Avances en el diagnóstico por resonancia magnética de la enfermedad arterial

Magnetic resonance imaging is proving to be a very useful non-invasive imaging technique in the study of the long-term evolution of atheroma lesions. Not only is it applicable for the diagnosis of atherosclerotic disease but also for the characterization of the cellular mechanisms implied in the development of vascular damage. The four main lesions found in atherosclerosis -the onset of the lesion with the appearance of remodeling, the development of vulnerable plaque, thrombus formation and the organization of the thrombus by connective tissue- have been reported in detail, in both experimental animal models and in humans, from the images obtained by magnetic resonance imaging. Even though we do not yet dispose of sensitive enough methods to study the evolution of fat in coronary arteries, the high resolution images obtained in carotid or aortic plaques by magnetic resonance allow us to visualize the effect produced by statin therapy or by other protective maneuvers such as the reduction of LDL levels or the increase of HDL levels. Atherosclerotic disease must be considered as a growing tumoral process and our main goal should be to determine the degree of malignancy more than trying to quantify the stenosis. Therefore, imaging techniques constitute an essential instrument to determine the plaque characteristics, and evaluate the phase of development to thereby predict the evolution of these lesions.