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In vivo measurement of plaque neovascularisation and thermal heterogeneity in intermediate lesions of human carotid arteries
  1. Konstantinos Toutouzas1,
  2. Maria Drakopoulou1,
  3. Constantina Aggeli1,
  4. Charalampia Nikolaou1,
  5. Ioannis Felekos1,
  6. Haralampos Grassos1,
  7. Andreas Synetos1,
  8. Konstantinos Stathogiannis1,
  9. Antonis Karanasos1,
  10. Eleftherios Tsiamis1,
  11. Elias Siores2,
  12. Christodoulos Stefanadis1
  1. 1First Department of Cardiology, Hippokration Hospital, Athens, Greece
  2. 2Centre for Materials Research & Innovation, University of Bolton, Bolton, UK
  1. Correspondence to Professor Konstantinos Toutouzas, First Department of Cardiology, Hippokration Hospital, 26 Karaoli and Dimitriou str., Holargos, Athens 15562, Greece; ktoutouz{at}


Objectives Both neoangiogenesis and inflammation contribute in atherosclerosis progression. Contrast-enhanced ultrasound (CEUS) provides visualisation of plaque neovascularisation. Microwave radiometry (MR) allows in vivo non-invasive measurement of temperature of tissues, reflecting inflammatory activation. We assessed the association of carotid plaque temperature, measured by MR, with plaque neovascularisation assessed by CEUS in intermediate lesions.

Methods Consecutive patients with coronary artery disease and carotid atherosclerosis underwent carotid ultrasound imaging, CEUS and MR. Plaque texture, plaque surface and plaque echogenicity were analysed. Contrast enhancement (CE) by CEUS was defined as the % percentage of signal intensity difference, prior and post contrast infusion. Thermal heterogeneity (ΔT) was assigned as maximal temperature along the carotid artery minus minimum.

Results Eighty-six carotid arteries of 48 patients were included. Fatty plaques had higher CE% and ΔT compared with mixed and calcified (p<0.01 for all comparisons). Heterogeneous plaques had higher CE% and ΔT compared with homogenous (p<0.01 for all comparisons). Plaques with irregular surface had higher CE% and ΔT compared with plaques with regular (p<0.01 for all comparisons). There was a good correlation between ΔT and CE (R=0.60, p<0.001).

Conclusions Carotid plaque neovascularisation on CEUS examination is associated with increased thermal heterogeneity and ultrasound characteristics of plaque vulnerability in intermediate lesions.

  • Imaging And Diagnostics

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