Abstract
Carotid ultrasonography (CUS) is essential for evaluating the carotid artery lesion in the following reasons. First, CUS is useful as a screening examination for patients with risk factors, because of its noninvasiveness and feasibility. Patients with hypertension, DM, hyperlipidemia or cardiovascular diseases have frequently progressive carotid artery lesions. CUS is recommended in patients with such risk factor who are symptom. Second, CUS is used to follow up carotid artery lesions, because of its non-invasiveness. Carotid artery stenosis often progresses increasing stroke risks, while the stenosis is retracted in some patients. Third, CUS can evaluate the nature of plaque not only morphologically but also pathologically. Plaques are classified into echolucent, echogenic and hyperechoic from their echogenesity, and these classifications reflect atheroma/thrombus, fibrous tissue and calcification, respectively. Such tissue characterization is useful to evaluate the plaque vulnerability. Forth, CUS allows us to recognize the plaque mobility. Recently some plaques were found to strain with heartbeat, although the existence of floating thrombus attached to plaques has been known for many years. Strained plaques are considered reflect acute intra-plaque hemorrhage, and this finding is the serious sign of unstable plaque.
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