Shear wave elastography imaging of carotid plaques: feasible, reproducible and of clinical potential

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• 作者：Kumar V Ramnarine ; James W Garrard ; Baris Kanber…
• 关键词：Ultrasound ; Carotid ; Plaque ; Stenosis ; Shear wave ; Elastography ; Elastogram
• 刊名：Cardiovascular Ultrasound
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：12
• 期：1
• 全文大小：2,035 KB
• 参考文献：Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med 325: pp. 445-453 CrossRef
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• 刊物主题：Ultrasound; Angiology; Cardiology; Imaging / Radiology;
• 出版者：BioMed Central
• ISSN：1476-7120

文摘

Background Shear Wave Elastography (SWE) imaging is a novel ultrasound technique for quantifying tissue elasticity. Studies have demonstrated that SWE is able to differentiate between diseased and normal tissue in a wide range clinical applications. However its applicability to atherosclerotic carotid disease has not been established. The aim of this study was to assess the feasibility and potential clinical benefit of using SWE imaging for the assessment of carotid plaques. Methods Eighty-one patients (mean age 76?years, 51 male) underwent greyscale and SWE imaging. Elasticity was quantified by measuring mean Young’s Modulus (YM) within the plaque and within the vessel wall. Echogenicity was assessed using the Gray-Weale classification scale and the greyscale median (GSM). Results Fifty four plaques with stenosis greater than 30% were assessed. Reproducibility of YM measurements, quantified by the inter-frame coefficient of variation, was 22% within the vessel wall and 19% within the carotid plaque. Correlation with percentage stenosis was significant for plaque YM (p--.003), but insignificant for plaque GSM (p--.46). Plaques associated with focal neurological symptoms had significantly lower mean YM than plaques in asymptomatic patients (62 kPa vs 88 kPa; p--.01). Logistic regression and Receiver Operating Characteristic (ROC) analysis showed improvements in sensitivity and specificity when percentage stenosis was combined with the YM (area under ROC--.78). Conclusions Our study showed SWE is able to quantify carotid plaque elasticity and provide additional information that may be of clinical benefit to help identify the unstable carotid plaque.