Types of neurovascular symptoms and carotid plaque ultrasonic textural characteristics

The aim of this study was to identify the echo morphology and stenosis of carotid plaques that corresponded to ipsilateral asymptomatic status, amaurosis fugax, hemispheric transient ischemic attack, and stroke. One hundred ninety-two plaques (150 patients), producing stenosis in the range of 50% to 99% and associated with various neurovascular manifestations, were studied. These plaques were imaged on duplex scans, and a series of textural features was produced in a computer to distinguish quantitatively their various echo patterns. Amaurosis fugax corresponded to dark, severely stenosed atheromas (90%); hemispheric transient ischemic attack and stroke corresponded to plaques with intermediate echoic characteristics and intermediate stenosis (80%); and asymptomatic status corresponded to bright, moderately stenosed plaques (70%; P < .05). The significance of these findings is discussed.