![]() Although some 3D vessel wall MRI techniques can provide information on plaque characterization, degree of stenosis, luminal surface condition, and wall boundaries, 12, 18–21 they need long imaging times. However, for clinical use, this technique is limited because of its small coverage and long scan times needed for acquiring multicontrast images, restricting effective clinical usage. 12, 15–17 It has been used for prospective studies that helped to establish the concept of high-risk (vulnerable) carotid plaque. Two-dimensional high-resolution multicontrast magnetic resonance imaging (2D-MC MRI) is a reliable and reproducible imaging technique to distinguish plaque components such as irregular surface, IPH, and presence of a large lipid-rich necrotic core (LRNC) within arterial walls. 5, 9–14 Thus, identification of both vulnerable plaques and true plaque burden is crucial for better risk assessment in the carotid arteries. 7, 8 In addition, plaques with high-risk features, primarily identified by multicontrast MRI, are frequently found in arteries with <50% stenosis. However, measurement of stenosis alone underestimates the severity of plaque burden due to positive wall remodeling. 4–6 Imaging techniques that quantify luminal stenosis are the current clinical standard. Studies have demonstrated that plaque burden and specific components of plaque composition such as intraplaque hemorrhage (IPH) are predictors of increased risk for stroke. 1–3 Determining plaque vulnerability before the onset of stroke is critical for the prevention of cerebrovascular events. Customer Service and Ordering InformationĬarotid atherosclerotic plaques are identified in ≈1 in 5 patients presenting with transient ischemic attack or stroke.Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).
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