Purpose: The aim of this study is to determine the stability of carotid atherosclerotic plaque (CAP) using contrast-enhanced ultrasound (CEUS).
Methods: CEUS images of 93 patients were evaluated to observe new vessels within CAPs. Microembolic signals (MES) were detected using transcranial Doppler (TCD). Thirty-four patients with hyperechoic plaques were evaluated as the control group.
Results: Eighty percent (75/93) of plaques showed contrast enhancement on CEUS, including 50.7% (38/75) of hypoechoic plaques and 49.3% (37/75) of mixed echoic plaques. No plaques in the control group showed enhancement on CEUS. With TCD, 35.5% (33/93) of patients were positive for MES. Plaques with grade 2 or 3 enhancement on CEUS had a higher positive rate for MES. Forty-one patients with grade 2 or 3 enhancement on CEUS presented with fresh infarctions confirmed by computed tomography (CT) and magnetic resonance imaging (MRI).
Conclusions: In conclusion, grade 2 or 3 contrast enhancement observed on CEUS indicated vulnerable plaques.
Keywords: Carotid atheromatous plaque; Contrast-enhanced ultrasound (CEUS); Microembolus signal (MES); Neovascularization; Transcranial Doppler (TCD).