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Vulnerable Plaques

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Table 2. Imaging modalities that have been used or proposed to evaluate "VP" and similar conditions (modified from MacNeill 2003; Fayad 2001)

Imaging Modality SpatialResolution () Vessel Wall Penetration(mm) Features Detected Comments
Image of vessel wall Fibrous Cap Lipid Core Inflammation Calcium Thrombus
Invasive Methods Angiography   NA *       * * Reference standard for stenotic lesions
Intravascular Ultrasound (IVUS) 40~100 ~10 * * *   * * Characterizes vessel wall and morphology, good for calcified plaque, poor for lipids
Angioscopy Visual Poor * * *     * Direct visualization of lumen surface, using color and surface appearance to identify vulnerable plaques
Optical Coherence Tomography (OCT) 2~30 1~2   * * * * * Provides cross-sectional images of vessel wall and quantifies fibrous cap thickness and extent of lipid collections
Thermography 500 Poor       *     Images temperature heterogeneity due to rise in temperature in macrophage-rich areas in plaque
Raman Spectroscopy NA 1~1.5   * * * *   Analysis of Raman spectrum for chemical composition of atherosclerotic plaque
Near infrared Spectroscopy 2
Intravascular MRI 160 Good   * * * * * Measurements of cap thickness and characterization of atherosclerotic lesion
Non-invasive Methods Surface Ultrasound 400 Good * * *   * * Characterizes vessel wall and morphology, good for calcified plaque, poor for lipids
Computed Tomography   NA         * * More useful for detection of calcified plaques
Nuclear Scintigraphy Poor NA     *     * Based on specific binding of radioactive labeled molecules to the target tissue (such as radiolabeled LDL)
Standard MRI 300 Good   * * * * * Measurements of cap thickness and characterization of atherosclerotic lesion

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