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Plaque echogenicity was graded as echolucent (1), predominantly echolucent (2), predominantly echogenic (3), or echogenic (4). Sonographic findings were compared between patients with acute (group 1) and chronic (group 2) stroke.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>In group 1 (n = 39 patients), the carotid plaques were grade 1 in 21, grade 2 in 22, grade 3 in 9, and grade 4 in 4 carotid arteries. In group 2 (n = 21), the carotid plaques were grade 1 in 2, grade 2 in 8, grade 3 in 4, and grade 4 in 11 carotid arteries. Plaque echogenicity was lower in group 1 than in group 2 (<jats:italic>p<\/jats:italic> &lt; 0.05). Plaque echolucency was associated independently with acute stroke from the degree of stenosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions.<\/jats:title><jats:p>Patients with acute infarcts have predominantly echolucent plaques, regardless of the degree of stenosis. \u00a9 2012 Wiley Periodicals, Inc. 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