title: Sonographic evaluation of carotid artery atherosclerosis in the elderly: relationship of disease severity to stroke and transient ischemic attack.
abstract: Doppler and real-time ultrasound (US) were performed to evaluate the extent of atherosclerotic changes in the carotid artery and to assess their relationship to prevalent cerebrovascular disease. Real-time US scans and Doppler measurements of the carotid arteries were analyzed in 5,201 subjects aged 65 years or older. Severity of atherosclerotic lesions was associated with increased frequencies of hyperechoic, irregular, and heterogeneous textured lesions (P < .0001). The severity of internal carotid artery stenosis was associated with thickening of the intima-media layer of the common carotid artery wall (r = .37, P < .0001). A history of stroke and transient ischemic attack (TIA) was more likely when hyperechoic, heterogeneous, and irregular lesions were seen in the carotid artery. Internal carotid artery stenosis correlated better with prevalent stroke and TIA than did sonographic descriptions of plaque texture. However, the prevalence of hyperechoic, heterogeneous, and irregular lesions increased as the degree of internal carotid stenosis increased. On real-time images alone, the average of the internal carotid artery maximal wall thickness is the sonographic measure of atherosclerosis that enables the best prediction of prevalent stroke and TIA.
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, Boston, Mass.
authors.forename: J F
authors.initials: JF
authors.lastname: Polak
authors.forename: D H
authors.initials: DH
authors.lastname: O'Leary
authors.forename: R A
authors.initials: RA
authors.lastname: Kronmal
authors.forename: S K
authors.initials: SK
authors.lastname: Wolfson
authors.forename: M G
authors.initials: MG
authors.lastname: Bond
authors.forename: R P
authors.initials: RP
authors.lastname: Tracy
authors.forename: J M
authors.initials: JM
authors.lastname: Gardin
authors.forename: S J
authors.initials: SJ
authors.lastname: Kittner
authors.forename: T R
authors.initials: TR
authors.lastname: Price
authors.forename: P J
authors.initials: PJ
authors.lastname: Savage
mesh_terms: D000368:Aged; D001161:Arteriosclerosis / Q000150:complications / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D014463:Ultrasonography