ABSTRACT
This chapter reviews some of the underlying pathobiology of atherosclerosis and discusses the basics of magnetic resonance imaging (MRI) with respect to the concept of atherosclerosis imaging. Permanent pacemakers and implanted cardioverter defibrillators are considered absolute contraindications to MRI due to the risk of pacemaker failure or rapid rhythm induction due to the oscillating magnetic fields. Plaques containing large atheromatous cores are more prone to disruption, and indeed three-quarters of such plaques are responsible for the atherothrombotic complications leading to acute coronary syndromes. Magnetic resonance can provide information about cardiac anatomy, function, perfusion, and metabolism. Spin echo imaging can provide excellent discrimination of various components of the heart and has flexible contrast characteristics, depending on the programmed parameters of the imaging sequence. Gradient echo imaging is especially useful for vascular lumen angiography. Targeted MR contrast agents that characterize thrombus are under development.
