Matthias Stuber

Magnetic resonance imaging of atherosclerosis: classical and molecular imaging

Despite advances in both treatment and prevention, complications of atherosclerotic disease remain the leading cause of morbidity and mortality in the Western World. While atherosclerosis may slowly progress over years or decades, the occurrence of thrombosis as a consequence of sudden plaque rupture often leads to abrupt life threatening complications. Such acute events may explain why a large percentage (∼ 50%=250,000 in the US/year) of people dying from coronary artery disease die suddenly without manifestation of typical symptoms [2].

Technical Principles of MRA

In this chapter we discuss the basic principles underlying magnetic resonance angiography (MRA) and the specific boundary conditions that apply to the different vascular beds. Unlike X-ray angiography, MRA does not expose the patient to potentially harmful ionizing radiation nor does it require iodinated contrast. In addition, it has the potential to noninvasively visualize the vessel wall, atherosclerotic plaque, and thrombus, thereby providing new insights into the process and stage of atherosclerotic disease. MRA is primarily based on blood flow and can be divided into “bright blood” and “black blood” methods depending on whether blood appears “bright” or “black” on the MR images.