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Cardiovascular magnetic resonance in carotid atherosclerotic disease.

Dong L, Kerwin WS, Ferguson MS, Li R, Wang J, Chen H, Canton G, Hatsukami TS, Yuan C - J Cardiovasc Magn Reson (2009)

Bottom Line: Atherosclerosis is a chronic, progressive, inflammatory disease affecting many vascular beds.Disease progression leads to acute cardiovascular events such as myocardial infarction, stroke and death.Advances in carotid vessel wall CMR allow comprehensive assessment of morphology inside the wall, contributing substantial disease-specific information beyond luminal stenosis.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiology, University of Washington, Seattle, WA, USA. lido2@u.washington.edu

ABSTRACT
Atherosclerosis is a chronic, progressive, inflammatory disease affecting many vascular beds. Disease progression leads to acute cardiovascular events such as myocardial infarction, stroke and death. The diseased carotid alone is responsible for one third of the 700,000 new or recurrent strokes occurring yearly in the United States. Imaging plays an important role in the management of atherosclerosis, and cardiovascular magnetic resonance (CMR) of the carotid vessel wall is one promising modality in the evaluation of patients with carotid atherosclerotic disease. Advances in carotid vessel wall CMR allow comprehensive assessment of morphology inside the wall, contributing substantial disease-specific information beyond luminal stenosis. Although carotid vessel wall CMR has not been widely used to screen for carotid atherosclerotic disease, many trials support its potential for this indication. This review summarizes the current state of knowledge regarding carotid vessel wall CMR and its potential clinical application for management of carotid atherosclerotic disease.

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Related in: MedlinePlus

The rupture prone atherosclerotic plaque has a thin fibrous cap overlaying a large necrotic core. This Movat's Pentachrome stain shows a carotid plaque with a large necrotic core (block arrow) containing hemorrhage (red staining). The fibrous cap shows a dramatic thinning near the shoulder of the core (arrow in the lumen). (Magnification 10×)
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Figure 3: The rupture prone atherosclerotic plaque has a thin fibrous cap overlaying a large necrotic core. This Movat's Pentachrome stain shows a carotid plaque with a large necrotic core (block arrow) containing hemorrhage (red staining). The fibrous cap shows a dramatic thinning near the shoulder of the core (arrow in the lumen). (Magnification 10×)

Mentions: While detection of prior plaque rupture has clinical implications, a more compelling question is whether detectable precursors of cap rupture exist. The concept of the disruption-prone or high-risk/vulnerable plaque, initially derived from coronary studies, has been increasingly shown to apply in the carotid circulation. Histological studies have shown that the most common feature of plaques prone to rupture is a thin fibrous cap with a large underlying necrotic core (Figure 3) [36-39]. These features are key targets of carotid vessel wall CMR and are potential imaging markers for risk of stroke/transient ischemic attack.


Cardiovascular magnetic resonance in carotid atherosclerotic disease.

Dong L, Kerwin WS, Ferguson MS, Li R, Wang J, Chen H, Canton G, Hatsukami TS, Yuan C - J Cardiovasc Magn Reson (2009)

The rupture prone atherosclerotic plaque has a thin fibrous cap overlaying a large necrotic core. This Movat's Pentachrome stain shows a carotid plaque with a large necrotic core (block arrow) containing hemorrhage (red staining). The fibrous cap shows a dramatic thinning near the shoulder of the core (arrow in the lumen). (Magnification 10×)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2806867&req=5

Figure 3: The rupture prone atherosclerotic plaque has a thin fibrous cap overlaying a large necrotic core. This Movat's Pentachrome stain shows a carotid plaque with a large necrotic core (block arrow) containing hemorrhage (red staining). The fibrous cap shows a dramatic thinning near the shoulder of the core (arrow in the lumen). (Magnification 10×)
Mentions: While detection of prior plaque rupture has clinical implications, a more compelling question is whether detectable precursors of cap rupture exist. The concept of the disruption-prone or high-risk/vulnerable plaque, initially derived from coronary studies, has been increasingly shown to apply in the carotid circulation. Histological studies have shown that the most common feature of plaques prone to rupture is a thin fibrous cap with a large underlying necrotic core (Figure 3) [36-39]. These features are key targets of carotid vessel wall CMR and are potential imaging markers for risk of stroke/transient ischemic attack.

Bottom Line: Atherosclerosis is a chronic, progressive, inflammatory disease affecting many vascular beds.Disease progression leads to acute cardiovascular events such as myocardial infarction, stroke and death.Advances in carotid vessel wall CMR allow comprehensive assessment of morphology inside the wall, contributing substantial disease-specific information beyond luminal stenosis.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiology, University of Washington, Seattle, WA, USA. lido2@u.washington.edu

ABSTRACT
Atherosclerosis is a chronic, progressive, inflammatory disease affecting many vascular beds. Disease progression leads to acute cardiovascular events such as myocardial infarction, stroke and death. The diseased carotid alone is responsible for one third of the 700,000 new or recurrent strokes occurring yearly in the United States. Imaging plays an important role in the management of atherosclerosis, and cardiovascular magnetic resonance (CMR) of the carotid vessel wall is one promising modality in the evaluation of patients with carotid atherosclerotic disease. Advances in carotid vessel wall CMR allow comprehensive assessment of morphology inside the wall, contributing substantial disease-specific information beyond luminal stenosis. Although carotid vessel wall CMR has not been widely used to screen for carotid atherosclerotic disease, many trials support its potential for this indication. This review summarizes the current state of knowledge regarding carotid vessel wall CMR and its potential clinical application for management of carotid atherosclerotic disease.

Show MeSH
Related in: MedlinePlus