CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2024; 34(03): 460-468
DOI: 10.1055/s-0044-1779522
Original Article

Assessment of Carotid Plaque Enhancement on Contrast-Enhanced Ultrasound as a Predictor for Severe Coronary Artery Disease

1   Department of Diagnostic and Intervention Radiology, All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, India
1   Department of Diagnostic and Intervention Radiology, All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, India
Udit Chauhan
1   Department of Diagnostic and Intervention Radiology, All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, India
Barun Kumar
2   Department of Cardiology, All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, India
› Author Affiliations
Funding None.


Background and Aim Contrast-enhanced ultrasound (CEUS) can reliably identify vulnerable plaques. As atherosclerosis is a systemic disease, we evaluated whether contrast enhancement of carotid plaque (CECP) can predict severe coronary artery disease (CAD) by comparing CECP in patients who have had acute coronary syndromes (ACS) recently with asymptomatic individuals.

Settings and Design This case–control study was done at a tertiary care center during 2022.

Materials and Methods Fourteen participants were recruited in each group, after screening in-patients for carotid plaques and inclusion and exclusion criteria. Those who had history of ACS were enrolled as cases, while those who did not were enrolled as controls. All these patients underwent grayscale, Doppler, and CEUS examination for characterization of the carotid plaque. For cases, findings on CEUS were also compared with the severity of CAD on catheter coronary angiography.

Statistical Analysis Diagnostic parameters including sensitivity, specificity, and diagnostic accuracy were calculated and proportions were compared by using Fisher's exact test.

Results Eight out of 28 patients showed CECP. CECP and CAD were positively associated with p-Value of 0.033. Eighty-three percent patients with triple vessel disease and 50% patients with double vessel disease on coronary angiography showed CECP. Sensitivity and specificity of CECP for prediction of CAD were 50 and 92.9%, respectively.

Conclusion CECP on CEUS can predict CAD and is a more reliable indicator of severe CAD than plaque characteristics on grayscale and Doppler imaging; making it useful for screening of patients at risk of having CAD.

Availability of Data

The underlying research data of this article is not publicly available for patient privacy. The data are available from the corresponding author on reasonable request.

Ethical Approval

All the patients were explained the study and gave written and informed consent before enrollment. All procedures performed were in accordance with the ethical standards of the Institutional Ethics Committee and with the 1964 Helsinki Declaration and its later amendments. None of the figures submitted reveal the identity of the participants.

Publication History

Article published online:
23 February 2024

© 2024. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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