Evaluation of carotid artery stenosis using three-dimensional ultrasonography

Background : We evaluated carotid artery stenosis using a three-dimensional (3D) ultrasound (US) imaging system.Methods : Fifty-one patients who underwent magnetic resonance angiography (MRA) (n = 48), computed tomographic angiography (CTA) (n = 17), or digital subtraction angiography (DSA) (n = 11), as well as 3D-US imaging, were studied. The imaging machines employed were the Voluson 730 Expert (GE) for US imaging, Signa HDxt (GE) for MRA, Light Speed VCT (GE) for CTA, and Innova 3131 (GE) for DSA. 3D-US images along with 2D-US images were compared with the imaging data obtained by MRA, CTA, or DSA.Results : Static 3D-US images obtained using B mode demonstrated plaque as a total structure, and those obtained using color or power Doppler showed a flow image resembling that of 3D-CTA or DSA. Real time 3D-US images obtained using B mode demonstrated mobile plaque as a total structure. US imaging was superior to MRA for detection of mild carotid artery stenosis and plaque ulceration. Mobile plaque was demonstrated only in US images. Detection of high cervical lesions or calcified lesions was difficult by US imaging.Conclusion : 3D-US imaging with 2D-US is useful for demonstrating carotid artery stenosis as a total structure, as well as for detection of ulceration and mobile plaque.