[Tissue identification of carotid lesions using ultrasound]

Technical progress in echotomography has made it possible to identify a number of structures within the atheromatous lesion itself. Such echotomographic data were compared with peroperative findings and histology of the endarterectomy specimen in the context of carotid pathology. Appearances were differentiated in terms of the density and homogeneity of the echos obtained. Heterogeneous and relatively undense lesion corresponded in the majority of cases with moveable intraluminal matter or intraplaque hematomas. False negatives were due in one case to technical impossibility (calcifications) and in one case to multiple ulcerations. Regular and homogeneous appearances corresponded to fibrous plaques, rich in collagen and free of potential emboligenic material. Preoperatively, echotomography may be used to assess the histological characteristics of a plaque with a high degree of sensitivity and good specificity. This new approach may help in the choice of treatment and will improve knowledge of the natural history of carotid lesions necessary for the study of preventive treatment, in particular in asymptomatic patients.