Cardiac Magnetic Resonance Features of the Disruption-Prone and the Disrupted Carotid Plaque
Baocheng Chu, MD, PhD,
Marina S. Ferguson, MT,
Huijun Chen, PhD,
Daniel S. Hippe, BS,
William S. Kerwin, PhD,
Gador Canton, PhD,
Chun Yuan, PhD*,
Thomas S. Hatsukami, MD
Vascular Imaging Laboratory, University of Washington, Seattle, Washington
* Reprint requests and correspondence: Dr. Chun Yuan, Vascular Imaging Laboratory, 815 Mercer Street, Department of Radiology, University of Washington, Box 358050, Seattle, Washington 98109 (Email: cyuan{at}u.washington.edu).
Stroke is a leading cause of long-term disability and is the third most common cause of death in the U.S. and western countries. Twenty percent of strokes are thought to arise from the carotid artery. Histopathological studies have suggested that plaque disruption is a key factor in the etiology of carotid-related ischemic events. Features associated with plaque disruption include intraplaque hemorrhage, large necrotic cores with thin overlying fibrous caps, plaque neovasculature, and inflammatory cell infiltrate. In vivo high-spatial-resolution, multicontrast-weighted cardiac magnetic resonance (CMR) has been extensively evaluated using histology as the gold standard, and has documented reliability in the identification of these key carotid plaque features. This pictorial essay illustrates the capability of CMR for identifying features of disruption-prone and disrupted atherosclerotic carotid plaques.
Key Words: atherosclerosis • CMR • histology
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Abbreviations and Acronyms
| | CMR = cardiac magnetic resonance | | K
trans
= transfer constant | | MMP = matrix metalloproteinases | | MRA = magnetic resonance angiography | | TOF = time-of-flight | | vp
= fractional plasma volume | | WSS = wall shear stress |
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C. M. Kramer and J. Narula
Atherosclerotic Plaque Imaging: The Last Frontier for Cardiac Magnetic Resonance
J. Am. Coll. Cardiol. Img.,
July 1, 2009;
2(7):
916 - 918.
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