COMPARISON OF ULTRASONIC AND HISTOPATHOLOGICAL FEATURES OF CAROTID-ARTERY STENOSIS

Besides the degree of carotid artery stenosis, the composition of the plaque may help to predict the thromboembolic risk. Low echogenicity o n ultrasound and hemorrhage into the atheroma demonstrated histopathol ogically have been shown to be associated with a higher risk of emboli sm. Twenty-nine consecutive patients with carotid artery stenosis and scheduled for carotid endarterectomy were investigated preoperatively by B-mode ultrasound. Post-operatively the endarterectomy specimens we re examined histopathologically. Neither atheroma with hemorrhage nor atheroma without hemorrhage were significantly associated with echoluc ent ultrasound presentation. Out of the 10 lesions echolucent and homo geneous on ultrasound, six corresponded to atheroma with hemorrhage, t wo corresponded to atheroma with hemorrhage plus thrombus, two corresp onded to fibrous plaque plus thrombus, and one corresponded to pure th rombus. Out of the 4 lesions heterogeneous and predominantly echolucen t, one corresponded to atheroma without hemorrhage plus thrombus, one corresponded to atheroma with hemorrhage, one corresponded to atheroma with hemorrhage plus thrombus, one corresponded to atheroma with hemo rrhage plus fibrous plaque. Seven out of the 18 atheromas with hemorrh age did not present as purely or predominantly echolucent lesions, six of them were even homogeneously echogenic. Plaque surface could not r eliably be predicted by ultrasound. In our study, there was no signifi cant correlation between ultrasound and histology of the lesion.