Imaging of the unstable plaque: how far have we got?

Eur Heart J. 2009 Nov;30(21):2566-74. doi: 10.1093/eurheartj/ehp419. Epub 2009 Oct 15.

Abstract

Rupture of unstable plaques may lead to myocardial infarction or stroke and is the leading cause of morbidity and mortality in western countries. Thus, there is a clear need for identifying these vulnerable plaques before the rupture occurs. Atherosclerotic plaques are a challenging imaging target as they are small and move rapidly, especially in the coronary tree. Many of the currently available imaging tools for clinical use still provide minimal information about the biological characteristics of plaques, because they are limited with respect to spatial and temporal resolution. Moreover, many of these imaging tools are invasive. The new generation of imaging modalities such as magnetic resonance imaging, nuclear imaging such as positron emission tomography and single photon emission computed tomography, computed tomography, fluorescence imaging, intravascular ultrasound, and optical coherence tomography offer opportunities to overcome some of these limitations. This review discusses the potential of these techniques for imaging the unstable plaque.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acute Coronary Syndrome / diagnosis
  • Acute Coronary Syndrome / pathology*
  • Diagnostic Imaging / methods*
  • Diagnostic Imaging / trends
  • Endosonography / methods
  • Endosonography / trends
  • Forecasting
  • Humans
  • Magnetic Resonance Imaging / methods
  • Magnetic Resonance Imaging / trends
  • Magnetic Resonance Spectroscopy / methods
  • Microscopy, Fluorescence / methods
  • Microscopy, Fluorescence / trends
  • Rupture, Spontaneous / diagnosis
  • Tomography, Optical Coherence / methods
  • Tomography, Optical Coherence / trends
  • Tomography, X-Ray Computed / methods
  • Tomography, X-Ray Computed / trends