Carotid plaque Morphology: A comparison between duplex sonography and Ct angiography

Dr.Arnav Shandil; Dr Nikita Verma; Dr.Dinesh Sood; Dr Narvir S.Chauhan; Dr Ambuj Shandil

Volume : VIII, Issue : VI, June - 2019

Carotid plaque Morphology: A comparison between duplex sonography and Ct angiography

Dr. Arnav Shandil, Dr Nikita Verma, Dr. Dinesh Sood, Dr Narvir S. Chauhan, Dr Ambuj Shandil

Abstract :

Background and objectives: Cereovascular disease incidence is increasing in present day scenario with more and more people being affected by stroke. Stenosis degree is considered the leading parameter in the choice of therapeutic options but factors other than the degree of stenosis are also important in assessing whether a carotid lesion will remain clinically silent. Thus additional assessment of plaque morphologic parameters is necessary in order to better define the most correct therapeutic treatment . Some of these plaques are associated with a higher risk of embolism and occlusion, producing ischemic neurologic events.. The purpose of this study was to evaluate the diagnostic efficacy of multidetector row CT angiography (MDCTA) and Ultrasound in the evaluation of morphology of carotid plaque with MDCT being taken as reference standard Methods: Total of 30 patients with symptoms pertaining to cereovascular disease were selected over a period of one year and plaque morphology was evaluated and compared by both Doppler ultrasound and CT angiography. Results: We concluded that CDUS is inferior w.r.t CTA to assess plaque morphology and especially in identification of echogenic/mixed plaques For thrombosed, mixed/calcified plaques the co relation among the two modalities was excellent.This can be ascribed, due less resolution of usg with ightness of echogenic plaque being confused for calcification. Conclusion: We recommend the use of CDUS as a first line screening examination in a patient of cereovascular disease. However, because of its relative insensitivity in some important plaque risk determinants for example plaque ulceration and presence of echogenic plaques we recommend the use of a second more definitive screening examination like CTA prior to any intervention being undertaken (in cases of significant stenosis) in order to produce a detailed and reproducible plaque characterisation and assessment of the degree of stenosis.