Assessment of plaque vulnerability in carotid atherosclerotic plaques using contrast-enhanced ultrasound |
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| Institution: | 1. Senior Adviser (Radiology) Command Hospital (WC), Chandimandir, India;2. Consultant & HOD (Radiology), Army Hospital (R&R), Delhi Cantt, India;3. Commandant, Military Hospital, Chennai, India;4. Senior Adviser (Medicine & Neurology), INHS, Kalyani, India;5. Commandant, Military Hospital Shillong, India;6. Associate Professor, Department of Radiology, Armed Forces Medical College, Pune, India;1. Classified Specialist (Anaesthesia & CT Anaesthesia), Army Hospital (R&R), New Delhi, India;2. Senior Adviser (Anaesthesia & Trained in Paed Anaesthesia), Army Hospital (R&R), India;3. Consultant (Anaesthesia & CT Anaesthesia), Fortis Hospital, Mohali, India;4. Senior Adviser & HOD (Anaesthesia & CT Anaesthesia), AICTS, Pune, India;1. Graded Specialist (ENT), 5 Air Force Hospital, Jorhat, India;2. Senior Advisor & Head (ENT), Army Hospital (R&R), Delhi Cantt, India;1. Graded Specialist (Pulmonary Medicine), INHS Sanjivani, Kochi, India;2. Resident (Internal Medicine), INHS Asvini, Mumbai, India;3. Consultant (Medicine) & Pulmonary Medicine, INHS Asvini, Mumbai, India;4. Classified Specialist (Pulmonary Medicine), AIIMS, New Delhi, India;1. Senior Consultant (Pulmonary Medicine), Sakra World Hospital, Bengaluru, India;2. Professor & Head (Urology), MMIMSR MM Medical College, Ambala, India;3. Graded Specialist (Pulmonary Medicine), INHS Asvini, Mumbai, India;4. Consultant (Pulmonary Medicine), Army Hospital (R&R), New Delhi, India;1. Professor & Head (Pulmonary, Critical Care & Sleep Medicine), Army Institute of Cardiothoracic Sciences (AICTS), Pune, India;2. Graded Specialist, (Pulmonary, Critical Care & Sleep Medicine), Army Institute of Cardiothoracic Sciences (AICTS), Pune, India;3. Senior Advisor & Professor, (Pulmonary, Critical Care & Sleep Medicine), Army Institute of Cardiothoracic Sciences (AICTS), Pune, India;4. Assistant Professor & Graded Specialist, (Pulmonary, Critical Care & Sleep Medicine), Army Institute of Cardiothoracic Sciences (AICTS), Pune, India;1. Consultant (General Surgery), Prince Hashem Bin Abdullah II, Jordan;2. Senior Specialist (General Surgery), Prince Hashem Bin Abdullah II, Jordan;3. Senior Specialist (Anesthesia & Intensive Care), King Husain Medical Center, Jordan |
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| Abstract: | BackgroundAtherosclerotic carotid plaques are one of the most important causes of stroke. Apart from the severity of stenosis, there are certain plaque characteristics such as neovascularization and, surface ulceration which makes a plaque vulnerable. This study was performed to study the plaque characteristics using contrast-enhanced ultrasound (CEUS) and evaluate their association with presence of ischemic cerebrovascular symptoms in these patients.MethodsThis study included patients presenting at a tertiary care center, having carotid plaques causing >60% stenosis. CEUS was performed for assessment of intraplaque neovascularity and plaque surface characteristics. These plaque features were then evaluated for their association with presence of ischemic cerebrovascular symptoms in patients.ResultsSixty plaques were studied in 50 patients. Thirty-two plaques were associated with ischemic cerebrovascular symptoms. On CEUS, intraplaque neovascularization was seen in 38 of the 60 plaques studied (63.3%). There was statistically significant association of intraplaque neovascularity and plaque surface characteristics with presence of ischemic cerebrovascular symptoms.ConclusionCEUS allows better characterization of plaque surface characteristics and also depicts plaque neovascularization, which helps in determining the plaque vulnerability. It should be used as an adjunct to ultrasound and doppler assessment of carotid plaques. |
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| Keywords: | Carotid atherosclerotic plaques Contrast-enhanced ultrasound Intraplaque neovascularity Ischemic cerebrovascular symptoms |
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