Noninvasive Imaging of the Vulnerable Atherosclerotic Plaque

Correlation between Doppler Velocities and Duplex Ultrasound Carotid Cross-sectional Percent Stenosis

“…Vulnerable plaques are histopathologically characterized by active inflammation, large lipid core, thin fibrous cap, intraplaque hemorrhage, and neovascularization of the vasa vasorum (34). Another important issue to consider is plaque progression over time (33), especially in case of subclinical carotid atherosclerosis (35).…”

“…Thus, a more accurate staging of ICA stenosis could help physicians to improve follow-up of carotid disease. Actually, DUS evaluation allows assessment of both plaque composition (36) and grading plaque; however, the accuracy of ultrasound in detecting individual plaque components and characteristics shows a large variability (34). The second aim of this work was indeed to provide a tool for clinical practice by defining the distribution of both ICA-PSV and ICA-EDV values within five classes of area stenosis severity (ie, 40%-49%, 50%-59%, 60%-69%, 70%-79%, 80%-90%) with Standard Deviations and Standard Errors, as shown in Table 1.…”

The Essentials of Extracranial Carotid Ultrasonographic Imaging

“…These hypoechoic regions often represent foci of intraplaque hemorrhage, lipid, cholesterol, or proteinaceous material. 23,24 This form of atherosclerosis is considered unstable and has a high embolic potential with subsequent neurologic symptoms. 11 Plaque ulceration is another source of emboli; however, it can be difficult to identify on grayscale and color Doppler imaging.…”

PET imaging of aortic atherosclerosis: Is combined imaging of plaque anatomy and function an amaranthine quest or conceivable reality?

“…Much of this data has been obtained from studies comparing carotid artery appearances with tissue histology following end-arterectomy. 27 Steps towards functional molecular imaging have been made by combining the anatomical benefits of CT, and to lesser extent MRI, with nuclear medicine techniques. In this manner, radionuclide labelling of plaque components may subsequently be accurately co-localized using hybrid PET/ CT imaging (Figures 4, 5).…”