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A new method for characterizing carotid plaque: multiple cross-sectional view echomorphology.
S M Wijeyaratne1, S Jarvis, L A Stead
1General Infirmary at Leeds, England.
Journal of Vascular Surgery
|March 29, 2003
Summary
Multiple cross-sectional views (MCSV) of carotid plaque are more effective than single longitudinal views (SLV) for identifying symptomatic versus asymptomatic plaque. This ultrasound technique improves differentiation of plaque causing significant stenosis.
Area of Science:
- Vascular Ultrasound Imaging
- Carotid Artery Disease
- Cerebrovascular Ultrasound
Background:
- Carotid plaque characterization is crucial for stroke risk assessment.
- Differentiating symptomatic from asymptomatic carotid plaque is clinically important.
- Ultrasound B-mode gray-scale measurements offer objective plaque assessment.
Purpose of the Study:
- To compare the efficacy of single longitudinal view (SLV) versus multiple cross-sectional views (MCSV) ultrasound imaging.
- To determine which imaging method better differentiates symptomatic from asymptomatic carotid plaque (>70% stenosis).
Main Methods:
- Seventy-four internal carotid artery stenoses were analyzed using B-mode ultrasound.
- Computerized gray-scale median (GSM) analysis was performed on SLV and MCSV images.
- Plaque echogenicity and heterogeneity were quantified and compared between symptomatic and asymptomatic groups.
Main Results:
- No significant difference in mean SLV GSM between symptomatic and asymptomatic plaque.
- Minimum MCSV GSM was significantly lower in symptomatic plaque (P=.002).
- Axial GSM heterogeneity was significantly greater in symptomatic plaque (P=.0001).
Conclusions:
- Multiple cross-sectional views (MCSV) provide more sensitive assessment of carotid plaque characteristics.
- MCSV ultrasound imaging is superior to SLV for differentiating symptomatic from asymptomatic carotid plaque.
- Objective assessment of plaque echolucency and heterogeneity via MCSV aids in stroke risk stratification.