title: The use of Speckle Reduction Imaging (SRI) Ultrasound in the characterization of carotid artery plaques.
abstract: OBJECTIVE
  Speckle Reduction Imaging is a new algorithm that improves the image quality of B-mode scanning by reducing the reverberation artifacts. In the present study the value of this method for the characterization of atherosclerotic plaques in the internal carotid artery was investigated.
  
  
  METHODS
  Two hundred and twenty two patients (161 men, 61 women; mean age 73 years) referred for carotid ultrasound evaluation were included in the study. Patients with plaques of the internal carotid artery as identified by conventional B-mode scanning were investigated also with the addition of Speckle Reduction Imaging (SRI) with the use of a 4-11-MHz wide band linear transducer. Plaque morphology was rated according to a standardized protocol by two independent observers.
  
  
  RESULTS
  For the determination of plaque echogenicity, the reproducibility of SRI (kappa=0.83) was higher than that of conventional B-mode ultrasound (kappa=0.68). The interobserver agreement for plaque surface characterization was also higher for SRI (kappa=0.8) than for conventional B-mode (kappa=0.61). At the evaluation of the image quality through a semiquantitative analysis, SRI was rated superior in the plaque texture resolution, plaque borders determination, vessel wall demarcation and fibrous cap depiction. In addition, the level of "speckle" was reduced with the use of SRI.
  
  
  CONCLUSIONS
  SRI is a technique that shows good general agreement with high-resolution B-mode and can be used for the characterization of atherosclerotic plaques in the carotid artery. Furthermore, because this advanced technique allows reduction of ultrasound artifacts, it improves the image quality allowing more precise visualization of plaque morphological details.
authors.affiliation: 1st Department of Surgery, Vascular Division, LAIKON Hospital, Athens University Medical School, Greece. nliasis@forthnet.gr
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Liasis
authors.forename: Chris
authors.initials: C
authors.lastname: Klonaris
authors.forename: Athanasios
authors.initials: A
authors.lastname: Katsargyris
authors.forename: Sotirios
authors.initials: S
authors.lastname: Georgopoulos
authors.forename: Nicos
authors.initials: N
authors.lastname: Labropoulos
authors.forename: Chris
authors.initials: C
authors.lastname: Tsigris
authors.forename: Athanasios
authors.initials: A
authors.lastname: Giannopoulos
authors.forename: Elias
authors.initials: E
authors.lastname: Bastounis
mesh_terms: D000368:Aged; D000465:Algorithms; D016477:Artifacts; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D014463:Ultrasonography / Q000379:methods*