Atherosclerotic carotid plaques: Multimodality imaging with contrast-enhanced ultrasound, computed tomography, and magnetic resonance imaging

Figures

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  Figure 1. Box-and-whisker plot of computed tomography angiography attenuation of hypoechoic and hyperechoic plaques on B-mode ultrasound

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  Figure 2. Box-and-whisker plot of computed tomography angiography attenuation of plaques by composition on magnetic resonance imaging

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  Figure 3. Box-and-whisker plot of computed tomography angiography attenuation of plaques with (y) and without (n) neovascularization

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  Figure 4. A 71-year-old male with left middle cerebral artery stroke. Left internal carotid artery 80% stenosis. On contrast-enhanced ultrasound, moving microbubbles are seen on the shoulder of the plaque. On magnetic resonance imaging plaque imaging, it appears isointense on proton density, hypointense on T2-weighted with small hyperintense component, and hyperintense on T1-weighted and time-of-flight s/o fibrofatty plaque with a small hemorrhagic component. Surface ulceration is present

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  Figure 5. A 67-year-old male with left middle cerebral artery and middle cerebral artery-anterior cerebral artery watershed territory stroke. On computed tomography angiography (a), left internal carotid artery 80% stenosis. Plaque has attenuation of 37.6 HU. A Type 3 ulceration is present (dotted white arrows). On contrast-enhanced ultrasound, plaque neovascularization is seen with surface irregularity. On magnetic resonance imaging plaque imaging (b), plaque appears isointense on proton density and hypointense to isointense on T2-weighted. It is mildly hyperintense on T1-weighted and isointense on time-of-flight images s/o fibrofatty plaque. Surface ulceration is present