title: Advanced MRI for carotid plaque imaging.
abstract: Atherosclerosis is the ubiquitous underling pathological process that manifests in heart attack and stroke, cumulating in the death of one in three North American adults. High-resolution magnetic resonance imaging (MRI) is able to delineate atherosclerotic plaque components and total plaque burden within the carotid arteries. Using dedicated hardware, high resolution images can be obtained. Combining pre- and post-contrast T1, T2, proton-density, and magnetization-prepared rapid acquisition gradient echo weighted fat-saturation imaging, plaque components can be defined. Post-processing software allows for semi- and fully automated quantitative analysis. Imaging correlation with surgical specimens suggests that this technique accurately differentiates plaque features. Total plaque burden and specific plaque components such as a thin fibrous cap, large fatty or necrotic core and intraplaque hemorrhage are accepted markers of neuroischemic events. Given the systemic nature of atherosclerosis, emerging science suggests that the presence of carotid plaque is also an indicator of coronary artery plaque burden, although the preliminary data primarily involves patients with stable coronary disease. While the availability and cost-effectiveness of MRI will ultimately be important determinants of whether carotid MRI is adopted clinically in cardiovascular risk assessment, the high accuracy and reliability of this technique suggests that it has potential as an imaging biomarker of future risk.
authors: Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Room AG56b, Toronto, ON, M4N 3M5, Canada.
authors: Navneet
authors: N
authors: Singh
authors: Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Room AG56b, Toronto, ON, M4N 3M5, Canada.
authors: Alan R
authors: AR
authors: Moody
authors: Division of Cardiology, Department of Internal Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
authors: Idan
authors: I
authors: Roifman
authors: Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA.
authors: David A
authors: DA
authors: Bluemke
authors: Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Room AG56b, Toronto, ON, M4N 3M5, Canada. anna.zavodni@sunnybrook.ca.
authors: Anna E H
authors: AE
authors: Zavodni
mesh_terms: D001331:Automation; D002339:Carotid Arteries / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000473:pathology* / Q000628:therapy; D004867:Equipment Design; D005355:Fibrosis; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D018810:Magnetic Resonance Angiography / Q000295:instrumentation / Q000379:methods; D009336:Necrosis; D009389:Neovascularization, Pathologic; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011379:Prognosis; D012984:Software
keywords: Atherosclerosis; Cardiovascular risk; Carotid; Imaging; MRI