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AJNR - American Journal of Neuroradiology

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Plaque Imaging of the Internal Carotid Artery—Correlation of B-Flow Imaging with Histopathology

M. Reiter^a, R. Horvat^b, S. Puchner^a, W. Rinner^c, P. Polterauer^d,e, J. Lammer^a, E. Minar^f and R.A Bucek^a

^a University Clinic for Radiology–Department of Angiography and Interventional Radiology, Vienna General Hospital, Vienna, Austria
^b University Clinic for Histopathology, Vienna General Hospital, Vienna, Austria
^c University Clinic for Neurology, Vienna General Hospital, Vienna, Austria
^d University Clinic for Surgery, Department of Vascular Surgery, Vienna General Hospital, Vienna, Austria
^e Ludwig Boltzmann Institute of Interdisciplinary Vascular Research, Vienna General Hospital, Vienna, Austria
^f University Clinic for Internal Medicine II, Department of Angiology, Vienna General Hospital, Vienna, Austria

View larger version (64K): [in this window] [in a new window]   Fig 1. Magnified (A) BFI and (B) CDI images and (C) histologic specimen of a 78-year-old asymptomatic patient (Beletsky III, AHA II); ultrasonography was in almost perfect accordance with histologic examination results, which demonstrates a plaque with fibrous intimal cap, debris, foam cells, and cholesterol deposition. * indicates the plaque.

View larger version (51K): [in this window] [in a new window]   Fig 2. Magnified (A) BFI and (B) CDI images of a 51-year-old asymptomatic patient (Beletsky III, AHA III) indicating the regular surface on BFI and a suspected ulceration on CDI. Histopathologic examination results demonstrate the continuous integrity of the luminal surface of the plaque (C). · · · outlines the plaque, – ·· – outlines the adventitia, * indicates the plaque; arrow demonstrates the false-positive ulceration on the CDI image.

View larger version (80K): [in this window] [in a new window]   Fig 3. Magnified (A) BFI and (B) CDI images and (C) histologic specimen of a 76-year-old symptomatic patient (cerebral insult 4 weeks before imaging; Beletsky II, AHA I); imaging and histology clearly demonstrate the irregular luminal surface and the ulceration of the plaque with hemorrhage and concomitant inflammation. ··· outlines the plaque, – ·· – outlines the adventitia, * indicates the plaque; arrows demonstrate the ulcerations on BFI and CDI images.