Noninvasive carotid imaging techniques, including ultrasound, CT, MRI, and PET, offer opportunities to improve risk stratification and monitor therapeutic response in asymptomatic carotid atherosclerosis.
Noninvasive imaging techniques such as ultrasound, CT, MRI, and PET hold promise for improving risk stratification and individualizing management in patients with asymptomatic carotid atherosclerosis.
Managing asymptomatic carotid atherosclerosis with a view to preventing ischemic stroke is a challenging task. As the annual risk of stroke in untreated asymptomatic patients on average is less than the risk of surgical intervention, the key question is how to identify those asymptomatic individuals whose risk of stroke is elevated and who would benefit from surgery, while sparing low-risk asymptomatic patients from the risks of surgical intervention. The advent of a multitude of noninvasive carotid imaging techniques offers an opportunity to improve risk stratification in patients and to monitor the response to medical therapies; assessing efficacy at individual and population levels. As part of this, plaque measurement techniques (using ultrasound, computed tomography or MRI) may be employed in monitoring plaque/component regression and progression. Novel imaging applications targeted to plaque characteristics, inflammation and neovascularization, including contrast-enhanced ultrasound and MRI, dynamic contrast-enhanced MRI, and fluorodeoxyglucose-PET, are also being explored. Ultimately, noninvasive imaging and other advances in risk stratification aim to improve and individualize the management of patients with carotid atherosclerosis.
Degnan et al. (2011) conducted a review in Asymptomatic carotid atherosclerosis. Noninvasive carotid imaging techniques was evaluated. Noninvasive carotid imaging techniques, including ultrasound, CT, MRI, and PET, offer opportunities to improve risk stratification and monitor therapeutic response in asymptomatic carotid atherosclerosis.