润色：In addition we found a suspicious very low echoic substance at the distal end of the carotid artery plaque which slightly oscillated with the carotid artery pulsation

Furthermore, we observed a concerning low echoic substance located at the distal end of the carotid artery plaque. This substance exhibited slight oscillation in sync with the pulsation of the carotid artery, raising suspicion for potential pathology.