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Imaging of atherosclerosis (Part I)
H Kritz1, S R Underwood, H Sinzinger
1Wilhelm Auerswald Atherosclerosis Research Group, Vienna.
Insights
Early detection of atherosclerosis is crucial. Current imaging methods fail to identify early, metabolically active plaques, necessitating advanced non-invasive techniques for timely therapeutic intervention.
Area of Science:
- Cardiovascular Imaging
- Medical Diagnostics
- Pathology
Background:
- Atherosclerosis is a primary cause of death globally.
- Existing imaging methods (angiography, CT, ultrasound) detect advanced plaques, missing early, active lesions.
- Early-stage plaques are most responsive to therapeutic interventions.
Purpose of the Study:
- To review current diagnostic procedures for imaging atherosclerotic lesions.
- To highlight the limitations of conventional imaging in early plaque detection.
- To introduce advanced imaging modalities for early atherosclerosis diagnosis.
Main Methods:
- Review of diagnostic procedures including angiography, ultrasonography, computed tomography, and magnetic resonance tomography.
- Discussion of limitations in detecting early-stage atheromatous plaques.
- Introduction to scintigraphic imaging and positron emission tomography for plaque assessment.
Main Results:
- Conventional imaging techniques primarily detect morphological changes in advanced atherosclerotic plaques.
- Early, metabolically active atherosclerotic lesions remain largely undetected by standard methods.
- A need exists for non-invasive techniques to identify early plaque presence and extent.
Conclusions:
- Current imaging modalities are insufficient for early atherosclerosis detection.
- Advanced imaging techniques like scintigraphy and PET hold promise for assessing early, active lesions.
- Non-invasive assessment of early atherosclerotic disease is critical for effective treatment.
Abstract:
Atherosclerosis is the leading cause of morbidity and mortality in the Western World. Standard imaging techniques such as angiography, ultrasonography and computed tomography are still not effective in detecting atheromatous plaques in their early stages of development, when the lesions are most metabolically active and therapeutic interventions could beneficial. These techniques identify morphological changes such as increased wall thickness, decreased luminal diameter or related haemodynamic changes such as turbulence of blood flow. Unfortunately, all these phenomena occur when the plaque has evolved and encroaches on the lumen. There is a need for non-invasive methods that could assess the presence and the extension of atherosclerotic disease in its early stages, when the lesions are in their metabolically most active stage but still do not narrow the diameter of the lumen. Part I of this article presents an overview of the diagnostic procedures angiography, sonography, computed tomography and magnetic resonance tomography in imaging atherosclerotic lesions. Part II will concentrate on the diagnostic possibilities of scintigraphic imaging and positron emission tomography.