Computer-assisted ultrasonographic analysis of carotid plaques in relationto cerebrovascular symptoms, cerebral infarction, and histology

The objective of this study was to determine the relationship between plaqu e echogenicity as measured by computer and the incidence of cerebrovascular symptoms and cerebral infarction. The correlation between carotid plaque e chogenicity and plaque histology was also evaluated. In this prospective no nrandomized study, 38 consecutive patients with 54 atherosclerotic carotid plaques producing 50-99% stenosis were reviewed. The ultrasonic images of t he plaques were digitized and transferred to a computer. A histogram for ea ch plaque representing its composition was obtained. The median of the gray scale (GSM) of each histogram was used as measure of plaque echogenicity. Ail patients had a computed tomography (GT) brain scan performed to determi ne the presence of cerebral infarction. Twenty-eight plaques were examined histologically to determine the deposition of calcium, hemorrhage, choleste rol, and amorphous granular material. It is possible to identify carotid pl aques at high risk for development of cerebrovascular symptoms and cerebral infarction by the computerized measurement of plaque echogenicity. This me thod may be used to improve the criteria of patients selection for carotid endarterectomy.