Ultrasonic tissue characterization of atheromatous plaques using a high resolution real time scanner

Wolverson, Michael K.; Bashiti, Hind; Peterson, Gary J.

doi:10.1016/0301-5629(83)90005-4

Cited by 108 publications

(49 citation statements)

References 9 publications

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“…Some of these associations have been disputed, however, with other investigators failing to demonstrate more frequent symptoms associated with ulcerations 14,21 and plaque hemorrhage. 23,24 The documented ability of B-mode ultrasonographic scanning to detect plaque ulceration, 25 heterogeneity, 26,27 and hemorrhage, 28 though disputed by some, 24,29,30 has led to the demonstration that these ultrasound-defined characteristics are also associated with ipsilateral neurologic symptoms, 31 clinical events, 26 and MRI-defined infarcts. 18,32 The mechanisms by which carotid artery disease may be associated with neurological symptoms and stroke include (1) thrombotic occlusion of large vessels such as the carotid and middle cerebral arteries with hypoperfusion in the vascular distribution supplied by these vessels; (2) cerebral embolism of either atheromatous material from a ruptured or ulcerated carotid plaque or of fibrin-platelet material from a thrombotic plaque to distal vessels; or (3) manifestation or general marker of systemic atherosclerosis occurring at the large and small vessel level.…”

Section: Carotid Disease and The Brainmentioning

confidence: 99%

Relationships of Cerebral MRI Findings to Ultrasonographic Carotid Atherosclerosis in Older Adults

Manolio

Burke

O’Leary

et al. 1999

ATVB

182

160

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Abstract-Cerebral magnetic resonance imaging (MRI) has demonstrated a high prevalence of infarct-like lesions, white matter hyperintensities, and evidence of cerebral atrophy in older adults. While these findings are generally believed to be related to ischemia and atherosclerosis, their relationship to atherosclerosis in the carotid arteries remains to be explored. Study subjects were part of the multicenter Cardiovascular Health Study, a cross-sectional study of 3502 women and men Ն65 years of age undergoing cranial MRI and carotid ultrasonography. MRI infarcts were detected in 1068 participants (29.3%) and measurable carotid plaque in 2745 (75.3%). MRI infarcts, ventricular and sulcal widening, and white matter score were strongly associated with carotid intimal-medial thickness (IMT) and stenosis degree after adjustment for age and sex (all PϽ0.01). Associations with plaque characteristics were less strong and less consistent; MRI infarcts were weakly associated only with surface irregularity, and ventricular size was weakly associated only with lesion density (both PϽ0.04). In contrast, sulcal widening was strongly related to plaque characteristics, with scores being higher in those with heterogeneous and irregular plaque (both PϽ0.009 Key Words: stroke Ⅲ cerebrovascular disorders Ⅲ carotid arteries Ⅲ atherosclerosis Ⅲ aged Ⅲ epidemiology Ⅲ risk factors C erebral magnetic resonance imaging (MRI) has demonstrated a high prevalence of infarct-like lesions, white matter hyperintensities, and evidence of cerebral atrophy in older adults. 1-3 While these findings are related to standard risk factors for cardiovascular disease and are believed to be consequences of ischemia, 4 -6 their relationship to atherosclerosis in the carotid arteries has not been widely explored.Because the carotid arteries provide the majority of the brain's blood supply, detailed information on extent, severity, and characteristics of carotid atherosclerosis can be used to explore its relationships to cerebral MRI findings. Lesion characteristics such as increased density, heterogeneity, and surface irregularity have been shown to relate to prevalent clinically defined transient ischemic attack and stroke, 6 but these associations have not been examined for cerebral MRI findings.The Cardiovascular Health Study (CHS) cohort represents a large, multicenter sample of older men and women examined by both carotid ultrasonography and cerebral MRI. Cross-sectional data from these examinations were analyzed (1) to describe prevalences of MRI-defined infarcts, infarctlike lesions, and gray and white matter changes by quintile of common and internal carotid intimal-medial thickness (IMT); degree of carotid stenosis; and characteristics of carotid plaque; (2) to determine independence of carotid atherosclerosis/MRI abnormality associations from known clinical and subclinical cardiovascular disease and cardiovascular disease risk factors; and (3) to define relationships of MRI infarcts and ipsilateral carotid artery disease. MethodsCHS participants ...

