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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: METHODS, RESULTS. Meshes: Aged, Aged, 80 and over, Carotid Artery, Internal, Carotid Stenosis, Critical Illness, Endarterectomy, Carotid, Female, Humans, Male, Middle Aged, Patient Selection, Predictive Value of Tests, Prospective Studies, Reproducibility of Results, Sensitivity and Specificity, Severity of Illness Index, Ultrasonography, Doppler, Duplex.
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Can carotid ultrasound predict plaque histopathology? Context: Sixty consecutive patients with symptomatic, critical carotid stenosis were prospectively studied. Plaques were classified preoperatively into one of five types based on their echogenicity and were also assessed for irregularity and ulceration. These findings were then compared with the histopathological findings of the endarterectomy specimen. Of 33 plaques considered on ultrasound to be uniformly or predominantly echolucent (unstable), 27 were found to be largely fatty or haemorrhagic (PPV =82%). Of 17 plaques considered to be predominantly echogenic (stable) on ultrasound, 11 were found to be predominantly fibrotic (PPV = 65%). Correlation between ultrasound irregularity or ulceration and histopathology was poor.
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In routine clinical practice, ultrasound can identify with reasonable accuracy, plaques that are predominantly haemorrhagic or fatty, and therefore potentially unstable. This may have future implications in selection of patients for surgery.