Neuroimaging Clinics of North America

2016

DOI: 10.1016/j.nic.2015.09.007

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The Use of Contrast-enhanced Ultrasonography for Imaging of Carotid Atherosclerotic Plaques

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Steven B. Feinstein

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Surface Morphology1

методические аспекты проведения исследования1

Imaging Of Ulceration1

Other Ceus Applications1

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Cited by 31 publications

(39 citation statements)

References 54 publications

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“…Conventional US is generally not considered an optimal technique for the detection of irregular plaque surface and ulcerations, but 3D US and CEUS have recently proved effective for this purpose. 37 CT and MR offer very good results in detecting ulcerations when compared to histopathology, with performance significantly superior to that of US. 38…”

Section: Surface Morphologymentioning

confidence: 99%

CT and MR Imaging of Carotid Wall and Plaque

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et al. 2019

J Neurosonol Neuroimag

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Imaging of the carotid artery wall is the focus of several ongoing research studies that are investigating the optimal approach to identify so-called "vulnerable plaques". Even when standard arterial luminal imaging fails to indicate a stenosis in stroke patients, a non-stenotic plaque may be responsible for the stroke. Indeed, over the past decade there has been a paradigm shift in the diagnosis and risk stratification of patients with carotid artery disease, whereby nowadays more emphasis is put on plaque characterization, mainly by using computed tomography (CT) and magnetic resonance (MR), in addition to the usual assessment of stenosis and surface irregularities. In this review, we will discuss current state-of-the-art CT and MR techniques to characterize vulnerable plaques and summarize current developments in imaging-based assessment of carotid plaques, in order to identify ideal candidates for revascularization and to monitor the effects of medical therapy. JNN 116 http://www.j-nn.org J Neurosonol Neuroimag 2019;11(2):115-125 Luca Saba, et al. Imaging of Carotid Plaque ification and therapy selection in patients with both high-and low-degree carotid artery stenosis.and size of the lipid-rich-necrotic-core (LRNC), and active plaque inflammation. In the following sections the features linked to plaque vulnerability are presented. FIG. 4. Male patient with right hand weakness with ulceration in the (A) left internal carotid artery internal carotid artery visibile in the sagittal, (B) axial and (C) Coronal planes (white arrows).

“…Conventional US is generally not considered an optimal technique for the detection of irregular plaque surface and ulcerations, but 3D US and CEUS have recently proved effective for this purpose. 37 CT and MR offer very good results in detecting ulcerations when compared to histopathology, with performance significantly superior to that of US. 38…”

Section: Surface Morphologymentioning

confidence: 99%

CT and MR Imaging of Carotid Wall and Plaque

¹

,

²

,

³

et al. 2019

J Neurosonol Neuroimag

View full text Add to dashboard Cite

Imaging of the carotid artery wall is the focus of several ongoing research studies that are investigating the optimal approach to identify so-called "vulnerable plaques". Even when standard arterial luminal imaging fails to indicate a stenosis in stroke patients, a non-stenotic plaque may be responsible for the stroke. Indeed, over the past decade there has been a paradigm shift in the diagnosis and risk stratification of patients with carotid artery disease, whereby nowadays more emphasis is put on plaque characterization, mainly by using computed tomography (CT) and magnetic resonance (MR), in addition to the usual assessment of stenosis and surface irregularities. In this review, we will discuss current state-of-the-art CT and MR techniques to characterize vulnerable plaques and summarize current developments in imaging-based assessment of carotid plaques, in order to identify ideal candidates for revascularization and to monitor the effects of medical therapy. JNN 116 http://www.j-nn.org J Neurosonol Neuroimag 2019;11(2):115-125 Luca Saba, et al. Imaging of Carotid Plaque ification and therapy selection in patients with both high-and low-degree carotid artery stenosis.and size of the lipid-rich-necrotic-core (LRNC), and active plaque inflammation. In the following sections the features linked to plaque vulnerability are presented. FIG. 4. Male patient with right hand weakness with ulceration in the (A) left internal carotid artery internal carotid artery visibile in the sagittal, (B) axial and (C) Coronal planes (white arrows).

