Comparative study of non-invasive imaging evaluation on the stability of carotid atherosclerotic plaque

Objective This study will discuss the accuracy of the ultrasound, CT and magnetic resonance imaging(MRI) assessing of the stability of carotid plaques, and carries on the comparative analysis of the accuracy of three kinds of inspections. Methods We collected 60 complete carotid atherosclerotic plaques after carotid endarterectomy (CEA). And the pathological specimens were analyzed by gross and microscopic pathology analysis, about the diagnosis of each composition and stability. We collected the diagnostic results of plaque components and stability of carotid from color doppler ultrasound (CDUS), Computed tomographic angiography(CTA) and enhanced MRI(e-MRI) respectively. Take plaque pathology as the gold standard, we studied the diagnostic accuracy of the three inspections, with comparative analysis of three inspections to show strengths and weaknesses of them. Results The diagnostic accuracy of vulnerable plaque of CDUS, CTA, e-MRI was 51.7%, 16.7%, 81.7% respectively. In the assessment of thinness of fibrous cap, ultrasound and CTA can not achieve, the diagnostic accuracy of e-MRI was 63.3%. In the assessment of completeness of fibrous cap and thrombosis, CTA can not achieve, and the diagnostic accuracy of CDUS and e-MRI was almost equal. Diagnosis of ulcer formation of three diagnostic rates was 63.3%, 70.0%, 73.3% respectively. For the diagnosis of plaque hemorrhage, CTA was incapable, the diagnosis rate of CDUS and e-MRI was 25% and 60% respectively. The coincidence rate of three examination’s diagnosis about calcification was 80%, 80% and 71.7% respectively. Conclusions Three kinds of non-invasive imaging inspections of carotid artery plaque have their own advantages and disadvantages on the stability assessment. In the overall stability assessment, e-MRI holds the highest coincidence rate, followed by CDUS. At some point, CTA can help clinical evaluation in ulcer. Key words: Non-invasive; Carotid artery; Atherosclerotic plaque; Stability