Porcu Michele, Mannelli Lorenzo, Melis Marta, Suri Jasjit S, Gerosa Clara, Cerrone Giulia, Defazio Giovanni, Faa Gavino, Saba Luca
Department of Radiology, AOU Cagliari, University of Cagliari, Italy.
IRCSS SDN, Napoli, Italy.
Cardiovasc Diagn Ther. 2020 Aug;10(4):1005-1018. doi: 10.21037/cdt.2020.01.13.
Carotid artery stenosis (CAS) due to the presence of atherosclerotic plaque (AP) is a frequent medical condition and a known risk factor for stroke, and it is also known from literature that several risk factors promote the AP development, in particular aging, smoke, male sex, hypertension, hyperlipidemia, smoke, diabetes type 1 and 2, and genetic factors. The study of carotid atherosclerosis is continuously evolving: even if the strategies of treatment still depends mainly on the degree of stenosis (DoS) determined by the plaque, in the last years the attention has moved to the study of the plaque components in order to identify the so called "vulnerable" plaque: features like the fibrous cap status and thickness, the volume of the lipid-rich necrotic core and the presence of intraplaque hemorrhage (IPH) are risk factors for plaque rupture, that can be studied with modern imaging techniques. The aim of this review is to give a general overview of the principle histological and imaging features of the subcomponent of carotid AP (CAP), focalizing in particular on the features of CAP of patients affected by hypertension and diabetes (in particular type 2 diabetes mellitus).
由于动脉粥样硬化斑块(AP)导致的颈动脉狭窄(CAS)是一种常见的病症,也是已知的中风危险因素,并且从文献中可知,有几种危险因素会促进AP的发展,特别是衰老、吸烟、男性、高血压、高脂血症、吸烟、1型和2型糖尿病以及遗传因素。颈动脉粥样硬化的研究在不断发展:即使治疗策略仍主要取决于由斑块决定的狭窄程度(DoS),但在过去几年中,注意力已转向对斑块成分的研究,以识别所谓的“易损”斑块:诸如纤维帽状态和厚度、富含脂质的坏死核心体积以及斑块内出血(IPH)的存在等特征都是斑块破裂的危险因素,这些可以通过现代成像技术进行研究。本综述的目的是对颈动脉AP(CAP)子成分的主要组织学和成像特征进行概述,特别关注高血压和糖尿病(特别是2型糖尿病)患者的CAP特征。