MRI of carotid atherosclerosis
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Atherosclerotic disease of the carotid bifurcation is a major source of thrombo-embolism and subsequent stroke. Non-invasive in vivo investigations of the relationship between atherosclerotic plaque tissue composition/morphology and the development of neurological symptoms may provide critical information for the detection of vulnerable plaque. Magnetic resonance imaging (MRI), using phased-array technology and multiple contrast weighting, has been shown to be able to identify important features associated with vulnerable or culprit plaques. These features include fibrous cap, lipid rich necrotic core, intraplaque hemorrhage, and neovascularization. In addition, MRI can also be used to assess the overall morphological characteristics of a lesion such as vessel wall volume and plaque thickness. These abilities of MRI make it a unique technique to monitor the progression or regression of atherosclerosis and to potentially offer improved diagnosis with optimal treatment plans for patients with atherosclerotic disease. This talk addresses the different aspects of imaging techniques and processing methods for quantitative characterization of atherosclerotic lesions. This talk also discusses recent results on the relationship between MRI identified plaque features and neurological symptoms.