Translational Application of In Vivo Imaging and Mechanical Analysis for Atherosclerotic Plaque Vulnerability Assessment

摘要

Atherosclerotic arterial diseases, such as atherosclerotic plaque and aneurysm, are the main cause of mortality and disability. In current clinical practise, angiography using ultrasound, computerized tomography (CT) and magnetic resonance imaging (MRI) is the main approach to assess the disease severity. Numerous studies have shown that angiography measured degree of stenosis or maximum diameter is insufficient to assess the vulnerability of plaque or aneurysm. Histopathological analysis indicates that atherosclerotic tissue is composed of various components, including lipid-rich necrotic core (LRNC), calcium, haemorrhage and fibrous cap. As a multi-component structure, the stability of atherosclerotic tissue has a close relationship with its compositional features, such as the size of LRNC, presence of haemorrhage and the thickness and intactness of fibrous cap. With modern advanced medical imaging approaches, these compositional features can be captured non/mini-invasively. Results obtained from retrospective and prospective studies have shown that clinical symptom and recurrent cardiovascular event have a closed association with those compositional features. Medical images depicted compositional features, therefore, have a great potential in refining patient stratification.