Korean Journal of Clinical Laboratory Science (대한임상검사과학회지)

Korean Society for Clinical Laboratory Science (대한임상검사과학회)
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Spontaneous Echo Contrast Observed on Carotid Duplex Ultrasonography

경동맥이중초음파검사에서 관찰된 자발에코대조

  • Minho HAN (Neurology Laboratory, Severance Hospital, Yonsei University College of Medicine)
  • 한민호 (연세대학교 의과대학 세브란스병원 신경과)
  • Received : 2024.06.13
  • Accepted : 2024.07.04
  • Published : 2024.09.30
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Abstract

Spontaneous echo contrast is a swirling, smoke-like echographic pattern observed in B-mode ultrasound imaging, typically arising in areas of blood stasis or low-flow states. This hemodynamic disturbance generates low shear stress due to sluggish flow, leading to endothelial dysfunction and facilitating the activation of fibrinogen, a coagulation factor. Consequently, blood cells, including erythrocytes, readily aggregate, forming a spontaneous echo contrast, a precursor to thrombus formation. Spontaneous echo contrast is primarily found in the left atrium of patients with left atrial enlargement or the left atrial appendage of patients with atrial fibrillation. While less common, it can also be observed in the carotid arteries. This case report presents the imaging findings of spontaneous echo contrast detected during carotid duplex ultrasonography in a patient with metastatic cancer and discusses its clinical implications.

자발에코대조(spontaneous echo contrast)는 B 모드 초음파 영상에서 관찰되는 소용돌이 모양의 연기 같은 에코 패턴으로, 일반적으로 혈액 정체 또는 저유량 상태에서 발생한다. 이러한 혈류역학적 교란은 느린 흐름으로 인해 낮은 전단 응력을 발생시켜 혈관내피세포의 기능 장애를 유발하고 응고 인자인 섬유소원의 활성화를 촉진한다. 결과적으로 적혈구를 포함한 혈액 세포가 쉽게 응집하여 혈전 형성의 전구체인 자발에코대조를 형성한다. 자발에코대조는 주로 좌심방확장증이 있는 환자의 좌심방이나 심방세동 환자의 좌심방귀에서 발견되며, 드물게 경동맥에서도 관찰될 수 있다. 이 사례 보고서에서는 전이성 암환자의 경동맥이중초음파검사 중 관찰된 자발에코대조의 영상 소견을 제시하고 임상적 의미를 논의하고자 한다.

Keywords

References

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