Background: Intraplaque neovascularization in carotid artery plaque was assessed using contrast-enhanced ultrasonography (CEUS) and then the patient underwent carotid endarterectomy (CEA). Significant contrast flow was detected in the plaque and the findings from a pathological specimen are discussed.
Case: Asymptomatic severe left-sided carotid stenosis was detected by ultrasonography (US) in a 71-year-old man, and the patient underwent CEA. We assessed the contrast effects of perﬂubutane over time in CEUS. A pathological specimen of plaque selected during CEA was stained with Masson’s trichrome and immunostained using CD34 and CD146. Considerable inflow of contrast from the lumen to the plaque was observed on CEUS, and the plaque was entirely enhanced with contrast agent over time. The pathological findings of the specimen excised by CEA showed a connection between the vessel lumen and nearby neovascularization throughout the plaque.
Conclusion: The inflow of contrast agent into the plaque on CEUS corresponded with a histopathological finding of the neovascularization.