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Chest
Diagnosis
Cardiovascular Disorders
Diseases of the Aorta and Great Vessels
Atherosclerosis
Atherosclerosis
Santiago Martínez-Jiménez, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Arteriosclerosis

          • Definitions

            • Lipid deposition on arterial walls leading to thickening, hardening, & occlusion

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Angiographic Findings

                      • Nuclear Medicine Findings

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          Selected References

                                          1. Kerl JM et al: Accuracy of coronary artery stenosis detection with CT versus conventional coronary angiography compared with composite findings from both tests as an enhanced reference standard. Eur Radiol. 21(9):1895-903, 2011
                                          2. Gottlieb I et al: The absence of coronary calcification does not exclude obstructive coronary artery disease or the need for revascularization in patients referred for conventional coronary angiography. J Am Coll Cardiol. 55(7):627-34, 2010
                                          3. Grosse C et al: CT findings in diseases associated with pulmonary hypertension: a current review. Radiographics. 30(7):1753-77, 2010
                                          4. Marie I et al: Long-term follow-up of aortic involvement in giant cell arteritis: a series of 48 patients. Medicine (Baltimore). 88(3):182-92, 2009
                                          5. Silvera SS et al: Multimodality imaging of atherosclerotic plaque activity and composition using FDG-PET/CT and MRI in carotid and femoral arteries. Atherosclerosis. 207(1):139-43, 2009
                                          6. Ravipati G et al: Comparison of sensitivity, specificity, positive predictive value, and negative predictive value of stress testing versus 64-multislice coronary computed tomography angiography in predicting obstructive coronary artery disease diagnosed by coronary angiography. Am J Cardiol. 101(6):774-5, 2008
                                          7. Rudd JH et al: Atherosclerosis inflammation imaging with 18F-FDG PET: carotid, iliac, and femoral uptake reproducibility, quantification methods, and recommendations. J Nucl Med. 49(6):871-8, 2008
                                          8. Momiyama Y et al: Aortic plaque imaging and monitoring atherosclerotic plaque interventions. Top Magn Reson Imaging. 18(5):349-55, 2007
                                          9. Achenbach S: Computed tomography coronary angiography. J Am Coll Cardiol. 48(10):1919-28, 2006
                                          10. Raggi P et al: Atherosclerotic plaque imaging: contemporary role in preventive cardiology. Arch Intern Med. 165(20):2345-53, 2005
                                          11. Fayad ZA et al: Magnetic resonance imaging and computed tomography in assessment of atherosclerotic plaque. Curr Atheroscler Rep. 6(3):232-42, 2004
                                          12. Yuan C et al: MRI of atherosclerosis. J Magn Reson Imaging. 19(6):710-9, 2004
                                          13. Macura KJ et al: Pathogenesis in acute aortic syndromes: aortic dissection, intramural hematoma, and penetrating atherosclerotic aortic ulcer. AJR Am J Roentgenol. 181(2):309-16, 2003
                                          14. Takasu J et al: Aortic atherosclerosis detected with electron-beam CT as a predictor of obstructive coronary artery disease. Acad Radiol. 10(6):631-7, 2003
                                          15. Tatsumi M et al: Fluorodeoxyglucose uptake in the aortic wall at PET/CT: possible finding for active atherosclerosis. Radiology. 229(3):831-7, 2003
                                          16. Krinsky GA: Diagnostic imaging of aortic atherosclerosis and its complications. Neuroimaging Clin N Am. 12(3):437-43, 2002
                                          17. Frank H: Characterization of atherosclerotic plaque by magnetic resonance imaging. Am Heart J. 141(2 Suppl):S45-8, 2001
                                          18. Miller WT: Thoracic aortic aneurysms: plain film findings. Semin Roentgenol. 36(4):288-94, 2001
                                          19. Rauch U et al: Thrombus formation on atherosclerotic plaques: pathogenesis and clinical consequences. Ann Intern Med. 134(3):224-38, 2001
                                          20. Libby P: Changing concepts of atherogenesis. J Intern Med. 247(3):349-58, 2000
                                          21. Tunick PA et al: Atheromas of the thoracic aorta: clinical and therapeutic update. J Am Coll Cardiol. 35(3):545-54, 2000
                                          22. Tunick PA et al: Diagnostic imaging of thoracic aortic atherosclerosis. AJR Am J Roentgenol. 174(4):1119-25, 2000
                                          23. Stary HC et al: A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Arterioscler Thromb Vasc Biol. 15(9):1512-31, 1995
                                          24. Stary HC et al: A definition of initial, fatty streak, and intermediate lesions of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Circulation. 89(5):2462-78, 1994
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Synonyms

