Abstract

Stroke is the third leading cause of death in the developed countries and the most common cause of long term disability. Carotid artery atherosclerotic disease is the predominant precipitant of ischaemic events. Conventionally, angiography is used for the clinical assessment. However, angiography identifies only those lesions that encroach significantly into the lumen, and there is a poor correlation between the angiographic appearance of plaques and subsequent risk of plaque rupture. Efforts from the past 30 years indicate that atherosclerotic plaque vulnerability has a close relationship with certain morphological features, including fibrous cap thickness, size of lipid-rich necrotic core, presence of haemorrhage and luminal contours. Moreover, recent results indicate that critical mechanical conditions are additional driving factors in plaque rupture, when plaque loading exceeds material strength.

Accordingly this talk will focus on: (1) characterisation of morphology and compositional features in atherosclerotic plaque and its relationship with subsequent clinical events using in-vivo magnetic resonance (MR) imaging; (2) medical image-based mechanical analysis to seek new non-invasive bio-markers for plaque vulnerability assessment; and (3) the pathological impact of critical mechanical conditions within the plaque structure.