Visual and digital analysis of the ultrasound image in a stable and progressive carotid atherosclerotic plaque

Aim: Early identification of patients at higher risk of unstable atherosclerotic plaque development is essential for successful preventive treatment. The aim of the study was to identify the duplex sonography carotid atherosclerotic plaque risk characteristics for plaque progression. Methods: All patients who underwent regular sonographic examinations within 36 months were included in the analysis. At each control, the following characteristics of the atherosclerotic plaque in the carotid artery were evaluated: maximum width, echogenicity, homogeneity, plaque surface and the presence of calcifications. Univariate and multivariate logistic regression analyses were used for the statistical evaluation. Results: Stable atherosclerotic plaques in both carotid arteries were detected in 332 patients (125 males, mean age 66.7 +/- 9.7 years). Progressive atherosclerotic plaque in at least one carotid artery was detected in 255 patients (126 males, mean age 69.5 +/- 8.3 years). Multivariate logistic regression analysis identified 3 risk factors for carotid atherosclerotic plaque progression: plaque width (increasing the risk of plaque progression within 3 years by 73.5% per 1 mm; P < 0.0001), irregular plaque surface (increasing the risk of progression by 56.4%; P = 0.007) and exulcerated plaque (increasing the risk of progression by 81.9%; P = 0.025). Conclusion: The width and irregular and exulcerated surface of the carotid atherosclerotic plaque are independent risk factors for plaque progression.