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22 - Carotid magnetic resonance direct thrombus imaging

from Functional plaque imaging

Published online by Cambridge University Press:  03 December 2009

Alan Moody
Affiliation:
Sunnybrook Health Sciences Centre, Toronto ON, Canada
Jonathan Gillard
Affiliation:
University of Cambridge
Martin Graves
Affiliation:
University of Cambridge
Thomas Hatsukami
Affiliation:
University of Washington
Chun Yuan
Affiliation:
University of Washington
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Summary

Atherosclerosis is the basis of the majority of carotid artery disease which, via occlusive/stenotic disease and subsequent thromboembolic events, results in end organ (brain) damage. The ability to identify atherosclerotic carotid disease, characterize those patients with disease likely to cause end organ damage and then treat this disease as noninvasively as possible underlies many research questions into carotid disease at the present time. An improved understanding of the biological processes and interactions within atherosclerotic plaque enables a more rational and targeted approach to answering some of these questions. This is the case when designing new imaging techniques that attempt to specifically identify markers of high risk.

Over the last few years there has been a rapid expansion in our knowledge of the vascular biology of vessel wall disease. The American Heart Association (AHA) has defined a progression from minimal, nonthreatening, vessel wall disease to disease that is increasingly recognized as responsible for causing the terminal events leading to asymptomatic and symptomatic thromboembolic disease with subsequent end organ damage (Stary et al., 1995). The AHA classification defines type V disease as due to fibrous thickening not thought to be responsible for thromboembolic disease. Conversion of this to type VI disease however identifies high-risk atherosclerotic plaque. The three histological markers that define this stage are: surface erosions; thrombus and intraplaque hemorrhage.

Type
Chapter
Information
Carotid Disease
The Role of Imaging in Diagnosis and Management
, pp. 302 - 312
Publisher: Cambridge University Press
Print publication year: 2006

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