Case report

Randomized trials have established that treatment with statin (3-hydroxy-3-methylglutaryl-CoA reductase inhibitor) can reduce the progression of vulnerable carotid plaque. However, detection and evaluation of carotid plaque using conventional 2D (two-dimensional) carotid ultrasonography is not sufficient to evaluate the three-dimensional extent of carotid plaque. We experienced a case of carotid plaque in which the use of statin and 3D (three-dimensional) ultrasonography was proved to be superior to the conventional 2D method for evaluation and quantitative measurement of carotid plaque with high reliability. The patient was a 43-year-old man with hypertension. atrial fibrillation and a history oflacunar infarction. He was referred to our hospital because of left carotid bruit. 3D ultrasonography revealed vulnerable plaque in the left common carotid artery. The volume of the plaque was calculated to be 0.31mm3.Huvastatin, 20 mg daily, was started.Three months later. the plaque volume had diminished to 0.12 mm3 and the 2D characteristics of the plaque were improved. although the serum LDL cholesterol level was not changed before (157mg/dL) and after (152mg/dl) fluvastatin. These data suggest that 3D ultrasonography is a valid and useful tool that is superior to the conventional 2D method for evaluation and quantitative measurement of carotid plaque with high reliability. The present study indicates that fluvastatin improves the morphology of atherosclerotic carotid plaque. reducing its volume within 3 months.