Fabrizio Montecucco, MD, PhD, Division of Cardiology, Faculty of Medicine, Geneva University Hospital, Avenue de la Roseraie 64, 1211 Geneva 4, Switzerland, Tel.: +41 22 372 71 92, Fax: +41 22 382 72 45, E-mail:
Thromb Haemost. 2013 Oct;110(4):706-22. doi: 10.1160/TH13-02-0121. Epub 2013 Jun 27.
Several studies have been carried out on vulnerable plaque as the main culprit for ischaemic cardiac events. Historically, the most important diagnostic technique for studying coronary atherosclerotic disease was to determine the residual luminal diameter by angiographic measurement of the stenosis. However, it has become clear that vulnerable plaque rupture as well as thrombosis, rather than stenosis, triggers most acute ischaemic events and that the quantification of risk based merely on severity of the arterial stenosis is not sufficient. In the last decades, substantial progresses have been made on optimisation of techniques detecting the arterial wall morphology, plaque composition and inflammation. To date, the use of a single technique is not recommended to precisely identify the progression of the atherosclerotic process in human beings. In contrast, the integration of data that can be derived from multiple methods might improve our knowledge about plaque destabilisation. The aim of this narrative review is to update evidence on the accuracy of the currently available non-invasive and invasive imaging techniques in identifying components and morphologic characteristics associated with coronary plaque vulnerability.
已有多项研究表明易损斑块是缺血性心脏事件的主要罪魁祸首。从历史上看，研究冠状动脉粥样硬化疾病最重要的诊断技术是通过血管造影测量狭窄来确定残余管腔直径。然而，易损斑块破裂以及血栓形成，而不是狭窄，引发了大多数急性缺血事件，仅仅基于动脉狭窄的严重程度来量化风险是不够的。在过去的几十年中，在优化检测动脉壁形态、斑块成分和炎症的技术方面取得了重大进展。迄今为止，不建议使用单一技术来精确识别人类动脉粥样硬化进程的进展。相反，整合可以从多种方法中获得的数据可能会提高我们对斑块不稳定的认识。本叙述性综述的目的是更新目前可用的非侵入性和侵入性成像技术在识别与冠状动脉斑块易损性相关的成分和形态特征方面的准确性证据。
