Background: The aim of the study was to compare a computer assessment of carotid plaques with the quantity and distribution of inflammatory cells in the plaques and to find correlation with the incidence of cerebral stroke.Material and Methods: The material consisted of 20 carotid plaques causing stenoses of internal carotid arteries ranging from 70 to 99%. USG images of the plaques were assessed by a computer-assisted program for image analysis. For each plaque a histogram was obtained for which the gray scale median (GSM), a measure of plaque echogenicity, was determined. Then the quantity and distribution of inflammatory cells in plaques taken during endarterectomy were assessed and these data were compared with the GSM and the incidence of stroke. Moreover, grouping of cases according to histometric variables was analyzed.Results: Statistical analysis showed a considerable correlation between low GSM and the incidence of stroke. At the same time, a correlation between the presence of inflammatory cells on the edges of plaque with a low GSM was found and the analysis of clusters demonstrated a significant increase in the number of patients with strokes.
Conclusions: The use of computer analysis of USG images allows determining the echogenicity of any carotid plaque and can be applied in clinical studies in which the aim is to find characteristic parameters for an unstable plaque.

Keywords: Atherosclerosis - ultrasonography, Carotid Arteries - ultrasonography, Carotid Stenosis - ultrasonography, Image Processing, Computer-Assisted, Multicenter Studies as Topic, Stroke - pathology