title: In vivo measurement of plaque neovascularisation and thermal heterogeneity in intermediate lesions of human carotid arteries.
abstract: OBJECTIVE
  Both neoangiogenesis and inflammation contribute in atherosclerosis progression. Contrast-enhanced ultrasound (CEUS) provides visualisation of plaque neovascularisation. Microwave radiometry (MR) allows in vivo non-invasive measurement of temperature of tissues, reflecting inflammatory activation. We assessed the association of carotid plaque temperature, measured by MR, with plaque neovascularisation assessed by CEUS in intermediate lesions.
  
  
  METHODS
  Consecutive patients with coronary artery disease and carotid atherosclerosis underwent carotid ultrasound imaging, CEUS and MR. Plaque texture, plaque surface and plaque echogenicity were analysed. Contrast enhancement (CE) by CEUS was defined as the % percentage of signal intensity difference, prior and post contrast infusion. Thermal heterogeneity (ΔT) was assigned as maximal temperature along the carotid artery minus minimum.
  
  
  RESULTS
  Eighty-six carotid arteries of 48 patients were included. Fatty plaques had higher CE% and ΔT compared with mixed and calcified (p<0.01 for all comparisons). Heterogeneous plaques had higher CE% and ΔT compared with homogenous (p<0.01 for all comparisons). Plaques with irregular surface had higher CE% and ΔT compared with plaques with regular (p<0.01 for all comparisons). There was a good correlation between ΔT and CE (R=0.60, p<0.001).
  
  
  CONCLUSIONS
  Carotid plaque neovascularisation on CEUS examination is associated with increased thermal heterogeneity and ultrasound characteristics of plaque vulnerability in intermediate lesions.
authors.affiliation: First Department of Cardiology, Hippokration Hospital, 26 Karaoli and Dimitriou str., Holargos, Athens 15562, Greece. ktoutouz@gmail.com
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Toutouzas
authors.forename: Maria
authors.initials: M
authors.lastname: Drakopoulou
authors.forename: Constantina
authors.initials: C
authors.lastname: Aggeli
authors.forename: Charalampia
authors.initials: C
authors.lastname: Nikolaou
authors.forename: Ioannis
authors.initials: I
authors.lastname: Felekos
authors.forename: Haralampos
authors.initials: H
authors.lastname: Grassos
authors.forename: Andreas
authors.initials: A
authors.lastname: Synetos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Stathogiannis
authors.forename: Antonis
authors.initials: A
authors.lastname: Karanasos
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Tsiamis
authors.forename: Elias
authors.initials: E
authors.lastname: Siores
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000368:Aged; D001831:Body Temperature / Q000502:physiology*; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008872:Microwaves; D009389:Neovascularization, Pathologic; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D011874:Radiometry; D015203:Reproducibility of Results; D018608:Ultrasonography, Doppler / Q000379:methods*