Gimnich Olga A, Zil-E-Ali Ahsan, Brunner Gerd
Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA, USA.
Curr Atheroscler Rep. 2022 Feb;24(2):85-96. doi: 10.1007/s11883-022-00988-x. Epub 2022 Jan 26.
Vascular imaging is a complex field including numerous modalities and imaging markers. This review is focused on important and recent findings in atherosclerotic carotid artery plaque imaging with an emphasis on developments in magnetic resonance imaging (MRI) and computed tomography (CT).
Recent evidence shows that carotid plaque characteristics and not only established measures of carotid plaque burden and stenosis are associated independently with cardiovascular outcomes. On carotid MRI, the presence of a lipid-rich necrotic core (LRNC) has been associated with incident cardiovascular disease (CVD) events independent of wall thickness, a traditional measure of plaque burden. On carotid MRI, intraplaque hemorrhage (IPH) presence has been identified as an independent predictor of stroke. The presence of a fissured carotid fibrous cap has been associated with contrast enhancement on CT angiography imaging. Carotid artery plaque characteristics have been associated with incident CVD events, and advanced plaque imaging techniques may gain additional prominence in the clinical treatment decision process.
血管成像领域复杂，包含多种模式和成像标记物。本综述聚焦于动脉粥样硬化性颈动脉斑块成像的重要及最新发现，重点关注磁共振成像（MRI）和计算机断层扫描（CT）的进展。
近期证据表明，颈动脉斑块特征而非仅有的颈动脉斑块负荷和狭窄的既定测量指标与心血管结局独立相关。在颈动脉MRI上，富含脂质的坏死核心（LRNC）的存在与心血管疾病（CVD）事件的发生独立相关，而与作为斑块负荷传统测量指标的壁厚度无关。在颈动脉MRI上，斑块内出血（IPH）的存在已被确定为中风的独立预测因素。颈动脉纤维帽有裂隙与CT血管造影成像上的对比增强相关。颈动脉斑块特征与CVD事件的发生相关，先进的斑块成像技术可能在临床治疗决策过程中变得更加重要。
