. hunterru@u.washington.edu
authors.forename: Hunter R
authors.initials: HR
authors.lastname: Underhill
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Hatsukami
authors.forename: Zahi A
authors.initials: ZA
authors.lastname: Fayad
authors.forename: Valentin
authors.initials: V
authors.lastname: Fuster
authors.forename: Chun
authors.initials: C
authors.lastname: Yuan
mesh_terms: 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