Preoperative detection of the composition of atherosclerotic plaque in the carotid artery using ultrasonography and magnetic resonance imaging.

Preoperative identification of the components of atherosclerotic plaque was attempted using ultrasonography in five patients and magnetic resonance (MR) imaging in three patients before carotid endarterectomy. The correlation between surgical and histological findings, and preoperative ultrasonography and MR imaging was evaluated. Plaque consisting predominantly of calcification appeared as bright echo on ultrasonography and was tough. Plaque consisting predominantly of hemorrhage was echolucent, appeared as low intensity on T2-weighted MR images and was fragile. Such preoperative assessment of plaque composition using ultrasonography and MR imaging is useful for manipulation of atherosclerotic plaque during carotid endarterectomy.