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Eur J Neurol. 2016 Jul;23(7):1241-7. doi: 10.1111/ene.13017. Epub 2016 Apr 23.

Carotid plaque echogenicity predicts cerebrovascular symptoms: a systematic review and meta-analysis.

Author information

1
Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
2
Department of Biomedical Engineering - Radiation Sciences, Umeå University, Umeå, Sweden.
3
Department of Clinical Sciences, Danderyds Hospital, Karolinska Institute, Stockholm, Sweden.

Abstract

BACKGROUND AND PURPOSE:

Many reports have shown an association between hypoechoic (echolucent) carotid atherosclerotic plaques and unstable features. In this meta-analysis our aim was to determine the role of carotid plaque echogenicity in predicting future cerebrovascular (CV) symptoms.

METHODS:

Electronic databases (PubMed, MEDLINE, EMBASE and Cochrane Center Register) up to September 2015 were systematically searched. Studies with ultrasound-based characterization of carotid artery plaque echogenicity and its association with focal neurological symptoms of vascular origin were eligible for analysis. In the meta-analysis, heterogeneity was measured using I(2) statistics and publication bias was evaluated using the Begg-Mazumdar test. In addition several comparisons between subgroups were performed.

RESULTS:

Of 1387 identified reports, eight studies with asymptomatic patients and three studies with symptomatic patients were meta-analyzed. Pooled analysis showed an association between echolucent carotid plaques and future CV events in asymptomatic patients [relative risk 2.72 (95% confidence interval 1.86-3.96)] and recurrent symptoms in symptomatic patients [relative risk 2.97 (95% confidence interval 1.85-4.78)]. The association was preserved for all stenosis degrees in asymptomatic patients, whilst patients with echolucent plaques and severe stenosis were at higher risk of future events. Also, computer-assisted methods for assessment of carotid plaque echogenicity and studies analyzing ultrasound data collected after the year 2000 showed better prediction.

CONCLUSIONS:

In asymptomatic and symptomatic patients, analysis of carotid plaque echogenicity could identify those at high risk of CV events.

KEYWORDS:

carotid atherosclerosis; cerebrovascular symptoms; grey scale median; plaque echogenicity; ultrasound

PMID:
27106563
DOI:
10.1111/ene.13017
[Indexed for MEDLINE]

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