Evaluating vulnerable atherosclerotic plaque with MRI

Despite important clinical advances in prevention and treatment of atherosclerosis during the past 20 years, coronary artery disease remains the first cause of mortality in industrialized countries.¹ Atherosclerosis affects medium-and large-diameter arteries and is characterized by a thickening of the arterial intima typically composed of a lipid core with an overlying fibrous cap. Angiography remains the gold standard for diagnosis and quantification of atherosclerotic plaques that result in flow-limiting arterial stenoses but offers only an indirect view of atherosclerosis burden.² Positive remodeling of the arterial wall-a process in which the vessel dilates to limit the narrowing of the lumen in presence of atherosclerotic plaques-leads to a clear underestimation of the true extension of atherosclerosis disease with angiography.³