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(Circulation. 2003;108:2542.)
© 2003 American Heart Association, Inc.

Images in Cardiovascular Medicine

Visualization of the Ruptured Plaque by Magnetic Resonance Imaging

Frank Wiesmann, MD; Matthew D. Robson, PhD; Jane Francis, DCR; Steffen E. Petersen, MD; C. Paul Leeson, PhD, MRCP; Keith M. Channon, MD, MRCP; Stefan Neubauer, MD, MRCP

From the Department of Cardiovascular Medicine, John Radcliffe Hospital, University of Oxford, UK.

Correspondence to Frank Wiesmann, MD, Department of Cardiovascular Medicine, John Radcliffe Hospital, Headley Way, Oxford OX 3 9 DU, UK. E-mail frank.wiesmann@cardiov.ox.ac.uk

An extract of the first 250 words of the full text is provided, because this article has no abstract.

A 61-year-old man at risk of generalized arteriosclerosis due to heavy long-term smoking (60 pack-years) but no other risk factors was enrolled in a research study of atherosclerosis by noninvasive vascular MRI. The patient reported an episode of amaurosis fugax of the right eye 4 months before the scan but had no other clinical symptoms.

MRI of the neck vessels revealed a pronounced bilateral increase in wall thickness of internal carotid arteries as well as of the common carotid and vertebral arteries on both sides (Figure 1A and 1B). Immediately below the carotid bifurcation, the right common carotid artery showed significant thickening of the vessel wall with an appearance consistent with two atherosclerotic plaques (Figure 1B). On enlargement of the region of interest, both plaques showed a dark, lipid-rich core covered by a thin fibrous cap (Figure 1C). One lesion was suggestive of a ruptured plaque showing discontinuity of the fibrous cap (arrow). However, there was no evidence of significant luminal narrowing.

View larger version (41K): [in this window] [in a new window]   Figure 1. Magnetic resonance T2-weighted turbo-spin-echo images in transverse orientation revealing increased wall thickness of the carotid and vertebral arteries. A, Note the pronounced thickening of the posterior arterial wall in both the right and left internal carotid artery. B, Significantly thickened vessel wall in the left carotid bifurcation (LCAbif). Also shown are two arteriosclerotic lesions in the right common carotid artery (RCCA) with dark lipid core and thin fibrous cap. C, Close-up of right common carotid artery suggestive of . . . [Full Text of this Article]

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