Carotid artery imaging: The study of intra-plaque vascularization and hemorrhage in the era of the "vulnerable" plaque

Michele Porcu; Michele Anzidei; Jasjit S Suri; Bruce A Wasserman; Nicoletta Anzalone; Pierleone Lucatelli; Federico Loi; Roberto Montisci; Roberto Sanfilippo; Vasileios Rafailidis; Luca Saba

doi:10.1016/j.neurad.2019.03.009

Carotid artery imaging: The study of intra-plaque vascularization and hemorrhage in the era of the "vulnerable" plaque

J Neuroradiol. 2020 Nov;47(6):464-472. doi: 10.1016/j.neurad.2019.03.009. Epub 2019 Apr 4.

Authors

Affiliations

¹ Department of Medical Imaging, AOU of Cagliari, University of Cagliari, Cagliari, Italy. Electronic address: m.porcu@aoucagliari.it.
² Department of Radiological, Oncological and Anatomo-pathological Sciences, Sapienza University of Rome, Rome, Italy.
³ Monitoring and Diagnostic Division, AtheroPoint, Roseville, CA, USA.
⁴ The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁵ Neuroradiology Unit and CERMAC, San Raffaele Scientific Institute and Vita-Salute San Raffaele University, via Olgettina 60, 20132, Milan, Italy.
⁶ Department of Biomedial Sciences, Unit of Oncology and Molecular Pathology, University of Cagliari, Cagliari, Italy.
⁷ Department of Vascular Surgery, AOU of Cagliari, University of Cagliari, Cagliari, Italy.
⁸ Department of Radiology, AHEPA University General Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636 Thessaloníki, Greece.
⁹ Department of Medical Imaging, AOU of Cagliari, University of Cagliari, Cagliari, Italy.

PMID: 30954549
DOI: 10.1016/j.neurad.2019.03.009

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.

Publication types

Review

MeSH terms

Carotid Stenosis / diagnostic imaging*
Hemorrhage / diagnostic imaging*
Humans
Magnetic Resonance Imaging
Tomography, X-Ray Computed
Ultrasonography