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Magnetic resonance imaging of carotid plaques: current status and clinical perspectives

Rupture of a vulnerable carotid plaque is one of the leading causes of stroke. Carotid magnetic resonance imaging (MRI) is able to visualize all the main hallmarks of plaque vulnerability. Various MRI sequences have been developed in the last two decades to quantify carotid plaque burden and composi...

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Autores principales: Kassem, Mohamed, Florea, Alexandru, Mottaghy, Felix M., van Oostenbrugge, Robert, Kooi, M. Eline
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7607136/
https://www.ncbi.nlm.nih.gov/pubmed/33178798
http://dx.doi.org/10.21037/atm-2020-cass-16
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author Kassem, Mohamed
Florea, Alexandru
Mottaghy, Felix M.
van Oostenbrugge, Robert
Kooi, M. Eline
author_facet Kassem, Mohamed
Florea, Alexandru
Mottaghy, Felix M.
van Oostenbrugge, Robert
Kooi, M. Eline
author_sort Kassem, Mohamed
collection PubMed
description Rupture of a vulnerable carotid plaque is one of the leading causes of stroke. Carotid magnetic resonance imaging (MRI) is able to visualize all the main hallmarks of plaque vulnerability. Various MRI sequences have been developed in the last two decades to quantify carotid plaque burden and composition. Often, a combination of multiple sequences is used. These MRI techniques have been extensively validated with histological analysis of carotid endarterectomy specimens. High agreement between the MRI and histological measures of plaque burden, intraplaque hemorrhage (IPH), lipid-rich necrotic core (LRNC), fibrous cap (FC) status, inflammation and neovascularization has been demonstrated. Novel MRI sequences allow to generate three-dimensional isotropic images with a large longitudinal coverage. Other new sequences can acquire multiple contrasts using a single sequence leading to a tremendous reduction in scan time. IPH can be easily identified as a hyperintense signal in the bulk of the plaque on strongly T(1)-weighted images, such as magnetization-prepared rapid acquisition gradient echo images, acquired within a few minutes with a standard neurovascular coil. Carotid MRI can also be used to evaluate treatment effects. Several meta-analyses have demonstrated a strong predictive value of IPH, LRNC, thinning or rupture of the FC for ischemic cerebrovascular events. Recently, in a large meta-analysis based on individual patient data of asymptomatic and symptomatic individuals with carotid artery stenosis, it was shown that IPH on MRI is an independent risk predictor for stroke, stronger than any known clinical risk parameter. Expert recommendations on carotid plaque MRI protocols have recently been described in a white paper. The present review provides an overview of the current status and applications of carotid plaque MR imaging and its future potential in daily clinical practice.
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spelling pubmed-76071362020-11-10 Magnetic resonance imaging of carotid plaques: current status and clinical perspectives Kassem, Mohamed Florea, Alexandru Mottaghy, Felix M. van Oostenbrugge, Robert Kooi, M. Eline Ann Transl Med Review Article on Carotid Artery Stenosis and Stroke: Prevention and Treatment Part I Rupture of a vulnerable carotid plaque is one of the leading causes of stroke. Carotid magnetic resonance imaging (MRI) is able to visualize all the main hallmarks of plaque vulnerability. Various MRI sequences have been developed in the last two decades to quantify carotid plaque burden and composition. Often, a combination of multiple sequences is used. These MRI techniques have been extensively validated with histological analysis of carotid endarterectomy specimens. High agreement between the MRI and histological measures of plaque burden, intraplaque hemorrhage (IPH), lipid-rich necrotic core (LRNC), fibrous cap (FC) status, inflammation and neovascularization has been demonstrated. Novel MRI sequences allow to generate three-dimensional isotropic images with a large longitudinal coverage. Other new sequences can acquire multiple contrasts using a single sequence leading to a tremendous reduction in scan time. IPH can be easily identified as a hyperintense signal in the bulk of the plaque on strongly T(1)-weighted images, such as magnetization-prepared rapid acquisition gradient echo images, acquired within a few minutes with a standard neurovascular coil. Carotid MRI can also be used to evaluate treatment effects. Several meta-analyses have demonstrated a strong predictive value of IPH, LRNC, thinning or rupture of the FC for ischemic cerebrovascular events. Recently, in a large meta-analysis based on individual patient data of asymptomatic and symptomatic individuals with carotid artery stenosis, it was shown that IPH on MRI is an independent risk predictor for stroke, stronger than any known clinical risk parameter. Expert recommendations on carotid plaque MRI protocols have recently been described in a white paper. The present review provides an overview of the current status and applications of carotid plaque MR imaging and its future potential in daily clinical practice. AME Publishing Company 2020-10 /pmc/articles/PMC7607136/ /pubmed/33178798 http://dx.doi.org/10.21037/atm-2020-cass-16 Text en 2020 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Review Article on Carotid Artery Stenosis and Stroke: Prevention and Treatment Part I
Kassem, Mohamed
Florea, Alexandru
Mottaghy, Felix M.
van Oostenbrugge, Robert
Kooi, M. Eline
Magnetic resonance imaging of carotid plaques: current status and clinical perspectives
title Magnetic resonance imaging of carotid plaques: current status and clinical perspectives
title_full Magnetic resonance imaging of carotid plaques: current status and clinical perspectives
title_fullStr Magnetic resonance imaging of carotid plaques: current status and clinical perspectives
title_full_unstemmed Magnetic resonance imaging of carotid plaques: current status and clinical perspectives
title_short Magnetic resonance imaging of carotid plaques: current status and clinical perspectives
title_sort magnetic resonance imaging of carotid plaques: current status and clinical perspectives
topic Review Article on Carotid Artery Stenosis and Stroke: Prevention and Treatment Part I
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7607136/
https://www.ncbi.nlm.nih.gov/pubmed/33178798
http://dx.doi.org/10.21037/atm-2020-cass-16
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