Comparison of ultra-high frequency US with Contrast Enhanced MR Angiography and conventional US: evaluation of carotid atheromatous plaques and bioethical decision making.

Background and aim: The methods routinely used for the study of atherosclerotic plaque include conventional ultrasound (US) and Magnetic Resonance Imaging (MRI), and Computed Tomography (CT), each one with its own strength and weak points. The aim of this study is to investigate diagnostic capabilities of high frequency ultrasound (HFUS) in order to provide a close and accurate inspection of atherosclerotic plaque, evaluating the characteristics that can categorize it as stable or unstable.

Method: A total of 20 subjects (10 male, 10 female) were enrolled in order to assess presence/absence of carotid plaque by the use of Conventional US. All enrolled patients resulting positive for plaques presence at Color Doppler US examination underwent to Ultra High-frequency ultrasound exam, using a linear-array 48 MHz transducer, and Contrast MRI Angiography examination of the carotid arteries using a 1.5 Tesla scanner.

Results: HFUS could assess specific size ranges for the plaque and the lipid core. Conventional US and CEMRA failed the measurement of FC Thickness in 75% of cases, while HFUS could assess them precisely, experiencing specific values.

Conclusion: HFUS has proved to be reliable in defining the qualitative and quantitative values of plaque, highlighting, in a finer way, the characteristics of vulnerability.