Fifty-four atheromatous plaques of carotid arteries, obtained at autopsy, were scanned with a high-resolution real-time instrument, then histologically examined. Comparison between atherogenesis assessed first by histology then by ultrasonography allowed us to differentiate young from old plaques. An old plaque is characterized by a dense heterogeneous echo pattern and irregular borders or ulceration. Previous studies have shown a correlation between the presence of hemorrhage and ulceration of atheromatous plaques in the carotid, and the frequency of cerebral complications. Since these characteristics were mainly found in older plaques, we consider them to be the most important ones clinically.

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