🩻 Carotid Vulnerable-Plaque Feature Assessment
UseUse to tally vulnerable features (IPH, large lipid core, thin/ruptured cap, ulceration, ultrasound hypoechoge…
SourceSaba L, et al. Carotid Artery Wall Imaging: Perspective and Guidelines from the ASNR Vessel Wall Im…
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.
Methodology · worked example, guidelines & full notes
Vulnerable features, especially intraplaque hemorrhage, predict ipsilateral stroke independently of stenosis degree, so similar stenosis can carry different risk. (original synthesis · not guideline verbatim)
When to use
Use to tally vulnerable features (IPH, large lipid core, thin/ruptured cap, ulceration, ultrasound hypoechogenicity) and gauge plaque instability.
How it works
Count high-risk features: 0 → no definite vulnerability, 1 → vulnerable features present, ≥ 2 → highly vulnerable. Intraplaque hemorrhage carries particular weight.
Key points
- Vulnerable features, especially intraplaque hemorrhage, predict ipsilateral stroke independently of stenosis degree, so similar stenosis can carry different risk. (original synthesis · not guideline verbatim)
- The modified AHA-MRI Type VI denotes complex plaque with hemorrhage, thrombus, or cap rupture.
- This is a feature checklist, not a validated score, and supplements rather than replaces image interpretation.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Intraplaque hemorrhage IPH (MRI T1/MPRAGE hyperintensity) | Absent |
|---|---|
| Large lipid-rich necrotic core LRNC | Absent |
| Thin / ruptured fibrous cap | Absent |
| Plaque ulceration | Absent |
| Ultrasound hypoechogenicity/heterogeneity/juxtaluminal black area (JBA) | Absent |
→Vulnerable high-risk features0 features · no definite vulnerable features
- Positive features：none
- Significance：Vulnerable-plaque features (especially IPH) predict ipsilateral ischemic stroke risk independently of stenosis degree; the modified AHA-MRI classification Type VI = complex plaque (hemorrhage/thrombus/cap rupture). Multiple positives suggest instability.
- Decision aid：asymptomatic patients especially need individualized weighing.
| Intraplaque hemorrhage IPH (MRI T1/MPRAGE hyperintensity) | Present |
|---|---|
| Large lipid-rich necrotic core LRNC | Present |
| Thin / ruptured fibrous cap | Present |
| Plaque ulceration | Present |
| Ultrasound hypoechogenicity/heterogeneity/juxtaluminal black area (JBA) | Present |
→Vulnerable high-risk features5 features · highly vulnerable (multiple high-risk features)
- Positive features：intraplaque hemorrhage (IPH), large lipid-rich necrotic core (LRNC), thin/ruptured fibrous cap, plaque ulceration, ultrasound hypoechogenicity/heterogeneity/juxtaluminal black area
- Significance：Vulnerable-plaque features (especially IPH) predict ipsilateral ischemic stroke risk independently of stenosis degree; the modified AHA-MRI classification Type VI = complex plaque (hemorrhage/thrombus/cap rupture). Multiple positives suggest instability.
- Decision aid：asymptomatic patients especially need individualized weighing.
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using Carotid Vulnerable-Plaque Feature Assessment?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does Carotid Vulnerable-Plaque Feature Assessment upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Carotid Vulnerable-Plaque Feature Assessment calculated in practice? Can you show a worked example?
- Inputs: Intraplaque hemorrhage IPH (MRI T1/MPRAGE hyperintensity) Absent, Large lipid-rich necrotic core LRNC Absent, Thin / ruptured fibrous cap Absent, Plaque ulceration Absent, Ultrasound hypoechogenicity/heterogeneity/juxtaluminal black area (JBA) Absent → Result: Vulnerable high-risk features 0 features · no definite vulnerable features（Positive features: none, Significance: Vulnerable-plaque features (especially IPH) predict ipsilateral ischemic stroke risk independently of stenosis degree; the modified AHA-MRI classification Type VI = complex plaque (hemorrhage/thrombus/cap rupture). Multiple positives suggest instability., Decision aid: asymptomatic patients especially need individualized weighing.） Inputs: Intraplaque hemorrhage IPH (MRI T1/MPRAGE hyperintensity) Present, Large lipid-rich necrotic core LRNC Present, Thin / ruptured fibrous cap Present, Plaque ulceration Present, Ultrasound hypoechogenicity/heterogeneity/juxtaluminal black area (JBA) Present → Result: Vulnerable high-risk features 5 features · highly vulnerable (multiple high-risk features)（Positive features: intraplaque hemorrhage (IPH), large lipid-rich necrotic core (LRNC), thin/ruptured fibrous cap, plaque ulceration, ultrasound hypoechogenicity/heterogeneity/juxtaluminal black area, Significance: Vulnerable-plaque features (especially IPH) predict ipsilateral ischemic stroke risk independently of stenosis degree; the modified AHA-MRI classification Type VI = complex plaque (hemorrhage/thrombus/cap rupture). Multiple positives suggest instability., Decision aid: asymptomatic patients especially need individualized weighing.）