Contrast-Enhanced Ultrasound Identifies Carotid Plaque Rupture and Stroke: A Case Report

Contrast-Enhanced Ultrasound Identifies Carotid Plaque Rupture and Stroke: A Case Report

Carotid artery plaque rupture leading to stroke is a frequently encountered neurological emergency. Computed tomography angiography (CTA) and digital subtraction angiography (DSA) are typically employed for diagnosis. We present a unique case where contrast-enhanced ultrasound (CEUS) clearly identified the cause of stroke as the rupture of a vulnerable plaque in the carotid artery, leading to the formation of a floating thrombus.

This application of CEUS in diagnosing stroke caused by carotid plaque rupture is rare but highly valuable. The case highlights the practicality of using CEUS to identify the underlying cause of stroke. Compared to CTA and DSA, CEUS offers several advantages:

• Convenience: CEUS is a relatively quick and straightforward procedure.* Absence of Radiation Exposure: Unlike CTA, CEUS does not expose the patient to ionizing radiation.* Non-nephrotoxic: CEUS utilizes ultrasound contrast agents that are generally safe for patients with impaired renal function, unlike the iodinated contrast used in CTA and DSA.* Real-time Imaging: CEUS provides real-time imaging of blood flow, allowing for immediate assessment of the carotid arteries.* Bedside Examination: CEUS can be performed at the bedside, which is particularly beneficial for critically ill patients.

This case underscores the potential of CEUS as a valuable tool in the diagnosis of carotid artery plaque rupture leading to stroke. The modality's unique advantages make it a practical and effective option, particularly in situations where CTA or DSA may be contraindicated or unavailable.