Molecular imaging of atherosclerosis with magnetic resonance

Despite important clinical advances in the prevention and treatment of atherosclerosis during the past 20 years, atherosclerotic disease remains the first cause of mortality in industrialized countries. 1,2 Atherosclerosis is a complex disease where cholesterol deposition, inflammation, and plaque formation play a major role. Although the causes of atherosclerosis are not completely understood, most atherosclerotic lesions are characterized by a thickening of the arterial intima and are typically composed of a lipid core and an overlying fibrous cap. 3–6 X-ray angiography remains the gold standard for diagnosis and quantification of atherosclerotic plaques. X-ray angiography is an invasive technique that is used to visualize flow-limiting arterial stenoses, allowing for an indirect measure of atherosclerotic burden. Positive remodeling of the arterial wall — a process in which the vessel dilates to limit the narrowing of the lumen in the presence of atherosclerotic plaques — leads to an underestimation of the true extension of atherosclerosis disease with x-ray angiography.