The aim of this study in vitro of human fresh specimens was to quantitatively evaluate the contribution of the aqueous phase-intima interface (the first 400 msec of the reflected signal) in normal and atherosclerotic arterial walls. Seventy-five samples were studied, 15 normal, 15 fatty, 15 fibrofatty, 15 fibrous, and 15 calcific. A broadband transducer (4 to 14 MHz) was used. The aqueous phase-intima reflection (expressed in dB, mean + SD) was lowest in the fatty plaques (-35.3 + 2.5), differing in a highly significant way from that in all other groups: normal (-13.2 ± 8.8), fibrofatty ( -20.4 8.3), fibrous ( -13.0 ± 9.7), calcific ( -5.9 -+ 3.4). The echo coming from the intimamedia transition was of relatively low amplitude in normal and in fatty samples; typically, strong reflections from the intima-media transitions were present in the other pathologic subsets. In conclusion, the time domain echo pattern of the arterial wall may provide a useful clue to the structure of the plaque. Circulation 77, No. 3, 654-659, 1988. ULTRASONIC tissue characterization of atherosclerosis has been attempted in several studies in vitro. [1][2][3][4][5][6][7][8][9][10][11][12] The purpose of these studies has been twofold: (1) to test new variables of potential diagnostic use, and (2) to provide basic information for a better definition of limits and applicability of clinical echocardiography.Findings in vitro show that, in predominantly fatty samples of aortic wall, the values of the internal backscatter tend to overlap with those found in normal walls.9 In this previous study, the value of the specular echoes of aqueous phase-tissue interface -which is supposed to be strongly angle dependent -was purportedly "gated out." However, the detection of specular reflections is fundamental for the border identification with conventional echocardiographic instruments. 13 The aim of this study was to quantitatively evaluate the contribution of the "first interface" intimal echo in various normal and pathologic subsets of arterial wall.
Materials and methodsExperimental procedure. Fresh specimens of arterial wall were taken from human aortas at autopsy and those with one of four distinct kinds of lesions (fatty, fibrofatty, fibrotic, and