Potential of using shear wave elastography for ultrasound evaluation of unstable carotid atherosclerotic plaque

Objective. Testing the hypothesis about the possibility of using shear wave ultrasound elastography to assess the instability of atherosclerotic plaque in the carotid artery.

Material and methods. Twenty-six patients aged 69.1 ± 6.1 years with carotid artery stenosis were examined using Duplex (DS) on a Samsung V7 scanner. SWE of the atherosclerotic plaque was performed with a linear LA2-14A probe. Multiple circular regions of interest (ROI) of different sizes were used to maximize plaque capture. After carotid endarterectomy (CEA), histological examination of hematoxylin-stained atherosclerotic plaques was performed. Analysis of variance (ANOVA) was used.

Results. Young's modulus (E) of carotid atherosclerotic plaques was associated with the degree of ICA stenosis, the presence of a lipid-rich necrotic core (LRNC) in the plaque and the ultrasound characterization of the Geroulakos plaque type. The median value of the plaque stiffness index (E, IQR) were associated with the histological assessment of the thickness of the fibrous cap.

Conclusion. SWE can be used and is promising for the quantitative assessment of instability of carotid atherosclerotic plaques.

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