Carotid atherosclerosis: echographic patterns versus histological findings

Area of Science:

• Vascular Medicine
• Medical Imaging
• Pathology

Background:

• Carotid artery lesions impact clinical events.
• Accurate detection of atheromatous lesions is crucial for patient management.
• Echography is a non-invasive imaging modality.

Purpose of the Study:

• To evaluate the reliability of echography in detecting and characterizing carotid artery atheromatous lesions.
• To compare echographic findings with histological examination of explanted carotid arteries.
• To assess the diagnostic accuracy of ultrasound in identifying different types of carotid plaques.

Main Methods:

• Twenty-five explanted human carotid arteries were perfused under constant pressure.
• Echographic examination was performed to identify and characterize intimal thickening, soft plaques, hard lesions, thrombi, and mixed plaques.
• Histopathological analysis was conducted to correlate with echographic findings.

Main Results:

• Echography demonstrated excellent agreement with histological findings for various carotid lesions.
• Specific echographic patterns corresponded to intimal thickening, soft plaques (necrotic areas, cystic lesions), hard lesions (fibrous, fibrocalcific), and mixed atheromatous plaques.
• Echography accurately identified thrombi and their characteristics, such as the absence of a lumen-lesion interface in non-occluding thrombi.

Conclusions:

• Echography is a reliable method for detecting and characterizing atheromatous lesions in the carotid arteries.
• The high concordance between echographic and histological results supports its clinical utility.
• Vascular ultrasound imaging can aid in clinical decision-making due to its accuracy in assessing carotid lesion types.