ArticleEuropean radiology2019
A comparative study of color Doppler imaging and contrast-enhanced ultrasound for the detection of ulceration in patients with carotid atherosclerotic disease.
Article in European radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Diagnostic performance of MRI for detecting intraplaque hemorrhage in the carotid arteries: a meta-analysis.European radiology · 2019Pooled it
- Synchronous wearable ultrasound for early detection of coronary and carotid artery comorbidity.Science advances · 2026Article
- Angiogenesis within atherosclerotic plaques: Mechanical regulation, molecular mechanism and clinical diagnosis.Mechanobiology in medicine · 2025Review
- Contrast-Enhanced Ultrasound Feasibility in Assessing Carotid Plaque Vulnerability-Narrative Review.Journal of clinical medicine · 2023Review
- New Technologies in the Assessment of Carotid Stenosis: Beyond the Color-Doppler Ultrasound-High Frame Rate Vector-Flow and 3D Arterial Analysis Ultrasound.Diagnostics (Basel, Switzerland) · 2023Review
- Novel ultrasound techniques in the identification of vulnerable plaques-an updated review of the literature.Frontiers in cardiovascular medicine · 2023Review
- Advances in Noninvasive Carotid Wall Imaging with Ultrasound: A Narrative Review.Journal of clinical medicine · 2022Review
- Impact of H-Type Hypertension on Intraplaque Neovascularization Assessed by Contrast-Enhanced Ultrasound.Journal of atherosclerosis and thrombosis · 2022Article
- The utility of ultrasound and computed tomography in the assessment of carotid artery plaque vulnerability-A mini review.Frontiers in cardiovascular medicine · 2022Review
- Carotid Atherosclerosis, Ultrasound and Lipoproteins.Biomedicines · 2021Review
- Review of imaging biomarkers for the vulnerable carotid plaque.JVS-vascular science · 2021Review
- Ultrasonic Imaging of Carotid Inflammatory Plaque with Superparamagnetic Nanoparticles.Computational and mathematical methods in medicine · 2021Article
- Ultrasound Assessment of Extracranial Carotids and Vertebral Arteries in Acute Cerebral Ischemia.Medicina (Kaunas, Lithuania) · 2020Review
- Ultrasound methods of imaging atherosclerotic plaque in carotid arteries: examinations using contrast agents.Journal of ultrasonography · 2020Article
- Contrast imaging ultrasound for the detection and characterization of carotid vulnerable plaque.Cardiovascular diagnosis and therapy · 2020Review
- Ultrasonography of vulnerable atherosclerotic plaque in the carotid arteries: B-mode imaging.Journal of ultrasonography · 2020Article
- General principles and overview of vascular contrast-enhanced ultrasonography.Ultrasonography (Seoul, Korea) · 2020Article
- Carotid plaque composition by CT angiography in asymptomatic subjects: a head-to-head comparison to ultrasound.European radiology · 2019Article
- An Ultrasonographic Multiparametric Carotid Plaque Risk Index Associated with Cerebrovascular Symptomatology: A Study Comparing Color Doppler Imaging and Contrast-Enhanced Ultrasonography.AJNR. American journal of neuroradiology · 2019Observational
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
objectivesTo evaluate the diagnostic accuracy of color Doppler imaging (CDI) and contrast-enhanced ultrasound (CEUS) for diagnosing carotid ulceration, having multi-detector computed tomography angiography (MDCTA) as the reference method.
methodsPatients with carotid disease referred for ultrasound (US), either due to the occurrence of neurovascular symptoms or for screening purposes, were included in this study if at least one plaque causing moderate (50-69%) or severe (70-99%) internal carotid artery stenosis was detected. Carotid US with CDI technique, CEUS, and MDCTA were performed in all patients, investigating the presence of ulceration. The agreement between modalities was evaluated using kappa statistics.
resultsThe study population included 54 patients (median age 62 years, inter-quartile range 16.2) and 66 carotid arteries. The mean degree of stenosis was 68.5% (SD 12.2%) while 47.1% of plaques were symptomatic. MDCTA characterized 28.8% of plaques as smooth, 45.5% irregular, and 24.3% ulcerated. Flow reversal was detected with CDI in 65.5% of ulcerations, while swirling of the microbubbles and neovessels adjacent to the ulcer were detected with CEUS in 17.64%. The agreement for ulceration diagnosis was moderate between CDI and CEUS (kappa 0.473) and between CDI and MDCTA (kappa 0.473) and very good between CEUS and MDCTA (kappa 0.921). The sensitivity, specificity, and positive and negative predictive values of CDI for the diagnosis of ulceration were 41.2%, 97.95%, 87.5%, 82.8% respectively, while CEUS respective measures were 94.1%, 97.95%, 94.1%, and 97.95%.
conclusionCEUS outperformed CDI in terms of agreement with MDCTA and diagnostic accuracy for the diagnosis of ulcerated carotid plaque. KEY POINTS: • Superficial ulceration is a significant feature of carotid plaque vulnerability. • Color Doppler imaging has the potential to demonstrate carotid plaque ulceration but is characterized by limited sensitivity and moderate agreement with the reference method of multi-detector computed tomography angiography. • Contrast-enhanced ultrasound outperforms color Doppler imaging in terms of sensitivity for the detection of carotid plaque ulceration and in agreement with the reference method of multi-detector computed tomography angiography.
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