Usability of Ultrasonic MicroPure Imaging for Evaluating the Vulnerability of Carotid Atherosclerotic Plaques

Abstract

Objective-MicroPure is an ultrasound imaging technology used for detecting microcalcifications. This study aimed to evaluate the usefulness of the Firefly sign in ultrasonic MicroPure imaging for detecting the vulnerability of carotid plaques.Methods-Ultrasonic grey-scale imaging was used to detect carotid plaques. Ultrasonic MicroPure imaging was used to detect the Firefly sign and to determine the location and number of Firefly signs.Results-A total of 142 plaques were detected in 72 patients, and 62.0% were Firefly-positive plaques. The length or thickness, the risk of rupture and the percentage of vulnerable plaques were greater in the Firefly-positive plaques than in Firefly-negative plaques. The assessment of plaque vulnerability built on the 4-point Firefly scoring system showed that the area under the ROC curve was 0.750 (P < .001). The sensitivity and specificity of vulnerable plaques with a score of 2 points were 71.9 and 73.6%, respectively. Conclusion-The Firefly signs are widely present in carotid atherosclerotic plaques and can be detected with ultrasonic MicroPure imaging. Firefly signs located in fibrous caps may be associated with plaque vulnerability.

Multimodal ultrasound imaging: A method to improve the accuracy of diagnosing thyroid TI‐RADS 4 nodules

“…Sometimes, some "concentrated colloids" are displayed as tiny calcifications, thus causing misdiagnosis. 9…”

“…However, the “firefly” technology also has limitations. Sometimes, some “concentrated colloids” are displayed as tiny calcifications, thus causing misdiagnosis 9 …”

“…Multimodal ultrasound imaging has been the focus of ultrasound diagnosis of thyroid nodules in recent years, including the combined application of two or more methods in conventional ultrasound, ACR TI-RADS, shear wave elastography (SWE), super micro vascular imaging (SMI), contrast enhanced ultrasound (CEU), "firefly" imaging and artificial intelligence (AI), and so forth. [7][8][9][10] Imaging of thyroid TI-RADS 4 nodules by multimodal ultrasound can concentrate the advantages of various methods. It is expected to adjust the classification of nodules, improve the diagnostic accuracy of benign and malignant TI-RADS 4 nodules, and reduce the puncture rate and manual operation rate of thyroid TI-RADS 4 nodules to a certain extent.…”

“…Although surgical resection and pathological examination are the gold standard for differentiating benign and malignant thyroid nodules, noninvasive diagnostic methods are more easily accepted by patients and can avoid unnecessary biopsy and surgery. Multimodal ultrasound imaging has been the focus of ultrasound diagnosis of thyroid nodules in recent years, including the combined application of two or more methods in conventional ultrasound, ACR TI‐RADS, shear wave elastography (SWE), super micro vascular imaging (SMI), contrast enhanced ultrasound (CEU), “firefly” imaging and artificial intelligence (AI), and so forth 7–10 . Imaging of thyroid TI‐RADS 4 nodules by multimodal ultrasound can concentrate the advantages of various methods.…”

Advances in Noninvasive Carotid Wall Imaging with Ultrasound: A Narrative Review

“…These signs are located in the fibrous caps of carotid atheromas and may be associated with plaque vulnerability. A 4-point Firefly score system has been developed and recent studies indicate that Firefly-positive atherosclerotic lesions are at an increased risk for rupture and embolic cerebral infracts [ 35 ].…”