Characteristics of Unstable Carotid Plaques – New Image Modalities

Abstract

Ischemic stroke is a socially significant health problem due to high mortality and disability. One of the leading causes for cerebrovascular accidents is the carotid atherosclerosis. The mechanism of its formation presents not only lipid accumulation in the arterial wall but a complex inflammatory disease. The aims of this review are to point the new methods and approaches for diagnostic of the unstable and high-risk carotid plaques. The old plaque imaging modalities emphasized mainly to the degrees of luminal stenosis. The new possibilities reveal plaque morphology so detailed even compared to histological verification. Recent techniques as Shear wave elastography, optical coherence tomography, Superb microvascular imaging, USPIO MRI give information about the pathological mechanisms of carotid atherosclerosis. The efforts are directed to predict the atherosclerotic burden, plaque instability and the occurrence of cerebrovascular events for each patient and to optimize personal management.

Malignant ischemic stroke revealing a spontaneous carotid dissection in a young patient: Rare case report

“…While older imaging techniques focused on luminal stenosis, newer methods such as Shear wave elastography, optical coherence tomography, Superb microvascular imaging, and USPIO MRI provide detailed information about plaque morphology and pathological mechanisms. The ultimate goal of these methods is to predict atherosclerotic burden, plaque instability, and the likelihood of cerebrovascular events for each patient, in order to optimize personalized management [11] .…”

Insights from neuroradiology in acute disseminated encephalomyelitis

“…Neovascularization of the plaque is considered to be a potential risk factor for carotid plaque rupture. Contrast-enhanced ultrasound (CEUS) may be used to detect neovascularization within carotid vessels [11] .…”

Neutrophil–lymphocyte ratio as a prognostic factor for minute clear cell renal cell carcinoma diagnosed using multi-slice spiral CT

“…[ 25 ] Selahattin et al found that NLR can be used as an indicator for preoperative diagnosis of renal cell carcinoma. [ 26 ] Studies by Palin et al have found that NLR is significantly associated with increased colorectal cancer mortality. NLR is an inexpensive, simple, and effective clinical tool for predicting the prognosis of colorectal cancer patients.…”

“…In addition, NLR is an easily accessible biomarker that can be used determine a prognosis in renal cell carcinoma. Selahattin [ 26 ] found that the NLR may be a useful diagnostic biomarker parameter for renal cell carcinoma in the preoperative period. The findings of this earlier research are in agreement with those of our study.…”