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Fedak A, Ciuk K, Urbanik A. Ultrasonography of vulnerable atherosclerotic plaque in the carotid arteries: B-mode imaging. J Ultrason. 2020;20(81):e135-e145doi: 10.15557/JoU.2020.0022.
Fedak, A., Ciuk, K., & Urbanik, A. (2020). Ultrasonography of vulnerable atherosclerotic plaque in the carotid arteries: B-mode imaging. Journal of ultrasonography, 20(81), e135-e145. https://doi.org/10.15557/JoU.2020.0022
Fedak, Andrzej, et al. "Ultrasonography of vulnerable atherosclerotic plaque in the carotid arteries: B-mode imaging." Journal of ultrasonography vol. 20,81 (2020): e135-e145. doi: https://doi.org/10.15557/JoU.2020.0022
Fedak A, Ciuk K, Urbanik A. Ultrasonography of vulnerable atherosclerotic plaque in the carotid arteries: B-mode imaging. J Ultrason. 2020;20(81):e135-e145. doi: 10.15557/JoU.2020.0022. Epub 2020 Jun 15. PMID: 32609972; PMCID: PMC7418858.
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J Ultrason. 2020;20(81):e135-e145. doi: 10.15557/JoU.2020.0022. Epub 2020 Jun 15.

Ultrasonography of vulnerable atherosclerotic plaque in the carotid arteries: B-mode imaging.

Journal of ultrasonography

Andrzej Fedak, Katarzyna Ciuk, Andrzej Urbanik

Affiliations

  1. Department of Radiology, Jagiellonian University Medical College , Krakow , Poland.
  2. Students' Scientific Group at the Department of Radiology, Jagiellonian University Medical College , Krakow , Poland.

PMID: 32609972 PMCID: PMC7418858 DOI: 10.15557/JoU.2020.0022

Abstract

The most common type of stroke, i.e. ischemic stroke, is a great challenge for contemporary medicine as it poses both diagnostic and therapeutic difficulties. Atherosclerosis, which is rapidly beginning to affect more and more social groups, is the main cause of cerebrovascular accidents. Atherosclerosis is currently defined as a generalized, dynamic and heterogeneous inflammatory and immune process affecting arterial walls. Atherosclerotic plaque is the emanation of this disease. As the paradigm of the diagnosis of atherosclerosis has changed, it has become crucial to properly identify plaque instability within the carotid arteries by evaluating parameters and phenomena that signify a developing cascade of complications, eventually leading to stroke. Irrespective of the ultrasound technique employed, proper morphological evaluation of atherosclerotic plaque, involving observation of its echogenicity, i.e. subjective analysis of its structure, with the classification to Gray-Weale-Nicolaides types as well as assessment of the integrity of its surface, makes it possible to roughly evaluate plaque morphology and thereby its stability. This enables treatment planning and therapy monitoring. This evaluation should be a prelude to further diagnostic work-up, which involves non-invasive examinations that enable unambiguous assessment of plaque stability. These examinations include contrast-enhanced ultrasound to assess progression or recession of inflammation, which presents as plaque neovascularization, or shear wave elastography to objectively define tissue stiffness, and thereby its mineralization.

The most common type of stroke, i.e. ischemic stroke, is a great challenge for contemporary medicine as it poses both diagnostic and therapeutic difficulties. Atherosclerosis, which is rapidly beginning to affect more and more social groups, is the main cause of cerebrovascular accidents. Atherosclerosis is currently defined as a generalized, dynamic and heterogeneous inflammatory and immune process affecting arterial walls. Atherosclerotic plaque is the emanation of this disease. As the paradigm of the diagnosis of atherosclerosis has changed, it has become crucial to properly identify plaque instability within the carotid arteries by evaluating parameters and phenomena that signify a developing cascade of complications, eventually leading to stroke. Irrespective of the ultrasound technique employed, proper morphological evaluation of atherosclerotic plaque, involving observation of its echogenicity, i.e. subjective analysis of its structure, with the classification to Gray-Weale–Nicolaides types as well as assessment of the integrity of its surface, makes it possible to roughly evaluate plaque morphology and thereby its stability. This enables treatment planning and therapy monitoring. This evaluation should be a prelude to further diagnostic work-up, which involves non-invasive examinations that enable unambiguous assessment of plaque stability. These examinations include contrast-enhanced ultrasound to assess progression or recession of inflammation, which presents as plaque neovascularization, or shear wave elastography to objectively define tissue stiffness, and thereby its mineralization.

