Carotid plaque neoangiogenesis: Correlation of contrast enhanced ultrasound and echogenicity to MRI black blood sequences

Background and purpose: The aim of our study was to evaluate whether neovascularisation of the carotid plaque assessed by visual analysis of contrast enhanced ultrasound imaging (CEUS) correlates to hyperintensity signals in MRI black blood sequences. We further investigated correlation to echogenicity features of the plaque. Methods and results: Patients with > 50% symptomatic or > 60% asymptomatic stenoses were included. Ultrasound and MRI examination was carried out in every patient and included assessment of degree of stenosis, measurement of echogenicity and contrast enhanced imaging using a cadence CPS program with low mechanical index. Sonovue was used as a contrast agent. Contrast enhancement was evaluated visually (grade 0: no, grade 1: intermediate and grade 2: extensive enhancement). MRI included black blood sequences of the carotid artery and intraplaque hemorrhage was determined by presence of an hyperintensity signal within the carotid plaque Thirteen carotid plaques from 12 patients were included. Intraplaque hemorrhage detected by MRI (n = 10) showed a significantly higher neovascularization analyzed by CEUS (median grade 1 vs. 0, p = 0.03). There was no correlation with plaque echogenicity. Conclusion: Visual analysis of carotid plaque neovascularization assessed by contrast enhanced ultrasound imaging correlated significantly with a hyperintensity signal on MRI black blood sequences.

Reference:

1. Müller HFG, Viaccoz A, Kuzmanovic I, et al. Contrast-Enhanced Ultrasound Imaging of Carotid Plaque Neo-vascularization: Accuracy of Visual Analysis. Ultrasound Med. Biol. 2013.