Contrast-enhanced ultrasound and detection of carotid plaque neovascularization

Kunte, Hagen; Schmidt, Charlotte; Harms, Lutz; Rückert, Ralph-Ingo; Grigoryev, Maria; Fischer, Thomas

doi:10.1212/wnl.0b013e3182749f4c

Cited by 10 publications

(10 citation statements)

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“…So far, only few studies by us and others have directly compared CEUS and histopathology [2,18,23]. In this investigation, focal enhancements of contrast corresponded well to intraplaque neovascularization (Figs 1 and 4).…”

Section: Resultssupporting

confidence: 54%

“…Importantly, there appears to be a good correlation between ultrasound imaging and subsequent histopathological findings [2,11,18,19]. In particular, ultrasound investigations into intraplaque neovascularization have garnered increasing attention since intraplaque neovascularization holds promise as an indirect marker of the amount of infiltrated inflammatory cells [2,11,19].…”

Section: Introductionmentioning

confidence: 99%

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Identification of neovascularization by contrast–enhanced ultrasound to detect unstable carotid stenosis

et al. 2017

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BackgroundPlaque neovascularization accompanies local inflammation and critically contributes to plaque instability. Correct identification of intraplaque neovascularization by contrast–enhanced ultrasound (CEUS) may provide an additional risk marker in carotid stenosis. This pilot study investigates the correlation between histological evaluation of carotid plaque specimens and pre-surgery CEUS to identify neovascularization.Methods17 patients with high-grade internal carotid artery (ICA) stenosis were studied. CEUS was performed in all patients shortly before carotid endarterectomy. Neovascularization, infiltration of T cells and macrophages along with intraplaque hemorrhage were studied in excised plaques by immunohistochemistry. Ultrasound-based four-level and two-level classification systems for neovascularization were used. CEUS findings were compared with histological findings.ResultsScores on the CEUS-based four-level and two-level classifications were robustly correlated with the density of intraplaque vessels (r = 0.635, p = 0.006 and r = 0.578, p = 0.015, respectively). Histological evaluation of regions with strong and prolonged intraplaque enhancement typically showed strong intraplaque neovascularization in conjunction with acute intraplaque hemorrhage. Moreover, higher grades of intraplaque neovascularization as determined by ultrasound were associated with a higher percentage of macrophage-rich areas.ConclusionCEUS is a technique well suited to gauge the degree of neovascularization of carotid plaques. Future research will have to define the reliability and validity of CEUS in everyday clinical practice. Further, our study suggests that CEUS may also be useful to pick up features of vulnerable plaques such as acute intraplaque hemorrhages.

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Section: Resultssupporting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Identification of neovascularization by contrast–enhanced ultrasound to detect unstable carotid stenosis

et al. 2017

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“…Carotid contrast-enhanced ultrasonography (CEUS) can offer some information about the presence of neovascularization [73] in particular when microbubbles are used [74,75]. However, the reproducibility and utility of this modality for clinical care are not well established [76].…”

Section: The Plaque Neovascularizationmentioning

confidence: 99%

Imaging of the Carotid Artery Vulnerable Plaque

Saba¹,

Anzidei

Marincola

et al. 2013

Cardiovasc Intervent Radiol

111

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Atherosclerosis involving the carotid arteries has a high prevalence in the population worldwide. This condition is significant because accidents of the carotid artery plaque are associated with the development of cerebrovascular events. For this reason, carotid atherosclerotic disease needs to be diagnosed and those determinants that are associated to an increased risk of stroke need to be identified. The degree of stenosis typically has been considered the parameter of choice to determine the therapeutical approach, but several recently published investigations have demonstrated that the degree of luminal stenosis is only an indirect indicator of the atherosclerotic process and that direct assessment of the plaque structure and composition may be key to predict the development of future cerebrovascular ischemic events. The concept of ''vulnerable plaque'' was born, referring to those plaque's parameters that concur to the instability of the plaque making it more prone to the rupture and distal embolization. The purpose of this review is to describe the imaging characteristics of ''vulnerable carotid plaques.''

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“…Dies ist insbesondere wichtig, weil asymptomatische Stenosen mit echoarmen und ulzerierten Plaques mit einem erhöhten Risiko für distale arterielle Embolien und Schlaganfall einhergehen (10,11). Hypoechogene Plaques und höhergradige Karotisstenosen zeigten in der Kontrastmittelunterstützten B-Bild-Sonografie zudem häufiger eine Neovaskularisation, die mit einer erhöhten Plaqueinstabilität assoziiert ist (12,13 (16). In Zukunft sollten diese neuen Kriterien einheitlich verwendet werden.…”

Section: Atheroskleroseunclassified

Extrakranielle Farbduplexsonografie hirnversorgender Arterien

Steinke¹

2013

Nervenheilkunde

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ZusammenfassungDie Ultraschalldiagnostik der extrakraniellen hirnversorgenden Arterien spielt eine zentrale Rolle bei der Stratifizierung des Risikos für zerebrovaskuläre Ereignisse und für das Erkennen von Ursachen eingetretener Hirninfarkte. In dieser Übersicht werden neben etablierten Befunden Ergebnisse neuerer Arbeiten vorgestellt, die insbesondere Bedeutung für den täglichen Einsatz der sonografischen Diagnostik haben. Es wird auf die Technik und Relevanz der Messung der Intima Media-Dicke und die Signifikanz der Echomorphologie atherosklerotischer Plaques der carotis eingegangen, zudem werden die neuen sonografischen Kriterien der Klassifikation von Karotisstenosen eingehend dargestellt, die 2010 publiziert wurde und zunehmend verwendet wird. Im letzten Teil werden typische Befunde bei Dissektionen der extrakraniellen Arterien gezeigt und dabei insbesondere auf die Unterschiede von Dissektionen der A. carotis interna und communis hingewiesen.

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Contrast-enhanced ultrasound and detection of carotid plaque neovascularization

Cited by 10 publications

References 1 publication

Identification of neovascularization by contrast–enhanced ultrasound to detect unstable carotid stenosis

Identification of neovascularization by contrast–enhanced ultrasound to detect unstable carotid stenosis

Imaging of the Carotid Artery Vulnerable Plaque

Extrakranielle Farbduplexsonografie hirnversorgender Arterien

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