Characterization of atherosclerotic plaque by magnetic resonance imaging

Atherosclerosis, the most common disease in the industrialized world, is still one of the most poorly explained and little understood problems in medicine. It is important to obtain reliable images of lipid-rich type IV and Va plaques, which, upon rupture, are most likely to cause acute ischemic events. The development of noninvasive methods to detect atherosclerotic plaque lesions and assess their composition promises to play an important role in the management of patients in the future.

This review highlights the advantages and disadvantages of magnetic resonance imaging (MRI) and intravascular ultrasound, compared with histopathologic findings, in detecting and determining the extent of atheromatous plaques.

Compared with intravascular ultrasound, MRI has been found to be superior in delineating lipid plaque components. Intravascular ultrasound, despite its better spatial resolution, is an invasive method and does not provide information on complex features of stenotic vessels. In vitro studies show that MRI of atherosclerotic plaques makes it possible to characterize the lesions in detail in terms of size, shape, and plaque tissue components.

Although MRI is in its early stages, it shows potential as a noninvasive method that can be used to evaluate atherosclerotic plaque and distinguish its components.