Accuracy of High-Resolution Ultrasound Imaging for Quantitative Assessment of Early Carotid Atherosclerosis

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Abstract
Since the introduction of ultrasound technology for the evaluation of carotid atherosclerosis, a continuous controversy exists about the accuracy of this method for quantitative assessment of atherosclerotic plaques. Potential pitfalls and limitations of ultrasound imaging for a correct classification of significant carotid stenosis (>50% lumen narrowing) and occlusion could be compensated by the additional combined use of Doppler sonography when compared with conventional angiographic techniques, which may no longer be used as the only reference method (''gold standard'') despite their traditionally widespread application in major clinical trials [1–3]. In contrast, the validity of ultrasound echotomography for the assessment of minor carotid artery irregularities producing

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