Combined spatiotemporal and frequency-dependent shear wave elastography enables detection of vulnerable carotid plaques as validated by MRI

• Published in: Scientific reports 2020-01, Vol.10 (1), p.403-403, Article 403
• Main Authors: Marlevi, David, Mulvagh, Sharon L., Huang, Runqing, DeMarco, J. Kevin, Ota, Hideki, Huston, John, Winter, Reidar, Macedo, Thanila A., Abdelmoneim, Sahar S., Larsson, Matilda, Pellikka, Patricia A., Urban, Matthew W.
• Format: Article
• Language: English
• Subjects: 59; 59/57; 639/166/985; 692/308/575; Aged; Aged, 80 and over; Arteriosclerosis; Carotid Arteries - diagnostic imaging; Carotid Arteries - pathology; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - pathology; Elasticity Imaging Techniques - methods; Feasibility studies; Female; Frequency dependence; Hemorrhage; Humanities and Social Sciences; Humans; Lesions; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medicin och hälsovetenskap; Middle Aged; multidisciplinary; Plaque, Atherosclerotic - diagnostic imaging; Plaque, Atherosclerotic - pathology; Plaques; Rupture; Science; Science (multidisciplinary); Spatio-Temporal Analysis; Ultrasonic imaging; Ultrasonography - methods; Ultrasound; Velocity
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-019-57317-7

Fatal cerebrovascular events are often caused by rupture of atherosclerotic plaques. However, rupture-prone plaques are often distinguished by their internal composition rather than degree of luminal narrowing, and conventional imaging techniques might thus fail to detect such culprit lesions. In this feasibility study, we investigate the potential of ultrasound shear wave elastography (SWE) to detect vulnerable carotid plaques, evaluating group velocity and frequency-dependent phase velocities as novel biomarkers for plaque vulnerability. In total, 27 carotid plaques from 20 patients were scanned by ultrasound SWE and magnetic resonance imaging (MRI). SWE output was quantified as group velocity and frequency-dependent phase velocities, respectively, with results correlated to intraplaque constituents identified by MRI. Overall, vulnerable lesions graded as American Heart Association (AHA) type VI showed significantly higher group and phase velocity compared to any other AHA type. A selection of correlations with intraplaque components could also be identified with group and phase velocity (lipid-rich necrotic core content, fibrous cap structure, intraplaque hemorrhage), complementing the clinical lesion classification. In conclusion, we demonstrate the ability to detect vulnerable carotid plaques using combined SWE, with group velocity and frequency-dependent phase velocity providing potentially complementary information on plaque characteristics. With such, the method represents a promising non-invasive approach for refined atherosclerotic risk prediction.