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

Liz Andréa V Baroncini,Antonio Pazin Filho,Carlos E Piccinato,Jesualdo Cherri,Simone G Ramos,Antonio R Martins,Luiz O Murta Junior

doi:10.1186/1476-7120-4-32

Liz Andréa V Baroncini, Antonio Pazin Filho + Show 5 more

Open Access

https://doi.org/10.1186/1476-7120-4-32

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Journal: Cardiovascular ultrasound	Publication Date: Aug 1, 2006
Citations: 64	License type: CC BY 2.0

Affiliation: Universidade de São Paulo

Abstract

BackgroundTo 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.MethodsTwenty-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.ResultsThe 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.ConclusionVideodensitometric 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.

Highlights

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
Several large randomized multicenter trials [1,2,3,4,5,6,7,8,9,10,11] have demonstrated the benefit of carotid endarterectomy (CEA) and recently with carotid artery stenting (CAS) [11,12,13] in the prevention of stroke, in both symptomatic and asymptomatic disease
The present study was designed to establish the correlation between quantitative analysis of ultrasound B-mode images of vulnerable carotid plaque on the basis of a videodensitometric digital texture characterization. and histological examination of the surgically removed plaque

Summary

Introduction

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. Several large randomized multicenter trials [1,2,3,4,5,6,7,8,9,10,11] have demonstrated the benefit of carotid endarterectomy (CEA) and recently with carotid artery stenting (CAS) [11,12,13] in the prevention of stroke, in both symptomatic and asymptomatic disease In these studies, the degree of internal carotid artery stenosis was the only criterion for selection of patients at high risk for stroke. The present study was designed to establish the correlation between quantitative analysis of ultrasound B-mode images of vulnerable carotid plaque on the basis of a videodensitometric digital texture characterization. and histological examination of the surgically removed plaque

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Results

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Conclusion