The development and potential of acoustic radiation force impulse (ARFI) imaging for carotid artery plaque characterization

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Allen, Jason, Ham, Katherine L, Dumont, Douglas M, Sileshi, Bantayehu, Trahey, Gregg E and Dahl, Jeremy J (2011) The development and potential of acoustic radiation force impulse (ARFI) imaging for carotid artery plaque characterization. Vascular Medicine, 16 (4). pp. 302-311. ISSN 1358-863X (print) 1477-0377 (online)

Abstract

Stroke is the third leading cause of death and long-term disability in the USA. Currently, surgical intervention decisions in asymptomatic patients are based upon the degree of carotid artery stenosis. While there is a clear benefit of endarterectomy for patients with severe (> 70%) stenosis, in those with high/moderate (50–69%) stenosis the evidence is less clear. Evidence suggests ischemic stroke is associated less with calcified and fibrous plaques than with those containing softer tissue, especially when accompanied by a thin fibrous cap. A reliable mechanism for the identification of individuals with atherosclerotic plaques which confer the highest risk for stroke is fundamental to the selection of patients for vascular interventions. Acoustic radiation force impulse (ARFI) imaging is a new ultrasonic-based imaging method that characterizes the mechanical properties of tissue by measuring displacement resulting from the application of acoustic radiation force. These displacements provide information about the local stiffness of tissue and can differentiate between soft and hard areas. Because arterial walls, soft tissue, atheromas, and calcifications have a wide range in their stiffness properties, they represent excellent candidates for ARFI imaging. We present information from early phantom experiments and excised human limb studies to in vivo carotid artery scans and provide evidence for the ability of ARFI to provide high-quality images which highlight mechanical differences in tissue stiffness not readily apparent in matched B-mode images. This allows ARFI to identify soft from hard plaques and differentiate characteristics associated with plaque vulnerability or stability.

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Item type Article
URI https://vuir.vu.edu.au/id/eprint/25752
DOI https://doi.org/10.1177/1358863X11400936
Official URL http://vmj.sagepub.com/content/16/4/302
Subjects Historical > FOR Classification > 1102 Cardiorespiratory Medicine and Haematology
Current > Division/Research > College of Sports and Exercise Science
Keywords atherosclerosis, carotid artery disease, carotid stenosis, endarterectomy carotid, imaging diagnostic, stroke, ultrasonography
Citations in Scopus 43 - View on Scopus
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