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London, United Kingdom 2013 E-Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 261 8 Vascular imaging Assessment of Novel ShearWave Elastography Ultrasound modality to predict Carotid Plaque Vulnerability: Clinical Feasibility Study J.W. Garrard1, S Nduwayo2, T.C. Hartshorne3, A.R. Naylor4, T.G. Robinson5, K.V. Ramnarine6, Department of Cardiovascular Sciences, University of Leicester, Leicester, UNITED KING-DOM1, Department of Cardiovascular Sciences, University of Leicester, Leicester, UNITED KING-DOM2, Department of Vascular and Endovascular Surgery, University of Leicester NHS Trust,, Leicester, UNITED KINGDOM3, Department of Vascular and Endovascular Surgery, University of Leicester NHS Trust,, Leicester, UNITED KINGDOM4, Department of Cardiovascular Sciences, University of Leicester, Leicester, UNITED KINGDOM5, Department of Medical Physics, Universi-ty of Leicester NHS Trust, Leicester, UNITED KINGDOM6 Improved methods of identifying the unstable carotid plaque are required, rather than reliance on percentage stenosis and blood-flow changes clinical history. ShearWaveElastography (SWE) imag-ing is a novel method of quantifying tissue stiffness whose use is being researched in liver, breast, thyroid and many other organs. SWE may be a reliable indicator in determining plaque risk stratifi-cation and the aim of this study is to assess the feasibility of SWE in assessing carotid plaques. Patients (126) were recruited; mean age 72, 67% male. Patients underwent SWE using a Super- SonicImagineAixplorer® ultrasound system. The Young’s Modulus (YM) was recorded as an esti-mation of tissue stiffness. The YM was compared in symptomatic and asymptomatic patients, and also linked to subjective assessments of B-mode plaque echogenicity. Histological features were as-sessed in 12 patients following carotid endarterectomy excision. 94 plaques of >30% stenosis were assessed. 55 plaques were symptomatic, YM (78.6+/-4.5kPa) was significantly lower (p=0.002) than in 39 asymptomatic plaques (104+/-8.4kPa). Echolucent plaques (73+/-8.5kPa) had significantly lower YM (p=0.017) than echogenic plaques (108+/-8.3kPa). Mean inter-frame coefficient of variation (CoV) was 0.22 compared to values quoted in liver studies (rang-ing from 0.12-0.17). Demographic analysis illustrated that smokers were more likely to have carotid disease, but no factor significantly impacted YM. Echolucent appearing plaques were twice as com-mon in symptomatic patients as asymptomatic. Plaques described on histology as unstable had a lower YM than stable plaques. The use of SWE in carotid plaques is feasible, with results showing good reproducibility. YM is re-lated to symptoms, plaque appearance and histological findings and therefore may show potential clinical value in the assessment of plaque vulnerability.


Karger_ESC London_2013
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