Correlation of carotid plaque neovascularization detected by using contrast-enhanced US with clinical symptoms

Radiology. 2009 May;251(2):583-9. doi: 10.1148/radiol.2512081829. Epub 2009 Mar 20.


Purpose: To determine the correlation between the degree of plaque enhancement with contrast agent microbubbles and clinical symptoms in patients with carotid atherosclerotic plaque.

Materials and methods: The study was approved by the hospital ethical committee, and informed consent was obtained from all patients. One hundred four patients (83 men: mean age, 64 years +/- 9 [standard deviation]; 21 women: mean age, 61 years +/- 10) with carotid plaques were studied with standard and contrast material-enhanced ultrasonography (US). Contrast enhancement in the plaque was evaluated with visual interpretation and quantitative analysis.

Results: Among the 104 patients, 35 (34%) had transient ischemic attack and/or cerebrovascular ischemic stroke. Plaque enhancement was found in 28 (80%) of 35 symptomatic patients and in 21 (30%) of 69 asymptomatic patients (P < .001). Enhanced intensity in the plaque (13.9 dB +/- 6.4) and the ratio of enhanced intensity in the plaque to that in the lumen of the carotid artery (0.54 +/- 0.23) in symptomatic patients were significantly greater than those in asymptomatic patients (8.8 dB +/- 5.2 [P < .001] and 0.33 +/- 0.19 [P < .001], respectively). Sensitivity and specificity were 74% and 62%, respectively, for enhanced intensity in the plaque (cutoff value, 10.0 dB) and 74% and 75%, respectively, for ratio of enhanced intensity in the plaque to that in the lumen of the carotid artery (cutoff value, 0.46).

Conclusion: Symptomatic patients had more intense contrast agent enhancement in the plaque than asymptomatic patients, suggesting that contrast-enhanced carotid US may be used for plaque risk stratification.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carotid Stenosis / diagnostic imaging*
  • Contrast Media
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neovascularization, Pathologic / diagnostic imaging*
  • Phospholipids*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Statistics as Topic
  • Sulfur Hexafluoride*
  • Ultrasonography


  • Contrast Media
  • Phospholipids
  • contrast agent BR1
  • Sulfur Hexafluoride