New quantification methods for carotid intra-plaque neovascularization using contrast-enhanced ultrasound

Zeynettin Akkus, Assaf Hoogi, Guillaume Renaud, Stijn C.H. van den Oord, Gerrit L. ten Kate, Arend F.L. Schinkel, Dan Adam, Nico de Jong, Antonius F.W. van der Steen, Johan G. Bosch

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


As carotid intra-plaque neovascularization (IPN) is linked to progressive atherosclerotic disease and plaque vulnerability, its accurate quantification might allow early detection of plaque vulnerability. We therefore developed several new quantitative methods for analyzing IPN perfusion and structure. From our analyses, we derived six quantitative parameters-IPN surface area (IPNSA), IPN surface ratio (IPNSR), plaque mean intensity, plaque-to-lumen enhancement ratio, mean plaque contrast percentage and number of micro-vessels (MVN)-and compared these with visual grading of IPN by two independent physicians. A total of 45 carotid arteries with symptomatic stenosis in 23 patients were analyzed. IPNSA (correlation r= 0.719), IPNSR (r= 0.538) and MVN (r= 0.484) were found to be significantly correlated with visual scoring (p < 0.01). IPNSA was the best match to visual scoring. These results indicate that IPNSA, IPNSR and MVN may have the potential to replace qualitative visual scoring and to measure the degree of carotid IPN.

Original languageEnglish
Pages (from-to)25-36
Number of pages12
JournalUltrasound in Medicine and Biology
Issue number1
StatePublished - Jan 2014
Externally publishedYes


  • Carotid plaque
  • Contrast agents
  • Contrast-enhanced ultrasound
  • Microbubbles
  • Microvessels
  • Plaque neovascularization
  • Quantification
  • Vasa vasorum


Dive into the research topics of 'New quantification methods for carotid intra-plaque neovascularization using contrast-enhanced ultrasound'. Together they form a unique fingerprint.

Cite this