The Train-Line Pattern on Duplex Ultrasound Helps Differentiate Intramural Thrombus from Atheromatous Plaque in Common Carotid Artery Dissection
<b>Background/Objectives:</b> Common carotid artery dissection (CCAD) can result in severe neurological sequelae; however, its diagnosis may be challenging due to consciousness disturbance and aphasia. The objective of this article is to propose a new imaging feature to assist in the ide...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-05-01
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| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/15/10/1297 |
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| Summary: | <b>Background/Objectives:</b> Common carotid artery dissection (CCAD) can result in severe neurological sequelae; however, its diagnosis may be challenging due to consciousness disturbance and aphasia. The objective of this article is to propose a new imaging feature to assist in the identification of CCAD. <b>Methods</b>: This retrospective case series enrolled 139 patients with discharge diagnoses of aortic dissection who underwent carotid ultrasound during admission over a period of three years. <b>Results</b>: Among these patients, 23 had type A aortic dissection, and 113 had type B aortic dissection or related conditions. Notably, among the 23 patients with type A aortic dissection, eight had associated common carotid artery dissection (CCAD), and a total of nine CCAD events were identified. Meanwhile, a B-mode ultrasound revealed six double lumens with intimal flaps and three intramural thrombi. The ‘train-line’ pattern in ultrasonography was discerned by detecting a hypoechoic thickened wall, which was characterized by a margin formed by two parallel linear reflections in close proximity. This distinctive “train-line” pattern was identified in three intimal flaps and two intramural thrombi. <b>Conclusions</b>: While double lumens and intramural thrombus are prevalent findings, the latter may be misinterpreted as atherosclerotic plaque. The “train-line” pattern may aid in distinguishing intramural thrombus from atheromatous plaque, offering an additional diagnostic tool alongside the identification of double lumens with intimal flaps. |
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| ISSN: | 2075-4418 |