Carotid Plaque Vulnerability Assessment Using Ultrasound Elastography and Echogenicity Analysis

Area of Science:

• Vascular Ultrasound
• Medical Imaging
• Biomedical Engineering

Background:

• Carotid artery stenosis is a significant risk factor for stroke.
• Differentiating symptomatic from asymptomatic carotid plaques is crucial for patient management.
• Current methods for plaque characterization have limitations.

Purpose of the Study:

• To evaluate ultrasound elastography and echogenicity analysis for discriminating carotid plaques.
• To compare plaque characteristics in symptomatic versus asymptomatic internal carotid artery (ICA) stenosis.

Main Methods:

• Recruited patients with symptomatic and asymptomatic ICA stenosis (>50%).
• Assessed plaque elastography and echogenicity features using ultrasound.
• Performed ROC curve analyses with bootstrapping for sensitivity and specificity.

Main Results:

• Symptomatic plaques showed lower maximum axial strain and shear strain magnitude.
• Symptomatic plaques had a higher percentage of low-intensity gray levels.
• Combined elastography and echogenicity yielded 71.6% sensitivity and 79.3% specificity for detecting vulnerable plaques.

Conclusions:

• Combining elastography and echogenicity analysis is useful for discriminating symptomatic from asymptomatic carotid plaques.
• This combined approach enhances the detection of vulnerable carotid plaques.
• This pilot study supports the clinical utility of these ultrasound techniques.