“…Обобщенная классификация описана в обзоре Saha SA, et al (2016): слабая степень (1) -наличие подвижных пузырьков в основании бляшки, умеренная степень (2) -наличие подвижных микропузырьков в плече бляшки, которые не достигают ядра или верхушки АСБ, выраженная степень (3) -наличие подвижных микропузырьков в области ядра и верхушки бляшки [18,30].…”

Section: методические аспекты проведения исследованияunclassified

Contrast-enhanced carotid ultrasound: current status

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Балахонова

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2019

Russ J Cardiol

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Unstable atherosclerotic plaques (ASP) are the cause of acute ischemia in the carotid and coronary systems. Numerous studies have shown a relationship between plaque instability, manifestations, echogenicity, histological findings and its neovascularization. The presence and extent of ASP neovascularization in the carotid arteries can be detected for the first time using contrast-enhanced carotid ultrasound. Contrast-enhanced carotid ultrasound does not have nephrotoxic effect; it also improves the accuracy of plaque ulceration detecting and determining the severity of stenosis. The article presents the opinions of the authors and international experts on contrast ultrasound of peripheral arteries. An analysis of the literature data and our own observations is presented. Significant parameters such as the doses, procedure onset time and duration, methods for the qualitative and quantitative assessment of plaque neovascularization are analyzed. The difficulties of contrast-enhanced ultrasound are described.

“…CEUS has also been introduced in carotid arteries and investigated in plaque surface evaluation and identification of irregularities and ulcerations, showing better results than conventional US [14, 78–84]. A recent study compared US and CEUS in the diagnosis of carotid ulcerations having MDCTA as the reference method.…”

Section: Imaging Of Ulcerationmentioning

confidence: 99%

“…On the other hand, the emergence and widespread availability of non-invasive cross-sectional imaging modalities such as multidetector computed tomography angiography (MDCTA) or magnetic resonance angiography (MRA) offered a valuable alternative to DSA, providing excellent spatial resolution and great accuracy for evaluation of plaque fine surface characteristics [12]. Nevertheless, the role of US has been significantly boosted by the introduction of US contrast media and recent evidence concludes that contrast-enhanced ultrasound (CEUS) contributes significantly to the characterisation of carotid plaques, in terms of both surface delineation (ulcer detection and characterisation) and internal structure (visualisation of intraplaque neovascularisation) [13, 14]. …”

Section: Introductionmentioning

confidence: 99%

Imaging of the ulcerated carotid atherosclerotic plaque: a review of the literature

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et al. 2017

Insights Imaging

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Carotid atherosclerotic disease constitutes a major modern health problem whose diagnosis primarily relies on imaging. Grading of stenosis has been long used as the main factor for risk stratification and guiding of management. Nevertheless, increasing evidence has shown that additional plaque characteristics such as plaque composition and surface morphology play an important role in the occurrence of symptoms, justifying the term “vulnerable plaque”. Carotid plaque surface characteristics either in the form of surface irregularities or ulceration represent an important factor of vulnerability and are associated with the occurrence of neurologic symptoms. The delineation of the carotid plaque surface can be performed with virtually all imaging modalities including ultrasound, contrast-enhanced ultrasound, multi-detector computed tomography angiography, magnetic resonance angiography and the traditional reference method of angiography. These techniques have shown varying levels of diagnostic accuracy for the identification of ulcerated carotid plaques or plaque surface irregularities. As a consequence and given its high clinical significance, radiologists should be familiar with the various aspects of this entity, including its definition, classification, imaging findings on different imaging modalities and associations. The purpose of this review is to present the current literature regarding carotid plaque ulcerations and present illustrative images of ulcerated carotid plaques.Teaching Points • Plaque surface and ulceration represent risk factors for stroke in carotid disease. • Characterisation of the plaque surface and ulcerations can be performed with every modality. • US is the first-line modality for carotid disease and identification of ulcerations. • The administration of microbubbles increases US accuracy for diagnosis of carotid ulceration. • MDCTA and MRA are valuable for diagnosing ulceration and evaluating plaque composition.

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