Carotid artery imaging: The study of intra-plaque vascularization and hemorrhage in the era of the “vulnerable” plaque - 16/10/20

Doi : 10.1016/j.neurad.2019.03.009

Michele Porcu ^a,^⁎ , Michele Anzidei ^b, Jasjit S. Suri ^c, Bruce A Wasserman ^d, Nicoletta Anzalone ^e, Pierleone Lucatelli ^b, Federico Loi ^f, Roberto Montisci ^g, Roberto Sanfilippo ^g, Vasileios Rafailidis ^h, Luca Saba ^a
^a Department of Medical Imaging, AOU of Cagliari, University of Cagliari, Cagliari, Italy
^b Department of Radiological, Oncological and Anatomo-pathological Sciences, Sapienza University of Rome, Rome, Italy
^c Monitoring and Diagnostic Division, AtheroPoint, Roseville, CA, USA
^d The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
^e Neuroradiology Unit and CERMAC, San Raffaele Scientific Institute and Vita-Salute San Raffaele University, via Olgettina 60, 20132, Milan, Italy
^f Department of Biomedial Sciences, Unit of Oncology and Molecular Pathology, University of Cagliari, Cagliari, Italy
^g Department of Vascular Surgery, AOU of Cagliari, University of Cagliari, Cagliari, Italy
^h Department of Radiology, AHEPA University General Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636 Thessaloníki, Greece

^⁎Corresponding author at: Department of Medical Sciences and Public Health, University of Cagliari, S.S: 554, km 4,500, CAP: 09042, Monserrato, Cagliari, Italy.Department of Medical Sciences and Public HealthUniversity of CagliariS.S: 554, km 4Monserrato, Cagliari500, CAP: 09042Italy

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Abstract

Intraplaque hemorrhage (IPH) is one of the main factors involved in atherosclerotic plaque (AP) instability. Its recognition is crucial for the correct staging and management of patients with carotid artery plaques to limit ischemic stroke. Imaging plays a crucial role in identifying IPH, even if the great variability of intraplaque vascularization and the limitations of our current imaging technologies make it difficult. The intent of this review is to give a general overview of the main features of intraplaque vascularization and IPH on Ultrasound (US), Computed Tomography (CT), Magnetic Resonance (MR) and Nuclear Medicine, and a brief description on the future prospectives.

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Esquema

Introduction

Atherosclerotic plaque in carotid arteries: the features

Imaging of carotid artery plaque vascularization and IPH

Ultrasound and contrast enhanced ultrasound

Computed tomography

Nuclear medicine

Magnetic resonance

Clinical implications and future prospective

Conclusions

Funding

Disclosure of interest

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Vol 47 - N° 6

P. 464-472 - novembre 2020 Regresar al número

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Carotid artery imaging: The study of intra-plaque vascularization and hemorrhage in the era of the “vulnerable” plaque - 16/10/20

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