title: Shear Wave Elastography Imaging for the Features of Symptomatic Carotid Plaques: A Feasibility Study.
abstract: OBJECTIVE
  Shear wave elastography (SWE) was performed to evaluate the Young's modulus of carotid plaques in patients presenting with cerebrovascular incidents, to estimate the clinical value and feasibility of this approach.
  
  
  METHODS
  Sixty-one patients (mean age, 65 years; 45 men) underwent common duplex ultrasonic examination and SWE evaluation. The patients were divided into the symptomatic and asymptomatic groups based on the presence of unilateral focal neurological symptoms. Elasticity and echogenicity of the carotid plaque was assessed by Young's modulus and Gray-Weale classification, respectively.
  
  
  RESULTS
  A total of 271 carotid plaques were assessed through duplex ultrasonic examination and SWE imaging. The Bland-Altman test revealed a perfect reproducibility of Young's modulus measurement using SWE. The interframe coefficient of variation was 16% within the 271 plaques. In the 61 representative plaques, significant correlations were found between Gray-Weale classification and mean Young's modulus (r = 0.728, P < .01) when the confounding factors were controlled. The mean Young's modulus of representative plaques in symptomatic group was lower than those in asymptomatic groups (mean Young's modulus: 81 kPa versus 115 kPa; P < .01). Logistic regression combined with receiver operating characteristic analysis suggested increased sensitivity and specificity for the identification of symptomatic carotid plaques when the mean Young's modulus was combined with stenosis rate.
  
  
  CONCLUSIONS
  Shear wave elastography can evaluate the Young's modulus of carotid plaque stably, and could serve as an additional method for the detection of symptomatic carotid plaques, which, in combination with common ultrasound, can promote the efficiency of differentiating symptomatic carotid plaques.
authors.affiliation: Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, Shenyang, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Lou
authors.affiliation: Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, Shenyang, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, Shenyang, China.
authors.forename: Li
authors.initials: L
authors.lastname: Tang
authors.affiliation: Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, Shenyang, China.
authors.forename: Youhe
authors.initials: Y
authors.lastname: Jin
authors.affiliation: Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, Shenyang, China.
authors.forename: Jinsong
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, Shenyang, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Abdominal Ultrasonic Diagnosis, the First Affiliated Hospital of China Medical University, Shenyang, China.
authors.forename: Qiaobei
authors.initials: Q
authors.lastname: Li
mesh_terms: D000368:Aged; D059168:Carotid Intima-Media Thickness; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*; D019245:Compressive Strength; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013314:Stress, Mechanical; D063189:Symptom Assessment; D013718:Tensile Strength
keywords: Young's modulus; shear wave elastography; symptomatic carotid plaque; ultrasound