Detecting vulnerable carotid plaque and its component characteristics: Progress in related imaging techniques

Weng, Shi-Ting; Lai, Qi‐Lun; Cai, Meng‐Ting; Wang, Junjun; Zhuang, Liying; Chen, Lin; Mo, Yejia; Liu, Lu; Zhang, Yinxi; Qiao, Sanzheng

doi:10.3389/fneur.2022.982147

Cited by 7 publications

(8 citation statements)

References 83 publications

(97 reference statements)

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“…Further, previous studies have shown that CTA can identify plaque development following statin therapy ( 35 ). However, due to inadequate imaging resolution, studies have shown that CTA is not very accurate in differentiating between lipids, components of fibrotic tissue, and intraplaque inflammation ( 36 ).…”

Section: Discussionmentioning

confidence: 99%

Value of carotid intima thickness in assessing advanced carotid plaque vulnerability: a study based on carotid artery ultrasonography and carotid plaque histology

Zhao,

Zhang,

Wang

et al. 2024

Quant Imaging Med Surg

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Background Research has shown that carotid intima-media thickness (CIMT) could help to predict carotid plaque (CP) progression in patients with mild carotid stenosis. However, the debate continues as to the value of carotid intima thickness (CIT) in monitoring the development of CP in patients with severe carotid stenosis. This study sought to evaluate the relationships between CIT and the ultrasonic characteristics of CP and to analyze the value of CIT and the ultrasonic parameters of CP in assessing plaque vulnerability in advanced human carotid atherosclerosis. Methods A total of 55 individuals who underwent carotid endarterectomy (CEA) were included in the study (mean age: 65±7 years; female: 9.1%). CIMT and CIT were examined at the common carotid artery (CCA). Plaque textural features, such as the gray-scale median (GSM), superb microvascular imaging (SMI) level, and total plaque area (TPA), were also identified. A Spearman correlation coefficient analysis was performed to examine the relationship between CIT and the ultrasonic parameters of CP. The CIT of various plaque types was compared. Receiver operating characteristic (ROC) curves were used to analyze the diagnostic values of the ultrasound characteristics to evaluate CP vulnerability. Results The mean CIT of all the participants was 0.382±0.095 mm, the mean CIT of the participants with stable plaques was 0.328±0.031 mm, and the mean CIT of participants with vulnerable plaques was 0.424±0.106 mm (P<0.001). CIT was associated with the SMI level (Spearman’s correlation coefficient: r=0.392, P=0.005), TPA (Spearman’s correlation coefficient: r=0.337, P=0.012). Patients with thicker CIT had larger lipid cores, higher levels of plaque vulnerability, and more intraplaque hemorrhages (IPHs). The areas under the ROCs (AUCs) with 95% confidence interval (CI) for CIMT, CIT, the SMI level, the GSM, the TPA, and the combined model for identifying vulnerable plaques were 0.673 (0.533–0.793), 0.849 (0.727–0.932), 0.771 (0.629–0.879), 0.669 (0.529–0.790), 0.858 (0.738–0.938), and 0.949 (0.854–0.990), respectively. Conclusions CIT was associated with both the histology and ultrasonic features of CP. CIT may be helpful in the detection of severe CP development.

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Section: Discussionmentioning

confidence: 99%

Value of carotid intima thickness in assessing advanced carotid plaque vulnerability: a study based on carotid artery ultrasonography and carotid plaque histology

Zhao,

Zhang,

Wang

et al. 2024

Quant Imaging Med Surg

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“…Studies have shown that a hybrid approach with IVUS and NIRS imaging is particularly advantageous in identifying the distribution of lipid core plaques and exploring the relationship between vascular geometry, shear stress, and plaque composition [ 52 ]. While IVUS alone can detect fibrous atherosclerotic plaques, which may be obscured by the presence of calcification, NIRS can detect lipids even in the presence of calcifications [ 53 ]. In the PACMANAMI randomized clinical trial, the combination of IVUS and NIRS was successfully utilized to evaluate the effect of statins on plaque burden and composition [ 54 ].…”

