Ultrasonic tissue characterization of vulnerable carotid plaque: Correlation between videodensitometric method and histological examination

被引：20
作者：
Baroncini L.A.V. [1 ]
Pazin Filho A. [1 ]
Murta Jr. L.O. [2 ]
Martins A.R. [3 ]
Ramos S.G. [4 ]
Cherri J. [5 ]
Piccinato C.E. [5 ]
机构：
[1] Department of Internal Medicine, Faculdade de Medicina de Ribeirão Preto, University of São Paulo, São Paulo
[2] Department of Physics and Math, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, University of São Paulo, São Paulo
[3] Department of Pharmacology, Faculdade de Medicina de Ribeirão Preto, University of São Paulo, São Paulo
[4] Department of Pathology, Faculdade de Medicina de Ribeirão Preto, University of São Paulo, São Paulo
[5] Department of Surgery and Anatomy, Faculdade de Medicina de Ribeirão Preto, University of São Paulo, São Paulo
来源：
Cardiovascular Ultrasound | / 4卷 / 1期
关键词：
Carotid Endarterectomy; Carotid Plaque; Carotid Artery Stenting; Internal Carotid Artery Stenosis; Central Retinal Artery Occlusion;
D O I：
10.1186/1476-7120-4-32
中图分类号：
学科分类号：
摘要：
Background: To establish the correlation between quantitative analysis based on B-mode ultrasound images of vulnerable carotid plaque and histological examination of the surgically removed plaque, on the basis of a videodensitometric digital texture characterization. Methods: Twenty-five patients (18 males, mean age 67 ± 6.9 years) admitted for carotid endarterectomy for extracranial high-grade internal carotid artery stenosis (≥ 70% luminal narrowing) underwent to quantitative ultrasonic tissue characterization of carotid plaque before surgery. A computer software (Carotid Plaque Analysis Software) was developed to perform the videodensitometric analysis. The patients were divided into 2 groups according to symptomatology (group I, 15 symptomatic patients; and group II, 10 patients asymptomatic). Tissue specimens were analysed for lipid, fibromuscular tissue and calcium. Results: The first order statistic parameter mean gray level was able to distinguish the groups I and II (p = 0.04). The second order parameter energy also was able to distinguish the groups (p = 0,02). A histological correlation showed a tendency of mean gray level to have progressively greater values from specimens with < 50% to >75% of fibrosis. Conclusion: Videodensitometric computer analysis of scan images may be used to identify vulnerable and potentially unstable lipid-rich carotid plaques, which are less echogenic in density than stable or asymptomatic, more densely fibrotic plaques. © 2006 Baroncini et al; licensee BioMed Central Ltd.
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共 32 条
[1]  
Barnett H.J.M., Taylor D.W., Eliasziw M., Fox A.J., Ferguson G.G., Haynes R.B., Rankin R.N., Clagett G.P., Hachinski V.C., Sackett D.L., Thorpe K.E., Math M., Meldrum H.E., Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis, N Engl J Med, 339, pp. 1415-1425, (1998)
[2]  
Beneficial effect of carotid endarterectomy in symptomatic patients with high - Grade carotid stenosis, N Engl J Med, 325, pp. 445-453, (1991)
[3]  
Endarterectomy for asymptomatic carotid artery stenosis, JAMA, 273, pp. 1421-1428, (1995)
[4]  
Barnett H.J.M., Meldrum H.E., Eliasziw M., The dilemma of surgical treatment for patients with asymptomatic carotid disease, Ann Intern Med, 123, pp. 723-725, (1995)
[5]  
Wilhjelm J.E., Gronholdt M.L.M., Wiebe B., Jespersen S.K., Hansen L.K., Sillesen H., Quantitative analysis of ultrasound B-mode images of carotid atherosclerotic plaque: Correlation with visual classification and histological examination, IEEE Trans Med Imag, 17, pp. 910-922, (1998)
[6]  
North American Symptomatic Carotid Endarterectomy Trial: Methods, patient characteristics, and progress, Stroke, 22, pp. 711-720, (1991)
[7]  
Paciaroni M., Eliasziw M., Sharpe B.L., Kappelle L.J., Chaturvedi S., Meldrum H., Barnett H.J.M., Long-Term clinical and angiographic outcomes in symptomatic patients with 70% to 90% carotid artery stenosis, Stroke, 31, pp. 2037-2042, (2000)
[8]  
Nadareishvili Z.G., Rothwell P.M., Beletsky V., Pagniello A., Norris J.W., Long-term risk of stroke and other vascular events in patients with asymptomatic carotid artery stenosis, Arch Neurol, 59, pp. 1162-1166, (2002)
[9]  
Rothwell P.M., Eliasziw M., Gutnikov S.A., Phil D., Warlow C.P., Barnett H.J.M., Sex difference in the effect of time from symptoms to surgery on benefit from carotid endarterectomy for transient ischemic attack and nondisabling stroke, Stroke, 35, pp. 2855-2861, (2004)
[10]  
Rothwell P.M., Gutnikov S.A., Warlow C.P., Reanalysis of the final results of the European Carotid Surgery Trial, Stroke, 34, pp. 514-523, (2003)
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