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Ultrasound methods of imaging atherosclerotic plaque in carotid arteries: examinations using contrast agents

Andrzej Fedak
Andrzej Fedak
, 
Robert Chrzan
Robert Chrzan
, 
Ositadima Chukwu
Ositadima Chukwu
 and 
Andrzej Urbanik
Andrzej Urbanik
   | Sep 28, 2020
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Article Category: research-article
Published Online: Sep 28, 2020
Page range: 191 - 200
Received: Mar 23, 2020
Accepted: Jul 11, 2020
DOI: https://doi.org/10.15557/jou.2020.0032
Keywords
© 2021 Polish Ultrasound Society. Published by Medical Communications Sp. z o.o.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Fig. 1.

A “natural history” of atherosclerotic plaque; Virmani–Burke (MRI) (12–14)
A “natural history” of atherosclerotic plaque; Virmani–Burke (MRI) (12–14)

Fig. 2.

Atherosclerotic plaque with signs of neovascularisation: a diagram
Atherosclerotic plaque with signs of neovascularisation: a diagram

Fig. 3.

Electron microscopic image of SonoVue microbubbles
Electron microscopic image of SonoVue microbubbles

Fig. 4.

Image of resonant frequency wave reception during the procedure (diy.audio.pl)
Image of resonant frequency wave reception during the procedure (diy.audio.pl)

Fig. 5.

A diagram of mutual interaction between ultrasounds and microspheres
A diagram of mutual interaction between ultrasounds and microspheres

Fig. 6.

MI <0.4; microsphere oscillation
MI <0.4; microsphere oscillation

Fig. 7.

Intermediate MI of 0.4–0.8; microsphere resonance
Intermediate MI of 0.4–0.8; microsphere resonance

Fig. 8.

MI >0.8; microsphere wall rupture
MI >0.8; microsphere wall rupture

Fig. 9.

Type (class) I atherosclerotic plaque, not visible on B-mode imaging, diagnosed using superb microvascular imaging (SMI) (present authors’ material)
Type (class) I atherosclerotic plaque, not visible on B-mode imaging, diagnosed using superb microvascular imaging (SMI) (present authors’ material)

Fig. 10.

CEUS, arterial phase, vessel lumen filling: well visible vessel lumen–plaque boundary; red arrow – plaque neovessel; yellow arrow – mechanical index value (present authors’ own material)
CEUS, arterial phase, vessel lumen filling: well visible vessel lumen–plaque boundary; red arrow – plaque neovessel; yellow arrow – mechanical index value (present authors’ own material)

Fig. 11.

Badanie CEUS – faza żylna, wypełnienie światła naczynia – zatarta granica światło naczynia–blaszka; strzałka niebieska – wartość MI, strzałka biała – obszar badanej blaszki (materiał własny)
Badanie CEUS – faza żylna, wypełnienie światła naczynia – zatarta granica światło naczynia–blaszka; strzałka niebieska – wartość MI, strzałka biała – obszar badanej blaszki (materiał własny)

Fig. 12.

CEUS: microcirculation phase. Obliterated vessel lumen– plaque boundary; black arrow – plaque area under examination, red arrow – MI value (present authors’ own material)
CEUS: microcirculation phase. Obliterated vessel lumen– plaque boundary; black arrow – plaque area under examination, red arrow – MI value (present authors’ own material)

Fig. 13.

Late phase, replenish mode, black arrow – plaque–vessel wall boundary, blue arrow – plaque–vessel lumen boundary, red arrow – MI value (present authors’ own material)
Late phase, replenish mode, black arrow – plaque–vessel wall boundary, blue arrow – plaque–vessel lumen boundary, red arrow – MI value (present authors’ own material)

Fig. 14.

CEUS using the classic method: visible contrast agent microsphere echoes in atherosclerotic plaque’s topography on the posterior wall of the vessel; black arrow – image of plaque with UEA echoes, red arrow – MI value (present authors’ own material)
CEUS using the classic method: visible contrast agent microsphere echoes in atherosclerotic plaque’s topography on the posterior wall of the vessel; black arrow – image of plaque with UEA echoes, red arrow – MI value (present authors’ own material)

Fig. 15.

CEUS using the modified classic method; red arrows – atherosclerotic plaque, blue arrow – time of contrast agent administration, yellow arrow – MI value (present authors’ own material)
CEUS using the modified classic method; red arrows – atherosclerotic plaque, blue arrow – time of contrast agent administration, yellow arrow – MI value (present authors’ own material)

Fig. 16.

CEUS using the transient method: visible echoes of the contrast agent in atherosclerotic plaque’s topography on the posterior wall of the vessel, GWN type (class) III circular plaque. A. Time: 33 sec from administration. B. Time: 111 sec from UEA administration; black arrow – plaque area with contrast agent echoes, blue arrow – image of the method, red arrow – MI (present authors’ own material)
CEUS using the transient method: visible echoes of the contrast agent in atherosclerotic plaque’s topography on the posterior wall of the vessel, GWN type (class) III circular plaque. A. Time: 33 sec from administration. B. Time: 111 sec from UEA administration; black arrow – plaque area with contrast agent echoes, blue arrow – image of the method, red arrow – MI (present authors’ own material)

Fig. 17.

CEUS using the TMIP method, replenish-flash mode: visible echoes of the contrast agent in atherosclerotic plaque’s topography on the posterior wall of the vessel, GWN type (class) I plaque. A. Before PD pulse. B. During the pulse. C. After PD pulse; white arrow – atherosclerotic plaque with contrast agent echoes; red arrow – MI value during the scan; blue arrow – indication of the method (present authors’ own material)
CEUS using the TMIP method, replenish-flash mode: visible echoes of the contrast agent in atherosclerotic plaque’s topography on the posterior wall of the vessel, GWN type (class) I plaque. A. Before PD pulse. B. During the pulse. C. After PD pulse; white arrow – atherosclerotic plaque with contrast agent echoes; red arrow – MI value during the scan; blue arrow – indication of the method (present authors’ own material)

Fig. 18.

Evaluation of the change of plaque enhancement with the contrast agent on GSM analysis. Red arrow – ROI, yellow and blue arrows – GSM values (present authors’ own material)
Evaluation of the change of plaque enhancement with the contrast agent on GSM analysis. Red arrow – ROI, yellow and blue arrows – GSM values (present authors’ own material)
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