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(Stroke. 2000;31:1651.)
© 2000 American Heart Association, Inc.

Original Contributions

Three-Dimensional Ultrasound Observation of Carotid Artery Plaque Ulceration

Ulf Schminke, MD; Lillian Motsch; Lutz Hilker Christof Kessler, MD

From the Department of Neurology, Ernst Moritz Arndt University Greifswald, Greifswald, Germany.

Correspondence to Ulf Schminke, Department of Neurology, Ernst Moritz Arndt University Greifswald, Ellernholzstrasse 1-2, D-17487 Greifswald, Germany. E-mail schminke{at}neurologie.uni-greifswald.de

Background and Purpose—Carotid artery plaque ulceration is associated with an increased risk of cerebral embolism. However, because of the rather poor diagnostic quality of conventional 2-D ultrasound and angiography compared with the evaluation of pathological specimens, little information exists on the natural course of carotid plaque ulceration. Recently, the introduction of 3-D ultrasound has made reproducible investigation of plaque morphology possible, providing a reliable plaque surface analysis.

Methods—We performed 3-D ultrasound examinations of 17 carotid artery plaques with an ulcerated surface in a prospective study of 16 patients (10 men, 6 women; mean±SD age 68.9±7.1 years) over a mean observation period of 17.6±6.3 months. Exactly parallel B-mode ultrasound scans (slice distance 0.1 mm) were acquired with a 5-MHz linear array probe clamped in a carriage device and driven by a mechanical step motor. The recorded images were reconstructed into a volumetric data set in a Cartesian coordinate system.

Results—At the end of the observation period, surface configuration had changed in 4 cases (23.5%). Plaque ulceration regressed in 3 cases, whereas ulcer progression occurred in 1 case. The remaining 13 plaques (76.5%) showed an unchanged surface configuration.

Conclusions—Through the use of 3-D ultrasound, it is possible to noninvasively examine the regression and progression of carotid artery plaque ulceration.

Key Words: atherosclerosis • carotid artery • ulcer • ultrasonography

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