Background: Three-dimensional ultrasonography (3D-US) has been recently developed and used mainly in the gynecological field. We have performed 3D-US examination of carotid artery lesions. Here we present an analysis of comparison with 2D-US. Materials and methods: We used three kinds of 3D-US machines (TOSHIBA SSA-700A, ALOKA SSD-5500 EX-3D5500 EX-3D, and PHILIPS HDI-5000 SONO CT) to examine atherosclerotic lesions of the carotid artery in 47 patients (37 men and 10 women; average age 70). Moreover, pathological findings of carotid endarterectomy specimens were also analyzed and compared with the 3D-US image in four cases. Results: We were able to visualize the lesions from multiple directions by 3D-US by a technical procedure after detecting each lesion in an axial view. 3D-US was particularly effective for recognizing ulceration by multidirectional view. The image corresponded to pathological findings in the carotid endarterectomy specimen. Conclusion: It is usually difficult to detect carotid lesions from all directions by usual 2D-US, because of the many tissues that surround and mask the carotid artery. 3D-US is useful for recognizing carotid lesions. The most diagnostically useful lesion is ulceration, which cannot be seen by axial view alone. 3D-US is considered to contribute to the diagnosis of carotid lesions.
