Imaging of atherosclerosis.

Area of Science:

• Cardiovascular Medicine
• Medical Imaging
• Pathology

Background:

• Atherosclerotic plaques leading to thrombus formation are not always identified by lumen stenosis.
• Current clinical focus remains on quantifying plaque-induced stenosis.
• High-risk plaque features like thin fibrous caps and necrotic cores are crucial but often overlooked by traditional methods.

Purpose of the Study:

• To review and compare novel imaging modalities for evaluating atherosclerotic plaques.
• To highlight the strengths and drawbacks of each imaging technique.
• To discuss the quantification of atherosclerosis using advanced imaging.

Main Methods:

• Review of current literature on advanced imaging techniques for atherosclerosis.
• Analysis of modalities capable of probing plaque composition and morphology.
• Comparison of imaging techniques based on their ability to detect high-risk plaque features.

Main Results:

• Novel imaging techniques can identify key features of high-risk plaques, including thin fibrous caps, necrotic cores, macrophage infiltration, neovascularization, and intraplaque hemorrhage.
• These advanced methods offer a more comprehensive evaluation than traditional stenosis quantification.
• Each imaging modality presents unique advantages and limitations.

Conclusions:

• Advanced imaging techniques are essential for a thorough evaluation of atherosclerosis.
• These methods enable the assessment of vulnerable plaque characteristics, improving risk stratification.
• Further research and clinical integration of these techniques are warranted for better patient outcomes.