Carotid Artery Atheroma: Ultrasound Appearance in Symptomatic and Asymptomatic Vessels

Steffen, Christina M.; Gray-Weale, Anthony C.; Byrne, Karen; Lusby, Robert J.

doi:10.1111/j.1445-2197.1989.tb01625.x

Cited by 63 publications

(34 citation statements)

References 21 publications

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“…3,4 Plaque echogenicity has been reported to be associated with stroke and other cerebrovascular events in univariate analysis in previous studies. [5][6][7][8][9][10][11][12][13][14][15][16] Most of these were cross-sectional, 6,7,9,[12][13][14][15] but an association has also been found in prospective studies. 5,8,10,11,16 Only 2 prospective studies have made adjustments for other cerebrovascular risk factors.…”

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confidence: 99%

Echolucent Plaques Are Associated With High Risk of Ischemic Cerebrovascular Events in Carotid Stenosis

2001

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Background-The purpose of the study was to assess in a prospective design whether plaque morphology is associated with risk of ischemic stroke and other cerebrovascular events in subjects with carotid stenosis. Methods and Results-A total of 223 subjects with carotid stenosis (123 with 35% to 49% degree of stenosis, 100 with 50% to 99% stenosis) and 215 control subjects matched by age and sex who participated in a population health survey at baseline were followed up for 3 years. Plaque echogenicity was assessed by ultrasound at baseline and scored as echolucent, predominantly echolucent, predominantly echogenic, or echogenic. Forty-four subjects experienced Ն1 ischemic cerebrovascular events in the follow-up period. Plaque echogenicity, degree of stenosis, and white blood cell count were independent predictors of cerebrovascular events. The unadjusted relative risk for cerebrovascular events was 13.0 (95% CI 4.5 to 37.4) in subjects with echolucent plaques and 3.7 (95% CI 0.7 to 18.2) in subjects with echogenic plaques when subjects without stenosis were used as the reference. The adjusted relative risk for cerebrovascular events in subjects with echolucent plaques was 4.6 (95% CI 1.1 to 18.9), and there was a significant linear trend (Pϭ0.015) for higher risk with increasing plaque echolucency. The adjusted relative risk for a 10% increase in the degree of stenosis was 1.2 (95% CI 1.04 to 1.4). Conclusions-Subjects with echolucent atherosclerotic plaques have increased risk of ischemic cerebrovascular events independent of degree of stenosis and cardiovascular risk factors. Subjects at high risk for ischemic vascular events may be identified by ultrasound assessment of plaque morphology.

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confidence: 99%

Echolucent Plaques Are Associated With High Risk of Ischemic Cerebrovascular Events in Carotid Stenosis

2001

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“…Heterogeneous lucencies have been associated with intraplaque and intraluminal thrombus and acute hemorrhage into plaque. 12,13,18 These findings are significantly more frequent in symptomatic plaques 12,13 and have predictive value for future symptoms. 14,15,19 Plaque configuration also appears to play a role, with crescentic plaques with scalloped borders having a greater frequency of ipsilateral ischemic events.…”

Section: Discussionmentioning

confidence: 74%

“…B-mode ultrasonography is an established technique for defining atheroma in the carotid artery bifurcation and has provided the basis for many studies of the relationship between plaque morphology and atheroembolic stroke from the carotid. [12][13][14][15][16][17][18][19] Correlation with TEE was made in 20 consecutive stroke patients to determine whether B-mode was able to visualize aortic plaque and to compare the morphological characteristics revealed by B-mode with those shown by TEE.…”

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confidence: 99%

A New Noninvasive Technique for Imaging Atherosclerotic Plaque in the Aortic Arch of Stroke Patients by Transcutaneous Real-Time B-Mode Ultrasonography

