Studies have demonstrated that plaque morphology can contribute to identification of patients at high risk of carotid artery atherosclerosis as well as the degree of stenosis in those with carotid atherosclerosis. Neovascularization of carotid plaques is associated with plaque vulnerability.
Communication of inwardly projecting neovessels with the lumen and inflammation synergistically contribute to intraplaque hemorrhage (IPH) and symptomatic presentations in patients with carotid stenosis and are more specific than the vasa vasorum. This condition could be a new therapeutic target, and regression of luminal neovessel sprouting and inflammation may help to prevent IPH development and a symptomatic presentation 1).
A study tested the hypothesis that inflammation and oxidative stress determined carotid IMT in patients with OSA. The carotid IMT, mean systolic and diastolic pressure (night and morning) were significantly higher and the level of thiols and high-density lipoprotein were significantly lower in our 121 OSA patients than in 27 controls (P < 0.05). The apnea/hypopnea index was correlated positively with E-selectin (r = 0.222, P = 0.014), total cholesterol (r = 0.185, P = 0.042), low-density lipoprotein (r = 0.264, P = 0.003) and HbA1c levels (r = 0.304, P = 0.001), but inversely with high-density lipoprotein level (r = -0.203, P = 0.025) in the 121 patients with OSA. In OSA subjects, multiple linear regression analysis revealed that age, systolic blood pressure and intercellular cell adhesion molecule-1 level associated independently with carotid IMT. Besides both age and systolic blood pressure, our study demonstrated that intercellular cell adhesion molecule-1 level was associated significantly with carotid IMT in those patients who had OSA but without metabolic syndrome 2).
The determination of the wall thickness [intima-media thickness (IMT)], the delineation of the atherosclerotic carotid plaque, the measurement of the diameter in the common carotid artery (CCA), as well as the grading of its stenosis are important for the evaluation of the atherosclerosis disease. All these measurements are also considered to be significant markers for the clinical evaluation of the risk of stroke. A number of CCA segmentation techniques have been proposed in the last few years either for the segmentation of the intima-media complex (IMC), the lumen of the CCA, or for the atherosclerotic carotid plaque from ultrasound images or videos of the CCA.
Three-dimensional ( 3D three-dimensional ) black blood imaging magnetic resonance (MR) imaging is a noninvasive and accurate way to quantify moderate to severe carotid artery atherosclerotic disease. With fast acquisition and large coverage, 3D three-dimensional BB black blood MR imaging has the potential to become an alternative imaging approach in evaluating the severity of atherosclerosis 3).