Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.202200821
Jornal Vascular Brasileiro
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Elastografia por cisalhamento (shear wave) para placas ateroscleróticas carotídeas extracranianas: princípios técnicos e como realizar

Shear wave elastography for extracranial carotid atherosclerotic plaques: technical principles and how to do it

Pedro Luciano Mellucci Filho; Matheus Bertanha; Rodrigo Gibin Jaldin; Winston Bonetti Yoshida; Marcone Lima Sobreira

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Resumo

Na esteira de estudos direcionados à placa aterosclerótica e em busca de variáveis quantificáveis que adicionem informações à tomada de decisão terapêutica, a avaliação a partir de elastografia shear wave (SWE) se apresenta como alternativa reprodutível e promissora. Utilizamos um único aparelho Logiq S8 (General Electric, Boston, Massachusetts, Estados Unidos) com um transdutor linear multifrequencial 8,5-11 MHz em 10 MHz em corte longitudinal. Consideramos critérios relevantes para a aquisição de imagem: adequada insonação longitudinal, diferenciação do complexo médio-intimal, delineamento de túnicas adventícias proximal e distal, lúmen vascular, boa visualização da placa aterosclerótica, ciclo em diástole ventricular e ausência de alterações incongruentes. A SWE é um método emergente e extremamente promissor no contexto da avaliação de placas carotídeas, podendo contribuir no futuro para a tomada de decisão terapêutica baseada em características relativas à placa aterosclerótica de forma reprodutível entre aparelhos e examinadores.

Palavras-chave

doenças das artérias carótidas, estenose das carótidas, ultrassonografia Doppler, interpretação de imagem assistida por computador, técnicas de imagem por elasticidade

Abstract

In the wake of studies targeting atherosclerotic plaques and searching for quantifiable variables that contribute additional information to therapeutic decision-making, plaque assessment using Shear Wave Elastography (SWE) is emerging as a reproducible and promising alternative. We used a single Logiq S8 device (General Electric, Boston, Massachusetts, United States) with an 8.5-11MHz multifrequency linear transducer at 10MHz in longitudinal section. We considered relevant criteria for image acquisition: adequate longitudinal insonation, differentiation of the intima-media complex, delineation of proximal and distal tunica adventitia and the vascular lumen, good visualization of the atherosclerotic plaque, cardiac cycle in ventricular diastole, and absence of incongruous changes. SWE is an emerging and extremely promising method for assessment of carotid plaques that may contribute to therapeutic decision-making based on characteristics related to the atherosclerotic plaque, with inter-device and inter-examiner reproducibility.

Keywords

carotid artery diseases; carotid stenosis; Doppler ultrasonography; computer-assisted image interpretation; elasticity imaging techniques

References

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Submitted date:
08/07/2022

Accepted date:
06/12/2023

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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