214 unit 1 pt 3 carotid plaque & pathology

Atherosclerosis is an -

accumulation of lipids, white blood cells and cell debris in the inner wall of the arterial wall

when plaque ruptures or breaks off it may cause -

• stenosis or a blocking

• blood clotting (thrombosis) leading to an abrupt closure of an artery

early plaque detection sign -

thickening of the intima and media layers

As tunica intima and media cannot be distinguished from one another the combined -

intima-media thickness is measured

the intima-media thickness measurement can provide -

valuable information about the amount of atherosclerosis present in the arterial wall

Intima & adventitia produce -

parallel echogenic lines

media produces -

hypoechoic in between intima and adventita

normal measurement for the intima media layer is -

0.9mm or less

plaque is most accurately evaluated with -

gray scale (2D image)

plaque assessment -

• vulnerable vs unstable plaque

• location

• extent

• severity

most accurate way to image plaque in a -

transverse view

uncomplicated -

stable

complicated -

unstable

uncomplicated plaque -

• stable

• uniform composition

• intact fibrous cap

complicated plaque -

• unstable

• large

• not uniform consistency

-ulcerated

-hemorrhaging

texture of plaque -

• homogenous

• heterogenous

Plaque surface (fibrous cap): Smooth -

surface appears continuous with no irregularities

Plaque surface (fibrous cap): Irregular -

• surface is discontinuous, may have multiple echo’s present

• possible ulcerations on surface

for carotid compare echogenicity to -

sternocleidomastoid muscle

Anechoic plaque echgenicity -

fresh thrombus

low echogenicity -

less echogenic than sternocleidomastoid muscle

strong echogenicity’s (hyperechoic) -

calcifications

intraplaque hemorrhage: thick cap -

less likely to break off and become an embolism

intraplaque hemorrhage: thin cap -

more likely to break off and become an embolism

plaque ulceration -

cavity within plaque

• > or equal to 2 mm to be considered a defect