M.G. TUKHBATULLIN¹, N.I. BAYAZOVA², N.R. ZAKIRZHANOV², G.E. YAROSHKEVICH², I.F. SHARAFISLAMOV²

¹ KSMA – Branch Campus of the FSBEI FPE RMACPE MOH Russia , 36 Butlerov Str., Kazan, Russian Federation, 420012

² Municipal Clinical Hospital No. 7, 54 Chuikov Str., 420103, Kazan, Russian Federation

Tukhbatullin M.G. ― D. Med. Sc., Professor, Head of Department of Ultrasound Diagnostics, tel. +7-987-275-15-51, e-mail: Munir.Tuhbatullin@tatar.ru

Bayazova N.I. ― doctor of the Department of Ultrasound Diagnostics, tel. +7-965-588-54-52, e-mail: natalibayzova70@dmail.com

Zakirzhanov N.R. ― doctor of the Department of Vascular Surgery, tel. +7-965-588-54-52, e-mail: znr85@mail.ruYaroshkevich G.E. ― doctor of Pathology Department, tel. +7-917-238-82-92, e-mail: kznyaroshkevich@gmail.com

Sharafislamov I.F. ― Head of the Department of Ultrasound Diagnostics, tel. +7-917-886-26-26, e-mail: sarusi@rambler.com.ru

The article provides an overview of ultrasound studies of atherosclerotic plaques in the carotid arteries using a contrast agent in 11 patients after lesions of cerebral circulation. The patients successively underwent duplex scanning and study with intravenous contrast agent Sono Vue (Bracco Imaging SpA, Italy) on Toshiba Aplio 500, Hitachi Noblus devices. The study of the carotid arteries was accompanied with visualization of perfused lumen, evaluation of the structure of atherosclerotic plaque and its neovascularization. The results of ultrasound examination with contrast agent were compared with the results of pathological studies. The contrast-enhanced ultrasound examination of atherosclerotic plaques in the carotid arteries revealed the following: the absence of neovascularization in plaque, small and expressed neovascularization, asymmetrical accumulation of contrast agent in the plaque; structurally heterogeneous plaques were predominantly hypoechoic, with violations of the integrity of the plaque operculum. The presence of neovascularization and the violation of the integrity of the operculum in an unstable atherosclerotic plaque was confirmed by histological examination. The using of contrast-enhanced ultrasound allows to more accurately assess the structure of the plaque’s surface, and helps to identify atherosclerotic plaque neovascularization, which is a factor of its destabilization. Considering the ease of implementation, and the safety of non-invasive contrast-enhanced ultrasound examination of vessels, it can be used in monitoring patients with unstable atherosclerotic plaques and choosing tactics of surgical treatment.

Key words: ultrasound examination of vessels, contrast agent, neovascularization, atherosclerotic plaque in the carotid arteries, vasa vasorum.

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