Carotid Artery Wall Imaging: Perspective and Guidelines from the ASNR Vessel Wall Imaging Study Group and Expert Consensus Recommendations of the American Society of Neuroradiology

L. Saba*, C. Yuan, T. S. Hatsukami, N. Balu, Y. Qiao, J. K. DeMarco, T. Saam, A. R. Moody, D. Li, C. C. Matouk, M. H. Johnson, H. R. Jager, M. Mossa-Basha, M. E. Kooi, Z. Fan, D. Saloner, M. Wintermark, D. J. Mikulis, B. A. Wasserman, Vessel Wall Imaging Study

*Corresponding author for this work

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Abstract

Identification of carotid artery atherosclerosis is conventionally based on measurements of luminal stenosis and surface irregularities using in vivo imaging techniques including sonography, CT and MR angiography, and digital subtraction angiography. However, histopathologic studies demonstrate considerable differences between plaques with identical degrees of stenosis and indicate that certain plaque features are associated with increased risk for ischemic events. The ability to look beyond the lumen using highly developed vessel wall imaging methods to identify plaque vulnerable to disruption has prompted an active debate as to whether a paradigm shift is needed to move away from relying on measurements of luminal stenosis for gauging the risk of ischemic injury. Further evaluation in randomized clinical trials will help to better define the exact role of plaque imaging in clinical decision-making. However, current carotid vessel wall imaging techniques can be informative. The goal of this article is to present the perspective of the ASNR Vessel Wall Imaging Study Group as it relates to the current status of arterial wall imaging in carotid artery disease.
Original languageEnglish
Pages (from-to)E9-E31
Number of pages23
JournalAmerican Journal of Neuroradiology
Volume39
Issue number2
DOIs
Publication statusPublished - 1 Feb 2018

Keywords

  • MULTIDETECTOR-ROW CT
  • ATHEROSCLEROTIC PLAQUE PROGRESSION
  • CONTRAST-ENHANCED ULTRASOUND
  • TURBO SPIN-ECHO
  • SURFACE IRREGULARITIES CORRELATE
  • RISK-ASSESSMENT STRATEGIES
  • TRANSIENT ISCHEMIC ATTACK
  • FISSURED FIBROUS CAP
  • RICH NECROTIC CORE
  • IN-VIVO MRI

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