Table 1.
MPVI | Plaque | Description | AHA classification |
---|---|---|---|
V = 0 |
Very stable |
Normal or slight intimal thickening |
Type I, some atherogenic lipoprotein and intimal thickening |
V = 1 |
Stable |
Moderate intimal thickening, no extracellular lipid, calcification or significant inflammation |
Type II (fatty streak), III (preatheroma) |
V = 2 |
Slightly unstable |
Small lipid core (<30% of plaque size); calcification may be present; thick fibrous cap (> 150 μm); little or no inflammation at plaque shoulders |
Type IV, Vb, and Vc with less than 30% NC by area; or VII/VIII |
V = 3 |
Moderately unstable |
Moderate lipid core (30 – 40% of plaque size) and fibrous cap (65 – 150 μm); moderate intraplaque hemorrhage; moderate inflammation. |
Type Va, IV/V with 30-40% NC by area |
V = 4 | Highly unstable | Large lipid core(>40%); thin fibrous cap (< 65 μm); large intraplaque hemorrhage; extensive inflammation; evidence of previous plaque rupture | Type VI; IV/V with > 40% NC by area |
Cap thickness threshold values were modified from previously published values to adjust to the differences between coronary and carotid plaques based on available literature.