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Figure 4 Carotid Ultrasound for Plaque Morphology

(A,B) Representative ultrasound images of atherosclerotic carotid plaques with ultrasound analysis. (A) Regular B-mode image of carotid atheroma as shown by arrowheads. Plaque-intima-media thickness (IMT)_max was measured in this mode as shown by an arrow. (B) Integrated backscatter (IBS)-mode image. The red dotted line indicates the region of interest (ROI) in the plaque (intima-media complex), and the blue dotted line indicates the ROI in the adventitia using the manual outline definition mode. Values of cIBS and plaque-IMT_max of this plaque are –19.6 dB and 2.44 mm, respectively. (C,D) Representative IBS images of carotid atheroma from baseline to follow-up. (C) Carotid atheroma at pretreatment. Values of cIBS and plaque-IMT_max of this plaque are –17.8 dB and 2.05 mm, respectively. (D) The same carotid atheroma post-pravastatin therapy (6 months). Values of cIBS and plaque-IMT_max of this plaque are –14.2 dB and 2.10 mm, respectively. CCA = common carotid artery; ICA = internal carotid artery. Adapted with permission from Watanabe et al. (50).