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Histologic and Biochemical Composition of Carotid Plaque and Its Impact on Ultrasonographic Appearance

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Multi-Modality Atherosclerosis Imaging and Diagnosis

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Abstract

Carotid ultrasound has been used in research as a tool to assess plaque composition and therefore indirectly plaque stability. Plaques that are prone to rupture are lipid rich, have a larger core covered by a thin fibrous cap, and are rich in inflammatory cells that secrete enzymes that degrade the extracellular matrix. This phenotype can be reflected in the ultrasound images. Echolucent plaques have more lipid, less calcium, more inflammation, and more matrix degradation than the echogenic ones, which can explain why they are also associated with higher risk for stroke. Further studies and technical improvements are needed so that carotid ultrasound can reflect more relevant plaque characteristics that are important for the risk of rupture and implementation in clinical scenarios. In the chapter, the pathophysiology of atherosclerosis is revised, as well as plaque composition. Finally, the focus is on how ultrasound has been contributing to the characterization of plaque components in the last decades, with a glimpse on the future trends.

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Authors and Affiliations

  1. Department of Cardiology, Skåne University Hospital, Lund University, Malmö, Sweden

    Isabel Gonçalves

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  1. Isabel Gonçalves
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Correspondence to Isabel Gonçalves .

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  1. Department of Radiology, A.O.U Cagliari - Polo di Monserrato, Bivio per Sestu, Italy

    Luca Saba

  2. Instituto Superior Técnico Institute for Systems and Robotics, Lisboa, Portugal

    João Miguel Sanches

  3. Hospital de Santa Maria, Lisboa, Portugal

    Luís Mendes Pedro

  4. Stroke Research and Monitoring Division, AtheroPoint(TM) LLC, Roseville, California, USA

    Jasjit S. Suri

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Gonçalves, I. (2014). Histologic and Biochemical Composition of Carotid Plaque and Its Impact on Ultrasonographic Appearance. In: Saba, L., Sanches, J., Pedro, L., Suri, J. (eds) Multi-Modality Atherosclerosis Imaging and Diagnosis. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7425-8_16

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  • DOI: https://doi.org/10.1007/978-1-4614-7425-8_16

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