Abstract
The composition of the atheroesclerotic coronary lesions is related with their evolution and the device selection for endoluminal treatment. To establish if the Video Densitometric Analysis (VDA) of the Intracoronary Ultrasound images (ICUS) can predict the composition of the atheroesclerotic plaque. 15 patients, 58.9 ± 9.8 years old, 87.5% males, in which we obtained ICUS pre and post Directional Coronary Atherectomy (DCA) with anathomopathologic analysis of the samples. The video ICUS images were digitalized in a 512 × 512 matrix and analyzed for densitometric differences with an Automatic Image Analysis System (AlAS) (Vidas 2000, Zeiss Kontron). The pre and post DCA images were compared in order to carry out the study on the resected atheroma. The components of the plaque were arbitrary divided in three densitometric categories using a 256 gray scale: High Density (HD) 121–255, Medium (MD) 81–120 and Low (LD) 3080. The relative percent of each component were automatically recorded. The DCA samples were microscopically examined and input in the AlAS. The components were divided in collagenous tissue (CT), lipid and necrotic debris (LND) and proliferative tissue (PT). The areas of each component were expressed as a percentage of the total. Linear Correlation Pearson Test was applied. Comparison between the ICUS and the histological composition of the plaque showed that the HD areas correspond to PT, the MD areas to CT and the LO to LND. The correlation between the percentage distribution of the densitometric categories and the anatomopathologic components showed a correlation coefficient (r) = 0.93 between HD and PT, r = 090 between MD and CT and r = 0.94 between LD and LND. The VDA of the ICUS can easily distinguish three basics components of the atheroesclerotic plaque: fibrous, lipid/necrotic and proliferative tissue. This capability may be of interest for device selection for endovascular treatment.
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