Ultrasonic Images of Occlusive Carotid Artery Disease Using Combined B-mode and Color Flow Mapping Methods. Detection of Plaque Hemorrhage and its Clinical Importance.:—Detection of Plaque Hemorrhage and its Clinical Importance—

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Ultrasonography was applied to 37 carotid arteries with occlusive lesions prior to carotid surgery. The relationship between plaque echogenicity and histological features of the carotid plaque, especially the presence or absence of hemorrhage, and between the plaque histology and clinical symptoms were examined retrospectively. The echogenicity of the plaque was divided into three grades, hypoechoic, isoechoic and hyperechoic, according to the degree of echogenicity compared to that of the intimal layer. Among the 37 carotid arteries, 9 were hypoechoic, 9 were isoechoic and 19 were hyperechoic. Plaque hemorrhage (PH) was found in 7 of the 9 hypoechoic, 2 of the 9 isoechoic and in none of the 19 hyperechoic plaques. Most of the cases of hypoechoic plaques were associated with hemorrhage. Neurological symptoms were found in 7 of 9 patients with PH and in 11 of 28 patients without PH. Plaque hemorrhage was found significantly more frequently in symptomatic lesions. It is considered possible to estimate PH by the echogenicity of the plaque and that PH plays an important role in the occurrence of clinical symptoms. In conclusion, ultrasonography, because of its potential for detecting plaque hemorrhage, is presented as one of the most important preoperative examination techniques in patients with occlusive carotid artery disease.
日本脳神経超音波学会の論文