title: Sonographic Detection of Abnormal Plaque Motion of the Carotid Artery: Its Usefulness in Diagnosing High-Risk Lesions Ranging from Plaque Rupture to Ulcer Formation.
abstract: We investigated the feasibility of using sonography of abnormal plaque motion to diagnose high-risk carotid lesions ranging from plaque rupture to ulcer formation. Fifty consecutive carotid arteries of 49 patients (71 ± 7 y, 37 males) who underwent carotid endarterectomy were investigated by carotid sonography to find a plaque concavity (sonographic ulcer [SU]), fine trembling motion inside the plaque (FTMI) and systolic retractive motion of the plaque surface (SRMS). Plaque rupture or ulcer, necrotic core and intra-plaque hemorrhage were determined at carotid endarterectomy. Twenty-two SUs, 41 cases of FTMI and 20 cases of SRMS were detected by carotid sonography. The sensitivity and specificity of SU in diagnosing plaque rupture or ulcer at carotid endarterectomy were 48% and 90%, and those of FTMI were 93% and 60%. Plaques with SRMS more frequently had both a necrotic core and intra-plaque hemorrhage than those without SRMS (80% vs. 30%, p = 0.0005). Abnormal plaque motion detected by carotid sonography is useful in detecting a ruptured or ulcerated plaque with a necrotic core and/or hemorrhage.
authors.affiliation: Sonographic Laboratory, Kashiwaba Neurosurgery Hospital, Sapporo, Japan.
authors.forename: Mutsuko
authors.initials: M
authors.lastname: Muraki
authors.affiliation: Faculty of Health Sciences, Hokkaido University School of Medicine, Sapporo, Japan. Electronic address: mikami@hs.hokudai.ac.jp.
authors.forename: Taisei
authors.initials: T
authors.lastname: Mikami
authors.affiliation: Department of Neurosurgery, Kashiwaba Neurosurgery Hospital, Sapporo, Japan.
authors.forename: Tetsuyuki
authors.initials: T
authors.lastname: Yoshimoto
authors.affiliation: Department of Neurosurgery, Kashiwaba Neurosurgery Hospital, Sapporo, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Fujimoto
authors.affiliation: Sonographic Laboratory, Kashiwaba Neurosurgery Hospital, Sapporo, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Kitaguchi
authors.affiliation: Faculty of Health Sciences, Hokkaido University School of Medicine, Sapporo, Japan.
authors.forename: Sanae
authors.initials: S
authors.lastname: Kaga
authors.affiliation: Department of Cardiovascular Medicine, Kashiwaba Neurosurgery Hospital, Sapporo, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Sugawara
authors.affiliation: Department of Neurosurgery, Kashiwaba Neurosurgery Hospital, Sapporo, Japan.
authors.forename: Kouichi
authors.initials: K
authors.lastname: Tokuda
authors.affiliation: Department of Neurosurgery, Kashiwaba Neurosurgery Hospital, Sapporo, Japan.
authors.forename: Sadao
authors.initials: S
authors.lastname: Kaneko
authors.affiliation: Department of Neurosurgery, Kashiwaba Neurosurgery Hospital, Sapporo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kashiwaba
mesh_terms: D000368:Aged; D000465:Algorithms; D020212:Carotid Artery Injuries / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D016894:Endarterectomy, Carotid; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D009038:Motion; D015203:Reproducibility of Results; D012421:Rupture / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*
keywords: Abnormal plaque motion; Carotid artery sonography; Plaque rupture; Plaque ulcer