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Three-dimensional ultrasound angiography (power mode) for the quantification of carotid artery atherosclerosis
B Griewing1, U Schminke, C Morgenstern
1Department of Neurology, Ernst-Moritz-Arndt University, Greifswald, Germany.
Insights
Three-dimensional (3D) ultrasound angiography precisely quantifies carotid artery plaque volume and surface characteristics. This advanced imaging technique offers high reliability for diagnosing atherosclerosis and aids in future clinical studies.
Area of Science:
- Vascular Ultrasound
- Cardiovascular Imaging
- Medical Diagnostics
Background:
- Carotid artery atherosclerosis is a significant cause of cerebrovascular disease.
- Accurate plaque characterization and quantification are crucial for risk assessment.
- Conventional ultrasound methods have limitations in precise plaque volume measurement.
Purpose of the Study:
- To evaluate the diagnostic accuracy and reliability of three-dimensional (3D) ultrasound angiography for carotid artery atherosclerosis.
- To compare 3D ultrasound angiography with conventional Doppler ultrasound for plaque assessment.
- To determine the intraobserver and interobserver variability of 3D ultrasound plaque quantification.
Main Methods:
- Conventional color-coded Doppler ultrasound and 3D ultrasound angiography were used to examine 35 patients with cerebrovascular disease.
- Continuous-wave Doppler ultrasound was used for initial stenosis diagnosis.
- 21 patients underwent repeated 3D ultrasound assessments to determine reliability.
Main Results:
- 65% of patients had carotid stenosis >50%.
- Ulcerated plaques were prevalent (72.9%).
- 3D ultrasound demonstrated high intraobserver (4.16%) and interobserver (5.87%) reliability, with plaque volume quantification showing minimal differences (8.5%) compared to 3D Color Doppler.
Conclusions:
- Three-dimensional ultrasound angiography provides a precise and reliable quantitative method for assessing carotid artery atherosclerosis.
- 3D ultrasound improves plaque differentiation and reduces the impact of echo shadowing.
- This technique is valuable for prospective clinical studies on atherosclerosis quantification.
Abstract:
Three-dimensional (3D) ultrasound angiography was performed to diagnose carotid artery atherosclerosis. Thirty-five patients (15 women, 20 men) with a history of cerebrovascular disease were examined using conventional color-coded Doppler ultrasound and 3D ultrasound angiography. Carotid stenosis was initially diagnosed using continuous-wave Doppler ultrasound. To determine intraobserver and interobserver reliabilities, 21 patients were evaluated using 3D ultrasound on three occasions. Sixty-five percent of patients were diagnosed with stenosis of more than 50%. Twenty-two percent of plaques had a smooth surface, 72.9% were ulcerated, and 5.1% were indeterminate. Data collection for 3D imaging required 5 minutes per patient, whereas image processing and plaque volume quantification required 30 minutes. Plaque volume ranged from 0.053 to 0.685 ml. The intraobserver and interobserver variabilities were 4.16 and 5.87%, respectively (r = 0.96, p < 0.0001; r = 0.89, p < 0.0001). 3D Color Doppler and 3D ultrasound angiography assessments of plaque volume differed by 8.5%. Plaques were more precisely differentiated using 3D ultrasound, and plaque volume quantification was less affected by echo shadowing after 3D reconstruction. In comparison to other techniques for the quantification of atherosclerotic lesions. 3D ultrasound angiography offers a more precise quantitative method for prospective, clinical studies of atherosclerosis.