Magnetic resonance imaging of atherothrombotic plaques

•Atherothrombotic carotid plaques are a predominant cause of ischaemic strokes.•Magnetic resonance imaging has the potential to assess the morphological and functional characteristics of carotid atherothrombosis.•By improving our understanding of the disease process, novel treatment strategies can be formulated against atherothrombosis.

Atherosclerosis remains the leading cause of long term morbidity and mortality worldwide, despite significant advances in its management. Vulnerable atherothrombotic plaques are predominantly responsible for thromboembolic ischaemic events in arterial beds, such as the carotid, coronary and lower limb arteries. MRI has emerged as a non-invasive, non-irradiating and highly reproducible imaging technique which allows detailed morphological and functional assessment of such plaques. It also has the potential to monitor the efficacy of established and evolving anti-atherosclerosis drugs. It is envisaged that by careful identification and understanding of the underlying cellular and molecular mechanisms that govern atherosclerosis, novel treatment strategies can be formulated which may reduce the persistent high mortality and morbidity rates associated with this disease. MRI shows promise in achieving this goal.