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.

引用

共 32 条

[11]

Roubin G.S., New G., Iyer S.S., Vitek J.J., Al-Mubarak N., Liu M.W., Yadav J., Gomez C., Kuntz R.E., Immediate and late clinical outcomes of carotid artery stenting in patients with symptomatic and asymptomatic carotid artery stenosis. A 5-year prospective analysis, Circulation, 103, pp. 532-537, (2001)

[12]

Biasi G.M., Froio A., Diethrich E.B., Deleo G., Galimberti S., Mingazzini P., Nicolaides A.N., Griffin M., Raithel D., Reid D.B., Valsecchi M.G., Carotid plaque echolucency increases the risk of stroke in carotid stenting. The imaging in carotid angioplasty and risk of stroke (ICAROS) study, Circulation, 110, pp. 756-762, (2004)

[13]

Yadav J.S., Wholey M.H., Kuntz R.E., Fayad P., Katzen B.T., Mishkel G.J., Bajwa T.K., Whitlow P., Strickman N.E., Jaff M.R., Popma J.J., Snead D.B., Cutlip D.E., Firth B.G., Ouriel K., Protected carotid-artery stenting versus endarterectomy in high-risk patients, N Eng J Med, 351, pp. 1493-1501, (2004)

[14]

Geroulakos G., Ramaswami G., Nicolaides A., James K., Labropoulos N., Belcaro G., Holloway M., Characterization of symptomatic and asymptomatic carotid plaques using high-resolution real-time ultrasonography, Br J Surg, 80, pp. 1274-1277, (1993)

[15]

Cipollone F., Prontera C., Pini B., Marini M., Fazia M., De Cesare D., Iezzi A., Ucchino S., Boccoli G., Saba V., Chiarelli F., Cuccurullo F., Mezzetti A., Overexpression of functionally coupled cyclooxygenase-2 and prostaglandin E synthase in symptomatic atherosclerotic plaques as a basis of prostaglandin E(2)-dependent plaque instability, Circulation, 104, pp. 921-927, (2001)

[16]

Gray-Weale A.C., Graham J.C., Burnett J.R., Byrne K., Lusby R.J., Carotid artery atheroma: Comparison of preoperative B-mode ultrasound appearance with carotid endarterectomy specimen pathology, J Cardiovasc Surg, 29, pp. 676-681, (1988)

[17]

Nandalur K.R., Baskurt E., Hagspiel K.D., Phillips C.D., Kramer C.M., Calcified carotid atherosclerotic plaque is associated less with ischemic symptoms than is noncalcified plaque on MDCT, AJR, 184, pp. 295-298, (2005)

[18]

Mathiesen E.B., Bonaa K.H., Joakimsen O., Echolucent plaques are associated with high risk of ischemic cerebrovascular events in carotid stenosis: The tromso study, Circulation, 103, pp. 2171-2175, (2001)

[19]

Gronholdt M.L.M., Nordestgaard B.G., Schroeder T.V., Vorstrup S., Sillesen H., Ultrasonic echolucent carotid plaques predict future strokes, Circulatio, 104, pp. 68-73, (2001)

[20]

Tegos T.J., Stavropoulos P., Sabetai M.M., Khodabakhsh P., Sassano A., Nicolaides A.N., Determinants of carotid plaque instability: Echoicity versus heterogeneity, Eur J Vasc Endovasc Surg, 22, pp. 22-30, (2001)

← 1 2 3 4 →