Carotid imaging in cardiovascular risk assessment

Ray, A. (2018)

Doctoral Thesis

Atherosclerotic changes of the carotid artery are associated with elevated cardiovascular risk. Non-invasive imaging studies of the artery can provide information on the presence or absence of abnormalities. Although the techniques are extensively used in clinical research their implementation in common practice is not widespread. In this thesis the potential benefits and challenges of carotid imaging in clinical practice are studied. Ultrasound and magnetic resonance imaging are the two modalities of interest. The findings suggest that ultrasound can be performed by the clinician in a routine outpatient setting. Clinicians are able to detect atherosclerotic plaques but not intima-media thickness. Plaques are highly prevalent in asymptomatic primary prevention patients. Magnetic resonance imaging is a new highly reproducible modality but requires further clinical validation. Its utility in individual patient risk assessment is unclear and ultrasound validity cannot be extrapolated to magnetic resonance. The use of a combination of the two imaging modalities may allow for estimation of the lamina adventitia in vivo. Finally, interpretation of the imaging parameters must be done in conjunction with all cardiovascular risk factors and treatment decision should not be based on imaging results alone.

• Atherosclerosis
• Cardiovascular disease
• Carotid artery
• Ultrasound
• Magnetic resonance imaging

• All authors: Ray, A.
• Supervisor: Huisman, M.V.; Rabelink, T.J.
• Co-supervisor: Tamsma, J.T.
• Committee: Roos, A. de; Bots, M.L.; Buren, M. van
• Qualification: Doctor (dr.)
• Awarding Institution: Vasculaire geneeskunde, Medicine / Leiden University Medical Center, Leiden University
• Date: 2018-05-15