Plaque Assessment in the Management of Patients with Asymptomatic Carotid Stenosis

J Kevin DeMarco; J David Spence

doi:10.1016/j.nic.2015.09.009

Plaque Assessment in the Management of Patients with Asymptomatic Carotid Stenosis

Neuroimaging Clin N Am. 2016 Feb;26(1):111-27. doi: 10.1016/j.nic.2015.09.009. Epub 2015 Oct 17.

Authors

J Kevin DeMarco¹, J David Spence²

Affiliations

¹ Department of Radiology, Michigan State University, Radiology Building, 846 Service Road, Room 184, East Lansing, MI 48824, USA. Electronic address: jkd@rad.msu.edu.
² Departments of Neurology and Clinical Pharmacology, Stroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute, Western University, 1400 Western Road, London, Ontario N6G 2V4, Canada.

PMID: 26610664
DOI: 10.1016/j.nic.2015.09.009

Abstract

The continued occurrence of stroke despite advances in medical therapy for asymptomatic carotid stenosis (ACS) strongly indicates that individual response to medical therapy may vary widely. This article reviews the literature that identifies MR imaging and ultrasound plaque features which are seen in patients at increased risk of future cardiovascular events. Imaging can identify plaque phenotype that is the most amendable to intensive medical therapy. There is also good evidence that plaque imaging can measure the individual response to medical therapy and the lack of response identifies a high-risk group of ACS patients.

Keywords: Asymptomatic carotid stenosis; Carotid atherosclerosis; MR imaging; Plaque; Ultrasonography.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Carotid Stenosis / diagnosis*
Evidence-Based Medicine
Humans
Image Interpretation, Computer-Assisted / methods*
Magnetic Resonance Angiography / methods*
Pattern Recognition, Automated / methods*
Plaque, Atherosclerotic / diagnosis*
Reproducibility of Results
Sensitivity and Specificity
Severity of Illness Index
Ultrasonography / methods*