Advanced Techniques for MRI of Atherosclerotic Plaque

Abstract

This review examines the state of the art in vessel wall imaging by MRI with an emphasis on the biomechanical assessment of atherosclerotic plaque. Three areas of advanced techniques are discussed. First, alternative contrast mechanisms, including susceptibility, magnetization transfer, diffusion and perfusion, are presented in regards to how they facilitate accurate determination of plaque constituents underlying biomechanics. Second, imaging technologies, including hardware and sequences, are reviewed in regards to how they provide the resolution and SNR necessary for determining plaque structure. Finally, techniques for combining MRI data into an overall assessment of plaque biomechanical properties, including wall shear stress and internal plaque strain, are presented. The paper closes with a discussion of the extent to which these techniques have been applied to different arteries commonly targeted by vessel wall MRI.

Quantitative Susceptibility Mapping for Carotid Atherosclerotic Plaques: A Pilot Study

“…19 This leads to opposite phase polarities, which could be utilized in QSM for better differentiation of diamagnetic components from intraplaque hemorrhage. 20 The correlations reported in this study between intraplaque hemorrhages and high relative susceptibility values would facilitate QSM-based identification of intraplaque Mean relative susceptibility value of hemorrhage was higher than lipid rich necrosis in all five cases, and mean relative susceptibility value of calcification was lower than lipid rich necrosis in all six cases. Statistical analysis proved that the mean relative susceptibility values of hemorrhage were significantly higher than the values of lipid rich necrosis (P = 0.0313, Wilcoxon signed-rank test, n = 5), and the values of calcification were statistically significantly lower than the values of lipid rich necrosis (P = 0.0156, Wilcoxon signed-rank test, n = 6).…”

High shear stress induces atherosclerotic vulnerable plaque formation through angiogenesis

“…Changes in vascular cyclic stress can also influence SS-mediated vascular remodelling of VSMCs [ 188 ]. MRI assessment of plaque biomechanical properties including wall SS and internal plaque strain provides information on early plaque progression and vessel remodelling [ 189 , 190 ]. More precise magnetic resonance, intravenous ultrasound (IVUS), CT and angiography were applied to analyse and predict plaque development and stability [ 191 ].…”

Susceptibility‐weighted imaging: current status and future directions

“…Normal vessel walls and calcification are diamagnetic , whereas IPH is paramagnetic. This leads to opposite phase polarities, which could be utilized in SWI and QSM for better differentiation of calcification from IPH . Although the detection and quantification of tiny foci of hemorrhage in asymptomatic carotid plaque are now possible using SWI (Fig.…”