Current Imaging Approaches and Challenges in the Assessment of Carotid Artery Disease

  • Krishnan Ravindran
  • Waleed BrinijikiEmail author
  • J. Kevin DeMarco
  • John HustonIII


Modern advances now allow for carotid plaque vulnerability to be assessed through noninvasive imaging techniques. Further paradigm shift has expanded imaging evaluation of carotid disease beyond stenosis measurement to thorough evaluation of carotid plaque characteristics. Key imaging features such as plaque ulceration, neovascularity, thickness of fibrous cap, and the presence of intraplaque hemorrhage can now be used to stratify risk of global plaque rupture. In this chapter, we focus on the three primary imaging modalities used to assess carotid plaque (MRI, CT, and ultrasound) and focus on imaging features of lipid-rich necrotic core and intraplaque hemorrhage on each. Additionally we discuss novel techniques within each modality used to evaluate plaque and consider relative merits.


Soft plaque Necrotic core Intraplaque hemorrhage Fibrous cap CTA MRA Ultrasound 



The views expressed in this chapter are those of the author and do not reflect the official policy of the Department of Army/Navy/Air Force, Department of Defense, or US Government.

The identification of specific products or scientific instrumentation does not constitute endorsement or implied endorsement on the part of the author, DoD, or any component agency.


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Krishnan Ravindran
    • 1
  • Waleed Brinijiki
    • 1
    Email author
  • J. Kevin DeMarco
    • 2
    • 3
  • John HustonIII
    • 1
  1. 1.Department of RadiologyMayo ClinicRochesterUSA
  2. 2.Department of RadiologyWalter Reed National Military Medical CenterBethesdaUSA
  3. 3.Department of RadiologyUniformed Services University of the Health SciencesBethesdaUSA

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