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J Cardiovasc Echogr. 2018 Oct-Dec;28(4):218-227. doi: 10.4103/jcecho.jcecho_57_18.

Three-Dimensional Echographic Evaluation of Carotid Artery Disease.

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Department of Medical, Surgical, Molecular and Critical Area Pathology, Pisa University, Pisa, Italy.
Department of Cardiac, Thoracic and Vascular, Pisa University, Pisa, Italy.
Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy.
Department of Translational Research and New Technologies in Medicine and Surgery, Pisa University, Pisa, Italy.


The introduction of three-dimensional echography (3D echo) in vascular field is not recent, but it still remains a seldom-used technique because of the costs of ultrasound probe and the need of dedicated laboratories. Therefore, despite significant prognostic implications, the high diagnostic accuracy in plaque definition, and the relative ease of use, 3D echo in vascular field is a niche technique. The purpose of this review is mainly clinical and intends to demonstrate the potential strength of a 3D approach, including technical aspects, in order to present to clinicians and imagers the appealing aspects of a noninvasive and radiation-free methodology with relevant diagnostic and prognostic correlates in the assessment of carotid atherosclerosis. A comprehensive literature search (since 1990s to date) using the PubMed, MEDLINE, and Cochrane libraries databases has been conducted. Articles written in English have been assessed, including reviews, clinical trials, meta-analyses, and interventional/observational studies. Manual cross-referencing was also performed, and relevant references from selected articles were reviewed. The search was limited to studies conducted in humans. Search terms, retrieved also with PubMed Advanced search and AND/OR Boolean operators (mainly in title and abstract), included three-dimensional, echo, stroke/transient ischemic attack, predictors, carotid, imaging, and biomarkers.


Carotid atherosclerosis; color Doppler ultrasound; internal carotid artery stenosis; three-dimensional ultrasound imaging; total plaque volume

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