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Section: Carotid Disease and The Brainmentioning

confidence: 99%

Relationships of Cerebral MRI Findings to Ultrasonographic Carotid Atherosclerosis in Older Adults

Manolio

Burke

O’Leary

et al. 1999

ATVB

182

160

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“…Plaque echogenicity as assessed by B-mode ultrasound has been found to reliably predict the content of soft tissue and the amount of calcification. [5][6][7][8] Plaques that appear echolucent on B-mode ultrasound are lipid-rich, whereas echogenic plaques have a higher content of fibrous tissue and calcification. 9 -11 In our above-mentioned study, 1 plaque echogenicity was assessed; in the current article, we report the cross-sectional associations of aortic PWV with carotid echolucent and echogenic plaques in 561 hypertensive and nonhypertensive subjects.…”

mentioning

confidence: 99%

Echogenic Carotid Plaques Are Associated With Aortic Arterial Stiffness in Subjects With Subclinical Carotid Atherosclerosis

et al. 2003

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Abstract-A better understanding of the interrelationships between the structure and function of the large arteries would lead to optimize cardiovascular disease prevention strategies. In this study, we investigated the relationships of aortic arterial stiffness assessed by carotid-femoral pulse-wave velocity (PWV), with carotid plaque echogenicity assessed by B-mode ultrasound. We analyzed 561 subjects (without coronary heart disease or stroke) who were volunteers for free health examinations (age, 58.3Ϯ10.8 years; 32.6% women). Extracranial carotid plaque echogenicity was graded from 1 (plaque appearing black or almost black) to 4 (plaque appearing white or almost white) according to the Gray-Weale classification. Plaques of grades 1 and 2 were defined as echolucent plaques, and plaques of grades 3 and 4 were defined as echogenic plaques. Key Words: atherosclerosis Ⅲ carotid arteries Ⅲ epidemiology Ⅲ hypertension, arterial Ⅲ ultrasonography S tudying the possible interrelationships between the structure and function of the large arteries would lead to a better understanding of the pathophysiology of vascular diseases, to a better evaluation of stroke and cardiovascular risks, and thus to the development of more adequate disease prevention strategies. In a recent study, we reported that the presence of carotid atherosclerotic plaques detected by B-mode ultrasound but not diffuse intima-media thickening was determinant of aortic arterial stiffness assessed by carotid-femoral pulse-wave velocity (PWV), independent of major known cardiovascular risk factors. 1 These findings obtained from a large study of hypertensive and normotensive subjects corroborate the recent results of the Rotterdam Study, showing that arterial stiffness was related to abdominal aortic and carotid atherosclerotic plaques. 2 The mechanisms linking arterial stiffness to atherosclerosis are not known at present. Atherosclerotic changes in the arterial wall could include smooth muscle cell proliferation, deposition of lipid and accumulation of collagen, elastin, and/or proteoglycans. 3,4 However, it is not known whether plaques with different contents are differentially related to arterial stiffness. Plaque echogenicity as assessed by B-mode ultrasound has been found to reliably predict the content of soft tissue and the amount of calcification. [5][6][7][8] Plaques that appear echolucent on B-mode ultrasound are lipid-rich, whereas echogenic plaques have a higher content of fibrous tissue and calcification. 9 -11 In our above-mentioned study, 1 plaque echogenicity was assessed; in the current article, we report the cross-sectional associations of aortic PWV with carotid echolucent and echogenic plaques in 561 hypertensive and nonhypertensive subjects.

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“…Histological studies revealed that media and adventitia thicknesses on ultrasound images are quite close to their real thicknesses 25 . Whilst internal hyperechogenic line represents the lumen-intima interface, external hyper-echogenic line represents the mediaadventitia interface and the distance between two lines indicates IMT.…”

Section: Discussionmentioning

confidence: 86%

Relation between cardiovascular disease risk factors and common carotid artery intima media thickness

Şafak¹,

Akçiçek²

2015

Kafkas J Med Sci

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Ultrasonic tissue characterization of atheromatous plaques using a high resolution real time scanner

Cited by 108 publications

References 9 publications

Relationships of Cerebral MRI Findings to Ultrasonographic Carotid Atherosclerosis in Older Adults

Relationships of Cerebral MRI Findings to Ultrasonographic Carotid Atherosclerosis in Older Adults

Echogenic Carotid Plaques Are Associated With Aortic Arterial Stiffness in Subjects With Subclinical Carotid Atherosclerosis

Relation between cardiovascular disease risk factors and common carotid artery intima media thickness

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