                                                    • Arteriosclerosis

                                                  • Definitions

                                                    • Lipid deposition on arterial walls leading to thickening, hardening, & occlusion

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Angiographic Findings

                                                              • Nuclear Medicine Findings

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Gross Pathologic & Surgical Features

                                                                      • Microscopic Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Consider

                                                                                  Selected References

                                                                                  1. Kerl JM et al: Accuracy of coronary artery stenosis detection with CT versus conventional coronary angiography compared with composite findings from both tests as an enhanced reference standard. Eur Radiol. 21(9):1895-903, 2011
                                                                                  2. Gottlieb I et al: The absence of coronary calcification does not exclude obstructive coronary artery disease or the need for revascularization in patients referred for conventional coronary angiography. J Am Coll Cardiol. 55(7):627-34, 2010
                                                                                  3. Grosse C et al: CT findings in diseases associated with pulmonary hypertension: a current review. Radiographics. 30(7):1753-77, 2010
                                                                                  4. Marie I et al: Long-term follow-up of aortic involvement in giant cell arteritis: a series of 48 patients. Medicine (Baltimore). 88(3):182-92, 2009
                                                                                  5. Silvera SS et al: Multimodality imaging of atherosclerotic plaque activity and composition using FDG-PET/CT and MRI in carotid and femoral arteries. Atherosclerosis. 207(1):139-43, 2009
                                                                                  6. Ravipati G et al: Comparison of sensitivity, specificity, positive predictive value, and negative predictive value of stress testing versus 64-multislice coronary computed tomography angiography in predicting obstructive coronary artery disease diagnosed by coronary angiography. Am J Cardiol. 101(6):774-5, 2008
                                                                                  7. Rudd JH et al: Atherosclerosis inflammation imaging with 18F-FDG PET: carotid, iliac, and femoral uptake reproducibility, quantification methods, and recommendations. J Nucl Med. 49(6):871-8, 2008
                                                                                  8. Momiyama Y et al: Aortic plaque imaging and monitoring atherosclerotic plaque interventions. Top Magn Reson Imaging. 18(5):349-55, 2007
                                                                                  9. Achenbach S: Computed tomography coronary angiography. J Am Coll Cardiol. 48(10):1919-28, 2006
                                                                                  10. Raggi P et al: Atherosclerotic plaque imaging: contemporary role in preventive cardiology. Arch Intern Med. 165(20):2345-53, 2005
                                                                                  11. Fayad ZA et al: Magnetic resonance imaging and computed tomography in assessment of atherosclerotic plaque. Curr Atheroscler Rep. 6(3):232-42, 2004
                                                                                  12. Yuan C et al: MRI of atherosclerosis. J Magn Reson Imaging. 19(6):710-9, 2004
                                                                                  13. Macura KJ et al: Pathogenesis in acute aortic syndromes: aortic dissection, intramural hematoma, and penetrating atherosclerotic aortic ulcer. AJR Am J Roentgenol. 181(2):309-16, 2003
                                                                                  14. Takasu J et al: Aortic atherosclerosis detected with electron-beam CT as a predictor of obstructive coronary artery disease. Acad Radiol. 10(6):631-7, 2003
                                                                                  15. Tatsumi M et al: Fluorodeoxyglucose uptake in the aortic wall at PET/CT: possible finding for active atherosclerosis. Radiology. 229(3):831-7, 2003
                                                                                  16. Krinsky GA: Diagnostic imaging of aortic atherosclerosis and its complications. Neuroimaging Clin N Am. 12(3):437-43, 2002
                                                                                  17. Frank H: Characterization of atherosclerotic plaque by magnetic resonance imaging. Am Heart J. 141(2 Suppl):S45-8, 2001
                                                                                  18. Miller WT: Thoracic aortic aneurysms: plain film findings. Semin Roentgenol. 36(4):288-94, 2001
                                                                                  19. Rauch U et al: Thrombus formation on atherosclerotic plaques: pathogenesis and clinical consequences. Ann Intern Med. 134(3):224-38, 2001
                                                                                  20. Libby P: Changing concepts of atherogenesis. J Intern Med. 247(3):349-58, 2000
                                                                                  21. Tunick PA et al: Atheromas of the thoracic aorta: clinical and therapeutic update. J Am Coll Cardiol. 35(3):545-54, 2000
                                                                                  22. Tunick PA et al: Diagnostic imaging of thoracic aortic atherosclerosis. AJR Am J Roentgenol. 174(4):1119-25, 2000
                                                                                  23. Stary HC et al: A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Arterioscler Thromb Vasc Biol. 15(9):1512-31, 1995
                                                                                  24. Stary HC et al: A definition of initial, fatty streak, and intermediate lesions of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Circulation. 89(5):2462-78, 1994