Predicting vascular events with iron oxide-enhanced MRI: improving cerebrovascular and cardiovascular risk stratification through imaging

摘要

Vascular diseases including stroke, myocardial infarction, cerebral aneurysm and aortic aneurysm are among the most widespread causes of death and disability globally. As these conditions are generally asymptomatic before unexpectedly presenting with cardiovascular or cerebrovascular events, it is challenging to identify which individuals can benefit from further intervention such as surgical intervention, aggressive medical management or close clinical surveillance. Noninvasive imaging has been proposed as the solution to this problem by individualizing risk assessment. MRI is a powerful tool that can identify atheromatous plaque constituents and can enhance risk prediction beyond vessel measurements such as degree of stenosis, the traditional marker of disease severity. Iron oxide nanoparticle contrast media have the potential to contribute additional information regarding vascular risk by demonstrating regions of inflammation. This review explores the capability of ultrasmall superparamagnetic iron oxide-enhanced MRI to improve the risk assessment of vascular events in the setting of carotid atherosclerosis, cerebral aneurysm and abdominal aortic aneurysm.