Abstract-Accumulation of cholesteryl esters (CEs) is a key event in the formation of atherosclerotic plaques. More recent work suggests a role for CEs in plaque rupture leading to thrombosis, which can result in an acute event such as myocardial infarction or stroke. In this study, we present nuclear magnetic resonance (NMR) protocols for quantification of CEs in plaques in situ. Total CEs quantified by 13 C magic-angle spinning (MAS) NMR in excised plaques from human carotid arteries and rabbit aortic arteries were in good agreement with the amounts determined by subsequent standard chemical assays. The latter analysis is disadvantageous because it requires that plaque lipids be extracted from the tissue, resulting in the loss of all phase information of CEs as well as other major plaque components. With our MAS-NMR protocol, the plaque components are preserved in their native phases. Combining MAS and off-MAS NMR, we were able to quantitatively distinguish isotropic (liquid) CEs from anisotropic (liquid-crystalline) CEs in plaque tissues. In a recent study, we applied a different 13 C MAS-NMR protocol to quantify crystalline cholesterol monohydrate in plaques. Together, these 2 studies describe a new, noninvasive MAS-NMR strategy for the identification and quantification of the major lipid components in plaques in situ. This approach will be useful for investigation of the relationship between plaque rupture and specific lipids in their biologically relevant phases. Key Words: NMR Ⅲ cholesteryl esters Ⅲ atherosclerotic plaques Ⅲ plaque rupture Ⅲ lipid phase T he formation of a lipid-rich lesion in the arterial wall is a key event in the initiation and progression of atherosclerosis. The lipid content and composition are important factors in predicting the stability of an atheromatous plaque. 1,2 Cholesteryl esters (CEs) constitute a major fraction of the lipid-rich core in the atherosclerotic plaque, and their abundance is highly associated with rupture of plaques and formation of thrombi. 3 Aortic plaques with a lipid core occupying Ͼ40% of the total plaque volume are at the highest risk of rupture. 4 It is hypothesized that the accumulation of noncrystalline CEs may soften the lipid core, making plaques with a thin, fibrous cap more prone to rupture. 5 A more specific suggestion is that the ratio of CEs to crystalline cholesterol monohydrate is a determinant of plaque "softness." 6 However, only very recently has an accurate quantification of crystalline cholesterol monohydrate in a plaque in situ been achieved. 7 In addition to the chemical abundance of CEs, the physical state of CEs and the proximity of CEs to other plaque components may be important for plaque stability. CE is a nonpolar lipid that does not mix well with polar lipids (eg, phospholipids) but can serve as a weak solvent for weakly polar lipids such as triglycerides and cholesterol. 3 Within plaques, CE is phase-separated from phospholipid/cholesterol bilayers and crystalline cholesterol. In some plaques, the CE pool is enriched with saturat...