Weinberger

Azhar

Danisi

et al. 1998

Stroke

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Background and Purpose-Aortic arch atherosclerotic plaque is a probable source of atheroembolic stroke. Transesophageal echocardiography (TEE) has been used to image the aorta of patients with stroke to identify atherosclerotic plaque. TEE is moderately invasive and does not always visualize plaques present in the distal ascending aorta and proximal aortic arch. Methods-In the current study, transcutaneous B-mode ultrasonography was performed to image the aortic arch through a lateral supraclavicular window, and the results were compared with those of TEE in 20 patients. The aorta was subdivided into the proximal ascending (PAsc), distal ascending (DAsc), proximal aortic arch (PAA), and distal aortic arch (DAA) to be certain the plaques identified by each technique were the same. Plaques were characterized as simple (Ͻ4 mm thick) or complex (Ͼ4 mm thick). Results-In the PAsc, 8 simple plaques were identified with TEE but not with B-mode. In the DAsc, 1 complex plaque was identified with both techniques, and B-mode identified 1 additional complex and 1 simple plaque. In the PAA, 6 simple and 5 complex plaques were identified by both techniques, and TEE identified 1 additional complex plaque. In the DAA, TEE identified 2 simple and 2 complex plaques; B-mode identified 3 complex plaques. Conclusions-B-mode imaging compared favorably with TEE in identification of plaques in the aortic arch and distal ascending aorta, although it could not identify simple plaques in the proximal ascending. B-mode could visualize plaques not seen by TEE in the distal ascending aorta. B-mode ultrasonography is complementary to TEE in performance of a comprehensive assessment of plaque in the aortic arch and provides a noninvasive method for sequential studies of plaques that can be visualized. (Stroke. 1998;29:673-676.)

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“…In this type of study, an observer performs the visual classification of the plaques based on their echolucent or echogenic pattern. A study performed by Steffen et al (1989) presented the evaluation of carotid plaques in ultrasound images in order to determine the echogenicity patterns associated with the presence or absence of symptoms. In the study, four types of echogenic and echolucent patterns were used to classify the carotid plaques in symptomatic or asymptomatic groups: type 1 -uniformly echolucent; type 2 -predominantly echolucent with small areas of echogenic pattern; type 3 -predominantly echogenic with small echolucent regions; and type 4 -uniformly echogenic.…”

Section: Analysis Of Atherosclerotic Plaques Morphologymentioning

confidence: 99%

“…Characteristics of echogenicity, texture and surface of atherosclerotic plaques are also addressed in various studies (Steffen et al, 1989;Widder et al, 1990;Geroulakos et al, 1993;Lovett et al, 2004;Lal et al, 2006) as indicators of neurological symptoms. Echolucent lesions, heterogenous plaques and ulcerations are described in many studies as the main characteristics associated with high risk for neurological symptoms (Biasi et al, 1998).…”

Section: Introductionmentioning

confidence: 99%

A review of computational methods applied for identification and quantification of atherosclerotic plaques in images

Jodas

Pereira

Tavares

2016

Expert Systems with Applications

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Evaluation of the composition of atherosclerotic plaques in images is an important task to determine their pathophysiology. Visual analysis is still as the most basic and often approach to determine the morphology of the atherosclerotic plaques. In addition, computer-aided methods have also been developed for identification of features such as echogenicity, texture and surface in such plaques. In this article, a review of the most important methodologies that have been developed to identify the main components of atherosclerotic plaques in images is presented. Hence, computational algorithms that take into consideration the analysis of the plaques echogenicity, image processing techniques, clustering algorithms and supervised classification used for segmentation, i.e. identification, of the atherosclerotic plaque components in ultrasound, computerized tomography and magnetic resonance images are introduced. The main contribution of this paper is to provide a categorization of the most important studies related to the segmentation of atherosclerotic plaques and its compo- * Corresponding author. Tel.: +351 22 508 1487; fax: +351 22 508 1445Email addresses: danilojodas@gmail.com (Danilo Samuel Jodas), aledir@sjrp.unesp.br (Aledir Silveira Pereira), tavares@fe.up.pt (João Manuel R. S. Tavares ) URL: http://www.fe.up.pt/~tavares (João Manuel R. S. Tavares ) October 12, 2015 nents in images acquired by the most used imaging modalities. In addition, the effectiveness and drawbacks of each methodology as well as future researches concerning the segmentation and classification of the atherosclerotic lesions are also discussed. Preprint submitted to Journal of L A T E X Templates

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Carotid Artery Atheroma: Ultrasound Appearance in Symptomatic and Asymptomatic Vessels

Cited by 63 publications

References 21 publications

Echolucent Plaques Are Associated With High Risk of Ischemic Cerebrovascular Events in Carotid Stenosis

Echolucent Plaques Are Associated With High Risk of Ischemic Cerebrovascular Events in Carotid Stenosis

A New Noninvasive Technique for Imaging Atherosclerotic Plaque in the Aortic Arch of Stroke Patients by Transcutaneous Real-Time B-Mode Ultrasonography

A review of computational methods applied for identification and quantification of atherosclerotic plaques in images

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