Visual analysis or semi-automated gray-scale-based color mapping of the carotid plaque: which method correlates the best with the presence of cerebrovascular symptoms and/or lesions on MRI?
OBJECTIVE
To determine the correlation between carotid plaque morphology, assessed by two different ultrasonographic methods, and presence of cerebrovascular events and/or lesions on magnetic resonance imaging (MRI).


METHODS
Visual analysis of plaque echogenicity using a five-type classification was performed. Further, a semi-automated gray-scale-based color mapping of the whole plaque and of its surface was achieved.


RESULTS
There were 31 (35%) symptomatic (23 strokes and 8 transitory ischemic attacks [TIAs]) and 58 (65%) asymptomatic carotid stenoses. MRI lesions related to the carotid stenosis if located in the ipsilateral cortical, subcortical, or watershed area, were present in 27 cases (30%). In a multivariate logistic regression model, degree of stenosis (P= .03) and a predominant red color on the surface (P= .04) were independent factors associated with the presence of cerebrovascular events and/or lesions on MRI. Sensitivity and specificity were, respectively, 80% and 63% by combining degree of stenosis and color mapping of plaque surface.


CONCLUSIONS
Degree of stenosis and a predominant red color on plaque surface were independent factors associated with the presence of cerebrovascular events and/or lesions on MRI. No correlation was observed with any particular type of plaque based on visual analysis alone.
Momjian
Isabelle
I
Department of Neurology, University Hospital Geneva, Geneva, Switzerland.
Momjian
Shahan
S
Albanese
Stéphane
S
Comelli
Mario
M
Lovblad
Karl
K
Sztajzel
Roman
R
D000368:Aged; D001921:Brain / Q000187:drug effects / Q000473:pathology*; D002339:Carotid Arteries / Q000473:pathology*; D016893:Carotid Stenosis / Q000188:drug therapy / Q000473:pathology*; D003116:Color; D003327:Coronary Disease / Q000473:pathology; D005260:Female; D006801:Humans; D006973:Hypertension; D002546:Ischemic Attack, Transient / Q000188:drug therapy / Q000473:pathology; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015999:Multivariate Analysis; D015588:Observer Variation; D016017:Odds Ratio; D012372:ROC Curve; D012680:Sensitivity and Specificity; D020521:Stroke / Q000188:drug therapy / Q000473:pathology