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Table 1 Morphological plaque vulnerability index (MPSI) classifications and comparison with AHA classifications

From: Local critical stress correlates better than global maximum stress with plaque morphological features linked to atherosclerotic plaque vulnerability: an in vivo multi-patient study

MPSI Category Corresponding AHA lesion types (modified) Description Level of vulnerability
0 I or II Normal or nearly normal wall. Very stable
1 III Moderate intimal thickening, no extracellular lipid, calcification or significant inflammation. Stable
2 IV/V with less than 30% NC by area; or VII; or VIII Advanced lesion with small necrotic core (<30% of plaque size), or can be fibrotic or calcified, thick fibrous cap (> 200 μm). Slightly unstable
3 IV/V with 30–40% NC by area Advanced lesion with Moderate lipid core (30–40% of plaque size) and fibrous cap (150–200 μm). Moderately unstable
4 IV/V with > 40% NC by area; or VI Advanced lesion with a very large necrotic core (>40%), thin fibrous cap (<150 μm), or with fibrous cap rupture, ulceration, or intraplaque hemorrhage. Very unstable
  1. Quantitative plaque lipid core size and cap thickness information will be based on plaque component contour information in this paper. In particular, plaque cap thickness will be calculated as the shortest distance between a lipid core and lumen, while the thin plaque cap may not be directly measurable by MRI.