Abstract 14444: Characterization of Carotid Atherosclerotic Plaque Vulnerability Using Novel Ultrasound Methods: A Comparison Study of Microbubble Contrast-Enhanced Ultrasound, Shear Wave Elastography Ultrasound and Magnetic Resonance Imaging
Introduction: Microbubble contrast-enhanced ultrasound (CEUS) detects intraplaque neovascularization (IPN) associated with plaque vulnerability. Shear wave elastography (SWE) assesses mechanical stiffness of tissues by measuring shear wave speed (SWS), traveling faster in stiffer tissues.
Hypothesis: We explored if parameters derived from CEUS and SWE associate with plaque components determined by MRI.
Methods: Patients with known or suspected cardiovascular disease were recruited to undergo carotid CEUS, SWE and MRI. CEUS was performed with low mechanical index (<0.20) imaging during Optison infusion. IPN was graded by microbubble location and kinetics. Longitudinal and transverse SWS (L_S, T_S) and L_S to T_S ratio (LTR) were measured. Plaque features including lipid-rich necrotic core (LRNC), loose matrix (LM), intraplaque hemorrhage (IPH) were assessed by 3.0T carotid MRI; proportion of LRNC and LM volume to total wall volume was determined.
Results: 40 patients (34 male; 68 ± 9 yrs), 73 plaques were studied (Table 1). In plaques with IPN by CEUS, T_S was 13% lower, and LTR was 19% higher; this effect was more noticeable in thicker plaques (≥3 mm). 27 plaques were analyzed by MRI; there was a trend for more LM and less LRNC in plaques with IPN. IPN was present in all plaques with IPH (p=0.03). T_S positively correlated to %volume LRNC and negatively correlated to %volume LM, while LTR had opposite trend (Fig. 1).
Conclusion: CEUS, SWE and MRI characterization of carotid plaques is feasible. “Soft” (lower T_S by SWE) plaques have IPN by CEUS, and more IPH and LM by MRI, while “stiff” (higher T_S) plaques have no IPN by CEUS, and have LRNC by MRI. Combining these novel ultrasound methods may permit rapid and efficient noninvasive plaque characterization with determination of vulnerability or healing.
Author Disclosures: R. Huang: Research Grant; Significant; GE healthcare investigator initiated trial. M.W. Urban: None. J. DeMarco: None. W. Brinjikji: None. H. Ota: None. J. Huston: None. T.A. Macedo: None. E.J. Dailey: None. M.E. Hagen: None. S.L. Mulvagh: Research Grant; Modest; GE healthcare investigator initiared trial.
- © 2016 by American Heart Association, Inc.