Abstract
Attempts to stratify carotid plaques according to clinical risk using single longitudinal view (SLV) echomorphology have not been uniformly successful. We compared SLV grey scale median measurements (SLV-GSM) with a newer technique of multiple cross-sectional view echomorphology (MCSV-GSM) in carotid plaques from 3 patient groups (asymptomatic, ocular, and hemispheric symptoms). SLV and MCSV images were obtained from 109 carotid stenoses (70-99%; 41 hemispheric, 17 ocular, 51 asymptomatic). SLV-GSM and MCSV-GSM(min) (lowest plaque MCSV image GSM) were determined to assess echolucency whilst MCSV-GSM(max-min) (highest minus lowest MCSV-GSM) assessed heterogeneity. Echolucency was greater (lower GSM) in plaques causing hemispheric symptoms versus asymptomatic plaques (MCSV-GSM(min), P = .002; SLV-GSM, P = .002). Only MCSV imaging detected differences in echolucency between asymptomatic plaques and those causing ocular symptoms (SLV-GSM, p = 0.84; MCSV-GSM(min), p = .003). Symptomatic plaques showed greater heterogeneity versus asymptomatic plaques, significantly in those causing ocular symptoms (hemispheric P = .126; AF P = .011). Both SLV and MCSV echomorphology confirm increased echolucency in plaques causing hemispheric sympto...Continue Reading
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