Imaging diagnosis and research progress of carotid plaque vulnerability

Area of Science:

• Neurology
• Cardiovascular Medicine
• Radiology

Background:

• Ischemic stroke (IS) presents significant disability, mortality, and recurrence risks.
• While carotid artery lumen stenosis from atherosclerotic plaque (AP) is a known cause, IS can occur even with mild stenosis.
• Vulnerable carotid plaque rupture is implicated in a substantial portion of IS cases.

Purpose of the Study:

• To analyze the pathological changes, characteristics, and formation mechanisms of carotid plaque vulnerability.
• To explore modern imaging methods for identifying plaque composition and vulnerability.
• To provide a reference for IS diagnosis and differential diagnosis.

Main Methods:

• Review of pathological components determining plaque vulnerability (fibrous cap, lipid core, hemorrhage, neovascularization, ulceration).
• Analysis of advancements in imaging technologies for detecting AP vulnerability.
• Correlation of imaging findings with plaque characteristics and IS occurrence.

Main Results:

• Vulnerable plaque components like thin fibrous caps and necrotic lipid cores are critical indicators.
• Imaging technologies are increasingly capable of detecting these specific plaque vulnerabilities.
• Accurate identification of vulnerable plaque is crucial for timely clinical intervention.

Conclusions:

• Understanding carotid plaque vulnerability is essential for managing ischemic stroke risk.
• Modern imaging offers promising tools for assessing plaque composition and predicting rupture.
• Early detection and intervention strategies targeting vulnerable plaques can mitigate IS impact.