期刊
RADIOLOGIA MEDICA
卷 127, 期 11, 页码 1254-1269出版社
SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s11547-022-01551-z
关键词
Carotid plaque; carotid stenosis; CEUS; Neovascularization; Atherosclerosis
资金
- Universita degli Studi di Roma La Sapienza within the CRUI-CARE Agreement
The study aimed to assess the efficacy of Multiparametric Ultrasound (MPUS) in evaluating carotid plaque vulnerability and carotid stenosis degree. The results showed that the combination of Contrast-Enhanced Ultrasound (CEUS) and 3D Arterial Analysis can be a powerful clinical tool to identify and stratify at-risk patients with atherosclerotic carotid artery disease.
Purpose Our purpose is to assess Multiparametric Ultrasound (MPUS) efficacy for evaluation of carotid plaque vulnerability and carotid stenosis degree in comparison with Computed Tomography angiography (CTA) and histology. Material and methods 3D-Arterial Analysis is a 3D ultrasound software that automatically provides the degree of carotid stenosis and a colorimetric map of carotid plaque vulnerability. We enrolled 106 patients who were candidates for carotid endarterectomy. Prior to undergoing surgery, all carotid artery plaques were evaluated with Color-Doppler-US (CDUS), Contrast-Enhanced Ultrasound (CEUS), and 3D Arterial analysis (3DAA) US along with Computerized Tomographic Angiography (CTA) to assess the carotid artery stenosis degree. Post-surgery, the carotid specimens were fixed with 10% neutral buffered formalin solution, embedded in paraffin and used for light microscopic examination to assess plaque vulnerability morphological features. Results The results of the CTA examinations revealed 91 patients with severe carotid stenoses with a resultant diagnostic accuracy of 82.3% for CDUS, 94.5% for CEUS, 98.4% for 3DAA, respectively. The histopathological examination showed 71 vulnerable plaques with diagnostic accuracy values of 85.8% for CDUS, 93.4% for CEUS, 90.3% for 3DAA, 92% for CTA, respectively. Conclusions The combination of CEUS and 3D Arterial Analysis may provide a powerful new clinical tool to identify and stratify at-risk patients with atherosclerotic carotid artery disease, identifying vulnerable plaques. These applications may also help in the postoperative assessment of treatment options to manage cardiovascular risks.
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