Assessment of subclinical atherosclerosis using contrast-enhanced ultrasound

Stijn C.H. Van Den Oord, Gerrit L. Ten Kate, Zeynettin Akkus, Guillaume Renaud, Eric J.G. Sijbrands, Folkert J. Ten Cate, Aad Van Der Lugt, Johan G. Bosch, Nico De Jong, Antonius F.W. Van Der Steen, Arend F.L. Schinkel

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Aims: The sensitivity of standard carotid ultrasound and colour Doppler for the detection of subclinical atherosclerotic plaques is suboptimal. The aim of this study is to assess whether contrast-enhanced ultrasound (CEUS) added to standard carotid ultrasound improves the detection of subclinical atherosclerosis. Methods and results: Carotid intima-media thickness (CIMT) measurement, standard carotid ultrasound including colour Doppler imaging, and CEUS were performed in 100 asymptomatic patients with one or more risk factors for atherosclerosis. CEUS was performed using intravenous administration of SonoVue™ contrast agent (Bracco S.p.A., Milan, Italy). CIMT, standard ultrasound, colour Doppler, and CEUS were reviewed by two independent observers. Standard ultrasound, colour Doppler, and CEUS were scored for the presence of atherosclerotic plaques. Subclinical atherosclerosis was diagnosed if patients had a CIMT above their age-corrected threshold value or if atherosclerotic plaques were present on standard carotid ultrasound clips or CEUS clips. McNemar's test was performed to compare between groups. Twenty-one patients (21%) had a thickened CIMT value and were considered to have subclinical atherosclerosis. Standard carotid ultrasound including colour Doppler demonstrated atherosclerotic plaques in 77 patients (77%). The addition of CEUS to the standard ultrasound protocol demonstrated atherosclerotic plaques in 88 patients (88%). The incorporation of CEUS into the standard carotid ultrasound protocol resulted in a significantly improved detection of patients with subclinical atherosclerosis (P < 0.01). Conclusion: CEUS has an incremental value for the detection of subclinical atherosclerosis in the carotid arteries. Atherosclerotic plaques which were only detected with CEUS and not with standard carotid ultrasound and colour Doppler imaging were predominantly hypoechoic. All rights reserved.

Original languageEnglish (US)
Pages (from-to)56-61
Number of pages6
JournalEuropean heart journal cardiovascular Imaging
Volume14
Issue number1
DOIs
StatePublished - Jan 2013

Keywords

  • Atherosclerosis
  • Carotid ultrasound
  • Contrast-enhanced ultrasound
  • Intima-media thickness

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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