Quest for the Vulnerable Atheroma: Carotid Stenosis and Diametric Strain--A Feasibility Study

Ultrasound Med Biol. 2016 Mar;42(3):699-716. doi: 10.1016/j.ultrasmedbio.2015.11.002. Epub 2015 Dec 23.

Abstract

The Bernoulli effect may result in eruption of a vulnerable carotid atheroma, causing a stroke. We measured electrocardiography (ECG)-registered QRS intra-stenotic blood velocity and atheroma strain dynamics in carotid artery walls using ultrasonic tissue Doppler methods, providing displacement and time resolutions of 0.1 μm and 3.7 ms. Of 22 arteries, 1 had a peak systolic velocity (PSV) >280 cm/s, 4 had PSVs between 165 and 280 cm/s and 17 had PSVs <165 cm/s. Eight arteries with PSVs <65 cm/s and 4 of 9 with PSVs between 65 and 165 cm/s had normal systolic diametric expansion (0% and 7%) and corresponding systolic wall thinning. The remaining 10 arteries had abnormal systolic strain dynamics, 2 with diametric reduction (>-0.05 mm), 2 with extreme wall expansion (>0.1 mm), 2 with extreme wall thinning (>-0.1 mm) and 4 with combinations. Decreases in systolic diameter and/or extreme systolic arterial wall thickening may indicate imminent atheroma rupture.

Keywords: Atheroma; Atherosclerosis; Carotid; Strain; Tissue Doppler; Vasa plaquorum; Vasa vasorum; Vulnerable plaque.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Blood Flow Velocity
  • Cardiac-Gated Imaging Techniques / methods
  • Carotid Stenosis / diagnostic imaging*
  • Carotid Stenosis / physiopathology*
  • Elastic Modulus
  • Elasticity Imaging Techniques / methods*
  • Feasibility Studies
  • Humans
  • Image Enhancement / methods
  • Image Interpretation, Computer-Assisted / methods
  • Perfusion Imaging / methods*
  • Plaque, Atherosclerotic / diagnostic imaging*
  • Plaque, Atherosclerotic / physiopathology*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Vascular Stiffness