Soft plaque検出における頸動脈エコーと高分解能MRIとの比較

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  • Comparison of Carotid Ultrasonography and High-resolution MRI for Detecting Soft Plaque

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It is very important to detect soft plaque in cerebral blood vessels because in most cases it is unstable and can be a potential cause of ischemic stroke. The purpose of this study was to compare carotid ultrasonography and high-resolution MRI for detecting soft plaque. We studied 24 consecutive patients (25 vessels) who underwent carotid endarterectomy (CEA) between April 2003 and October 2005. Ultrasonography and MRI examinations were conducted to identify plaque components prior to CEA in all cases. Pathohistologically, the plaque was lipid-rich in 16 cases, among which 12 lesions appeared hypoechoic on ultrasonography and 15 were diagnosed as soft plaque by MRI. Futhermore, intraplaque hemorrhage and a fibrous cap were identified by MRI. Sensitivity for detecting soft plaque was 75.0% for ultrasonography and 93.8% for MRI. In cases showing marked calcification or tortuousity of the carotid artery or when the lesion is located in a high position, it may be difficult to identify the plaque component by ultrasonography alone. High-resolution MRI is very useful in such cases. Although carotid ultrasonography is a useful and noninvasive technique, particularly for screening or follow-up, more accurate diagnosis of the plaque component can be achieved using high-resolution MRI.

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