Does Quantification of Carotid Plaque Surface Irregularities Better Detect Symptomatic Plaques Compared to the...

Area of Science:

• Vascular Imaging
• Cardiovascular Ultrasound
• Cerebrovascular Disease

Background:

• Carotid plaque surface irregularities are linked to stroke risk.
• Accurate quantification of these irregularities is crucial for risk stratification.
• Current imaging methods require evaluation for reliability and clinical correlation.

Purpose of the Study:

• To assess interobserver agreement of CDUS and CEUS in quantifying carotid plaque surface irregularities.
• To correlate objective (quantitative index) and subjective plaque assessments with stroke occurrence.

Main Methods:

• Observational study of 54 patients with 62 carotid plaques (31 symptomatic).
• Plaques with moderate to severe stenosis evaluated using CDUS and CEUS.
• Surface irregularities quantified via a surface irregularity index by two observers.
• Interobserver agreement and correlation with stroke occurrence analyzed.

Main Results:

• Both CDUS and CEUS demonstrated excellent interobserver agreement (ICC > 0.95).
• Irregular and ulcerated surfaces were observed in 69.4% of plaques.
• Quantitative surface irregularity index was significantly higher in symptomatic plaques (P < .05).
• Subjective plaque surface classification did not correlate with stroke occurrence (P > .05).

Conclusions:

• CDUS and CEUS provide reliable, reproducible quantification of carotid plaque surface irregularities.
• The quantitative surface irregularity index is a valuable objective measure associated with plaque symptoms.
• Subjective plaque assessment is less reliable for predicting stroke events compared to quantitative measures.