ULTRASONOGRAPHIC CHARACTERIZATION OF CAROTID PLAQUES

The composition of atherosclerotic plaques in the carotid artery is as sumed to be related to the development of neurological symptoms. The e cho patterns produced by B-mode ultrasound may be of use in the assess ment of the plaques' composition. It is suggested that fibrotic and '' stable'' plaques are more echogenic than lipid/hemorrhagic and echoluc ent or ''unstable'' plaques. B-mode ultrasound procedures were perform ed 1 day prior to surgery on 46 consecutive endarterectomies, Two obse rvers assessed the plaques according to their echo pattern and echogen icity and sorted them into three categories: 1) predominantly echoluce nt, 2) heterogeneous, and 3) predominantly echogenic, The intraobserve r agreement was moderate (kappa = 0.44) and the interobserver agreemen t low (kappa = 0.38), Furthermore, subjective categorization of plaque types resulted in type 1 plaques being as fibrotic as type 2 or 3 pla ques. We conclude that B-mode ultrasound and subsequent subjective cat egorization of atherosclerotic plaques cannot adequately determine the volume of fibrosis or lipids within the plaque. (C) 1998 World Federa tion for Ultrasound in Medicine & Biology.