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Published on: March 22, 2016
Magnetic resonance imaging of atherosclerosis
T Leiner1, S Gerretsen, R Botnar
1Department of Radiology, Maastricht University Hospital, The Netherlands. leiner@rad.unimaas.nl
Insights
Vascular wall composition, not just artery narrowing, predicts ischemic events. Advanced magnetic resonance imaging (MRI) shows promise for imaging vessel walls, with ongoing technical improvements enhancing its clinical potential for plaque detection.
Area of Science:
- Cardiovascular Imaging
- Medical Diagnostics
- Biomedical Engineering
Background:
- Growing evidence links vascular wall composition to acute ischemic syndromes, shifting focus from luminal narrowing.
- Magnetic Resonance Angiography (MRA) is established for assessing advanced atherosclerotic lesions.
- High-resolution, multisequence MRI shows potential for noninvasive, serial imaging of aortic and carotid vessel walls.
Purpose of the Study:
- To review the current status of MRI in plaque detection and characterization.
- To discuss the future role of MRI in evaluating vascular wall atherosclerosis.
- To highlight advancements enabling improved plaque imaging, particularly in coronary arteries.
Main Methods:
- Review of recent technical developments in MRI technology.
- Discussion of advancements in imaging techniques, including surface coils and high-field systems.
- Exploration of molecular imaging approaches using targeted contrast agents.
Main Results:
- Current MRI techniques have limitations in spatial resolution for coronary vessel wall characterization.
- Technical improvements (e.g., 3.0-T systems, parallel imaging) are enhancing signal-to-noise ratio and imaging speed.
- Molecular imaging offers potential for increased specificity in plaque component characterization.
Conclusions:
- Coronary vessel wall atherosclerosis imaging remains a significant challenge but is advancing.
- Ongoing MRI technological and molecular imaging developments are paving the way for wider clinical application.
- Improved MRI techniques will be crucial for noninvasive plaque detection and characterization, aiding in ischemic event risk assessment.
Abstract:
Abundant data now link composition of the vascular wall, rather than the degree of luminal narrowing, with the risk for acute ischemic syndromes in the coronary, central nervous system, and peripheral arterial beds. Over the past few years, magnetic resonance angiography has evolved as a well-established method to determine the location and severity of advanced, lumen-encroaching atherosclerotic lesions. In addition, more recent studies have shown that high spatial resolution, multisequence MRI is also a promising tool for noninvasive, serial imaging of the aortic and carotid vessel wall, which potentially can be applied in the clinical setting. Because of the limited spatial resolution of current MRI techniques, characterization of coronary vessel wall atherosclerosis, however, is not yet possible and remains the holy grail of plaque imaging. Recent technical developments in MRI technology such as dedicated surface coils, the introduction of 3.0-T high-field systems and parallel imaging, as well as developments in the field of molecular imaging such as contrast agents targeted to specific plaque constituents, are likely to lead to the necessary improvements in signal to noise ratio, imaging speed, and specificity. These improvements will ultimately lead to more widespread application of this technology in clinical practice. In the present review, the current status and future role of MRI for plaque detection and characterization are summarized.
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