Original Article
Lipid-rich carotid artery plaques appear echolucent on ultrasound B-mode images and may be associated with intraplaque haemorrhage*

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Objective:

To relate the histological composition of carotid artery plaques with morphology as evaluated by B-mode ultrasound.

Design:

Prospective study.

Material and Methods:

Seventy-eight symptomatic patients underwent carotid end-arterectomy after preoperative ultrasound Duplex scanning evaluating plaque morphology. Morphometric analysis of the removed specimen was performed in order to quantify content of lipid, haemorrhage, calcification and fibrous tissue.

Results:

Echolucent plaques contained more lipid (p = 0.01) and less calcification (p = 0.01) and fibrous tissue (p = 0.03) than echo-rich plaques. Intraplaque haemorrhage was directly related to lipid content (p = 0.004) and inversely related to amount of fibrous tissue in the plaque (p = 0.02).

Conclusion:

The intensity of the reflected B-mode ultrasound signal appears related to the histological composition of the plaque. The association between intraplaque haemorrhage and a high lipid content may support the theory of the lipid-rich plaque being more prone to rupture.

Key Words

Carotid plaque morphology
B-mode ultrasound
Histological examination

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*

This paper was presented at the 10th International Symposium on Cerebral Hemodynamics, Munich, Germany, 29 August-1 September 1996.