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Spontaneous Echo Contrast Observed on Carotid Duplex Ultrasonography
Korean J Clin Lab Sci 2024;56:273-276  
Published on September 30, 2024
Copyright © 2024 Korean Society for Clinical Laboratory Science.

Minho HAN

Neurology Laboratory, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Correspondence to: Minho HAN
Neurology Laboratory, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
E-mail: umsthol18@yuhs.ac
ORCID: https://orcid.org/0000-0003-2951-0963
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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.
Keywords : Carotid duplex ultrasonography, Hemodynamic disturbance, Spontaneous echo contrast

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