What finding on color Doppler would indicate an ulcerated plaque?

• A. Absence of color within the plaque
• B. Flow within the plaque
• C. Uniform color in the lumen
• D. No color flow near plaque

Answer: (B)

Ulcerated plaques show a breach that creates a crater on the plaque surface, allowing blood to enter and flow within the plaque itself. On color Doppler this appears as color signals extending into or inside the plaque boundaries, i.e., flow within the plaque. This intraplaque flow reflects a channel through the plaque and is a hallmark of ulceration and instability.

Absence of color within the plaque wouldn’t indicate an ulcer, since there’s no intraplaque flow; uniform color in the lumen is just normal laminar flow in the vessel, not intraplaque flow; and no color flow near the plaque wouldn’t demonstrate an ulcer either and could be due to sampling or signal issues.