Diagnostic Performance of Contrast‐Enhanced Ultrasound and High‐Resolution Magnetic Resonance Imaging for Carotid Atherosclerotic Plaques

Objectives The aim of this meta‐analysis was to evaluate the diagnostic value of contrast‐enhanced ultrasound (CEUS) and high‐resolution magnetic resonance imaging (HR‐MRI) in patients with carotid vulnerable plaques. Methods A systematic review was conducted in PubMed, Embase, Cochrane Library, and Web of Science using the search terms carotid artery , atherosclerotic plaque , CEUS , contrast‐enhanced ultrasound , HR‐MRI , and high‐resolution magnetic resonance . Studies published since the establishment of the library until December 2021 were retrieved. The statistical analyses were performed with Meta‐DiSc version 1.4. Beyond that, the potential sources of heterogeneity for CEUS and HR‐MRI were explored. Results Nine articles were included in this study. For CEUS, the pooled sensitivity and specificity for detecting carotid vulnerable plaques 91% (95% confidence interval [CI]: 84%, 95%) and 67% (95% CI: 54%, 79%), respectively. For HR‐MRI, the pooled sensitivity and specificity were 78% (95% CI: 72%, 83%) and 65% (95% CI, 56%, 73%), respectively. The area under the summary receiver operating characteristic curve for CEUS and HR‐MRI were 0.9218 and 0.8129, respectively. However, the difference in diagnostic accuracy between CEUS and HR‐MRI diagnostic accuracy was not statistically significant. Conclusions The study shows that the sensitivity of CEUS was higher than that of HR‐MRI, and the specificity was similar to HR‐MRI. CEUS and HR‐MRI provide a similar diagnostic yield in detecting a vulnerable plaque. Thus, CEUS may be a useful tool for the diagnosis of carotid vulnerable plaques.