Carotid plaque: comparison between visual and grey-scale median analysis

Area of Science:

• Vascular Ultrasound
• Cerebrovascular Disease

Background:

• Plaque morphology is a key prognostic factor for cerebrovascular events.
• Echolucent and heterogeneous plaques are associated with higher stroke risk.
• Traditional stroke risk assessment relies on visual interpretation of ultrasound plaque characteristics.

Purpose of the Study:

• To compare visual plaque echogenicity classification with computerized grey-scale median (GSM) measurements.
• To evaluate the correlation between visual assessment of plaque heterogeneity and GSM analysis.
• To determine the clinical utility of visual plaque assessment versus objective GSM measurement.

Main Methods:

• 68 patients with 86 carotid plaques (30-99% stenosis) underwent duplex scanning.
• Grey-scale median (GSM) was measured for plaque echogenicity.
• Visual echogenicity was assessed using a five-type classification system.
• Plaque heterogeneity was compared between visual and GSM methods in 47 patients.

Main Results:

• Mean GSM values increased significantly with plaque type (p < 0.02).
• A good concordance was found between visual analysis and GSM for plaque heterogeneity.
• Visual plaque echogenicity and heterogeneity correlate well with GSM measurements.

Conclusions:

• Visual assessment of carotid plaque echogenicity and heterogeneity aligns with objective GSM measurements.
• Visual plaque evaluation remains a valuable and reliable method in clinical practice for stroke risk stratification.
• This study validates traditional ultrasound-based plaque assessment techniques.