Section: Biomarkers Of Invasive Imagingmentioning

confidence: 99%

“…In this context, optical coherence tomography (OCT) emerges as a promising and dynamic imaging-based modality for the real-time visualization of microvascular structures. OCT offers an impressive spatial resolution of around 10 μm in tissue [ 189 ], which is approximately ten times higher than IVUS [ 53 ]. This makes OCT well-suited for investigating plaque microstructure, fibrous cap thickness, and lipid-rich regions, which are crucial indicators of plaque instability [ 41 ].…”

Section: Evaluating Imaging Modalities: a Comparative Approachmentioning

confidence: 99%

Novel Imaging-Based Biomarkers for Identifying Carotid Plaque Vulnerability

et al. 2023

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Carotid artery disease has traditionally been assessed based on the degree of luminal narrowing. However, this approach, which solely relies on carotid stenosis, is currently being questioned with regard to modern risk stratification approaches. Recent guidelines have introduced the concept of the “vulnerable plaque,” emphasizing specific features such as thin fibrous caps, large lipid cores, intraplaque hemorrhage, plaque rupture, macrophage infiltration, and neovascularization. In this context, imaging-based biomarkers have emerged as valuable tools for identifying higher-risk patients. Non-invasive imaging modalities and intravascular techniques, including ultrasound, computed tomography, magnetic resonance imaging, intravascular ultrasound, optical coherence tomography, and near-infrared spectroscopy, have played pivotal roles in characterizing and detecting unstable carotid plaques. The aim of this review is to provide an overview of the evolving understanding of carotid artery disease and highlight the significance of imaging techniques in assessing plaque vulnerability and informing clinical decision-making.

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“…Placement of an IVUS probe in the vessel allows for better visualization of the vessel dimensions and plaque morphology, thus assisting with interventional treatment. Furthermore, IVUS improves the assessment of plaque characteristics such as shape, size, and location, and enables real-time observation of plaque composition and texture (57). With improvements in technology, IVUS has been further developed with the emergence of a more complete technique, virtual histology-IVUS.…”

Section: Ultrasoundmentioning

confidence: 99%

“…Contrast-enhanced ultrasound is a technique that involves injection of microbubbles during an ultrasonic examination to enhance the reflective signal, allowing accurate assessment of the lumen and neovascularity within carotid plaques (57). Compared to conventional contrast agents, microbubbles eliminate the limitations of radiation exposure and nephrotoxicity (77).…”

Section: Ultrasoundmentioning

confidence: 99%

Characteristics and evaluation of atherosclerotic plaques: an overview of state-of-the-art techniques

He,

Luo,

et al. 2023

Front. Neurol.

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Atherosclerosis is an important cause of cerebrovascular and cardiovascular disease (CVD). Lipid infiltration, inflammation, and altered vascular stress are the critical mechanisms that cause atherosclerotic plaque formation. The hallmarks of the progression of atherosclerosis include plaque ulceration, rupture, neovascularization, and intraplaque hemorrhage, all of which are closely associated with the occurrence of CVD. Assessing the severity of atherosclerosis and plaque vulnerability is crucial for the prevention and treatment of CVD. Integrating imaging techniques for evaluating the characteristics of atherosclerotic plaques with computer simulations yields insights into plaque inflammation levels, spatial morphology, and intravascular stress distribution, resulting in a more realistic and accurate estimation of plaque state. Here, we review the characteristics and advancing techniques used to analyze intracranial and extracranial atherosclerotic plaques to provide a comprehensive understanding of atheroma.

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Detecting vulnerable carotid plaque and its component characteristics: Progress in related imaging techniques

Cited by 7 publications

References 83 publications

Value of carotid intima thickness in assessing advanced carotid plaque vulnerability: a study based on carotid artery ultrasonography and carotid plaque histology

Value of carotid intima thickness in assessing advanced carotid plaque vulnerability: a study based on carotid artery ultrasonography and carotid plaque histology

Novel Imaging-Based Biomarkers for Identifying Carotid Plaque Vulnerability

Characteristics and evaluation of atherosclerotic plaques: an overview of state-of-the-art techniques

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