Carotid atherosclerotic wall imaging by MRI.

High spatial resolution magnetic resonance imaging (MRI) is one of the most promising modalities for visualizing the carotid atherosclerotic plaque. MR allows direct visualization of the diseased vessel wall, is capable of characterizing plaque morphology, and can potentially monitor progression of the disease. Though ultrasound and angiography have been the principal methods for determining the severity of carotid atherosclerosis and the need for endarterectomy, these methods only measure percentage of vessel stenosis. There is strong evidence that this is not the best indicator for assessing clinical risk. Improved imaging techniques are therefore needed to reliably identify the high-risk plaques that lead to cerebrovascular events. This article focuses on the current state-of-the-art in MR carotid atherosclerotic plaque imaging to evaluate plaque morphology and composition.