Vascular imaging of atherosclerosis: Strengths and weaknesses

Area of Science:

• Cardiovascular Imaging
• Vascular Biology
• Medical Diagnostics

Background:

• Atherosclerosis is an inflammatory disease leading to serious cardiovascular complications like heart disease and stroke.
• Accurate identification and quantification of atherosclerotic burden are vital for patient management.
• Current imaging modalities for atherosclerosis assessment vary significantly in invasiveness, cost, resolution, and radiation exposure.

Purpose of the Study:

• To review the strengths and weaknesses of various imaging techniques used to measure atherosclerotic burden.
• To discuss the role of advanced imaging in detecting microvascular changes within atherosclerotic plaques.
• To explore the future potential of advanced imaging modalities as biomarkers for atherosclerosis.

Main Methods:

• Review of existing literature on cardiovascular imaging techniques for atherosclerosis.
• Analysis of imaging modalities including their invasiveness, cost, resolution, and radiation exposure.
• Discussion of novel microvascular imaging techniques like contrast-enhanced ultrasound and superb microvascular imaging.

Main Results:

• Imaging techniques differ in their risk-benefit profiles, necessitating careful consideration for routine screening.
• Microvascular imaging can detect intraplaque neovascularization, a potential indicator of plaque vulnerability and rupture risk.
• Advanced imaging shows promise for future applications in atherosclerosis risk stratification.

Conclusions:

• A comprehensive understanding of imaging technique characteristics is essential for effective atherosclerosis assessment.
• Microvascular imaging offers new insights into plaque biology and vulnerability.
• Future research should focus on validating advanced imaging modalities as reliable biomarkers for atherosclerosis.