References

  1. Am J Cardiol. 1990 Nov 6;66(16):37G-40G - PubMed
  2. J Geriatr Cardiol. 2019 Dec;16(12):872-879 - PubMed
  3. Int Angiol. 2003 Sep;22(3):284-9 - PubMed
  4. J Interv Cardiol. 2003 Jun;16(3):267-72 - PubMed
  5. Cerebrovasc Dis. 2004;17 Suppl 3:17-22 - PubMed
  6. J Clin Epidemiol. 1988;41(2):105-14 - PubMed
  7. Eur J Vasc Endovasc Surg. 2002 May;23(5):437-40 - PubMed
  8. Clin Physiol Funct Imaging. 2020 Jan;40(1):46-51 - PubMed
  9. Stroke Vasc Neurol. 2018 Feb 24;3(2):92-100 - PubMed
  10. Arterioscler Thromb Vasc Biol. 2009 Oct;29(10):1696-701 - PubMed
  11. Circ Cardiovasc Imaging. 2017 May;10(5): - PubMed
  12. Przegl Epidemiol. 2010;64(3):439-42 - PubMed
  13. Curr Opin Cardiol. 2001 Sep;16(5):285-92 - PubMed
  14. Curr Pharm Des. 2009;15(10):1095-106 - PubMed
  15. Circulation. 2003 Oct 14;108(15):1772-8 - PubMed
  16. Biomed Res Int. 2015;2015:293163 - PubMed
  17. J Intern Med. 2014 Dec;276(6):618-32 - PubMed
  18. Stroke. 2002 Apr;33(4):1057-62 - PubMed
  19. Clin Physiol Funct Imaging. 2013 Nov;33(6):431-5 - PubMed
  20. Med Biol Eng Comput. 2017 Dec;55(12):2183-2195 - PubMed
  21. JAMA. 2004 Oct 20;292(15):1845-52 - PubMed
  22. Angiology. 2001 Dec;52(12):867-9 - PubMed
  23. Eur Radiol. 2019 Apr;29(4):2137-2145 - PubMed
  24. Croat Med J. 2016 Aug 31;57(4):311-20 - PubMed
  25. Cardiovasc Ultrasound. 2014 Dec 08;12:49 - PubMed
  26. Circulation. 2003 Apr 29;107(16):2072-5 - PubMed
  27. PLoS One. 2017 Apr 7;12(4):e0175331 - PubMed
  28. Prog Cardiovasc Dis. 2002 Mar-Apr;44(5):349-56 - PubMed
  29. N Engl J Med. 2003 Dec 11;349(24):2316-25 - PubMed
  30. Arch Med Sci. 2019 Jan 11;16(1):58-65 - PubMed
  31. Neurol Res. 2015 Jun 23;:1-5 - PubMed
  32. N Engl J Med. 1991 Aug 15;325(7):445-53 - PubMed
  33. Lancet Neurol. 2019 Jun;18(6):559-572 - PubMed
  34. Stroke. 2012 Jul;43(7):1824-30 - PubMed
  35. Circulation. 2010 May 4;121(17):1941-50 - PubMed
  36. Int J Cardiol. 2016 Jan 15;203:1146 - PubMed
  37. Cerebrovasc Dis. 2007;23(1):75-80 - PubMed
  38. J Am Coll Cardiol. 2006 Jul 18;48(2):236-43 - PubMed
  39. Atherosclerosis. 2017 Jan;256:29-34 - PubMed
  40. J Neurosurg. 2016 Jan;124(1):27-42 - PubMed
  41. Eur Radiol. 2013 Jul;23(7):2030-41 - PubMed
  42. PLoS One. 2017 Oct 4;12(10):e0185261 - PubMed
  43. Neuroimaging Clin N Am. 2016 Feb;26(1):81-96 - PubMed
  44. Ultraschall Med. 2015 Apr;36(2):154-61 - PubMed
  45. Stroke. 2010 Jun;41(6):1151-6 - PubMed
  46. Stroke. 2000 Aug;31(8):1921-4 - PubMed
  47. Cerebrovasc Dis. 2015;40(3-4):165-74 - PubMed
  48. Neurosurg Rev. 2010 Oct;33(4):419-30 - PubMed
  49. Insights Imaging. 2017 Apr;8(2):213-225 - PubMed

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