Computer-assisted carotid plaque analysis: Characteristics of plaques associated with cerebrovascular symptoms and cerebral infarction

Objective: to correlate the echostructural characteristics of carotid plaqu es with neurological symptoms and cerebral infarcts. Materials: one hundred and five plaques were studied in 74 patients by colo ur-flow duplex ultrasound: 39 were symptomatic and 37 were associated with brain infarction on CT scanning. Methods: the images were ditigalised for computer-assisted image standardis ation, and divided in homogenous (n = 67) and heterogeneous (n = 38) groups . Parameters of the plaque image were analysed. Results: global echogenicity was significantly lower in symptomatic and in CT+ plaques (p<0.05). For homogeneous plaques, and echogenic cap (EC) was v isualised in 8.3% of symptomatic vs. 33.9% of asymptomatic (p<0.05) and in 7.7% for plaques that were CT+ vs. 37.7% for CT- (p<0.05). Surface disrupti on was visualised in 50% of symptomatic vs. 8.5% of asymptomatic (p=0.902) and in 46% of CT- vs. 9.4% of CT- plaques (p=0.002). For heterogenous plaqu es, the echolucent region was juxthaluminal in 67% of symptomatic and CT+ p laques vs. 33% in asymptomatic and CT- (p<0.01). Conclusion: echolucent plaques are associated with a higher neurological ri sk. In homogenous plaques the absence of an echogenic cap and disruption of the plaque surface also correlates with symptoms. In heterogeneous plaques , juxtluminal location of the echolucent region is an additional marker of increased risk.