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Comparative Study
. 2006 Aug 17:4:32.
doi: 10.1186/1476-7120-4-32.

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

Liz Andréa V Baroncini  1 , Antonio Pazin Filho, Luiz O Murta Junior, Antonio R Martins, Simone G Ramos, Jesualdo Cherri, Carlos E Piccinato
Affiliations
Comparative Study

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

Liz Andréa V Baroncini et al. Cardiovasc Ultrasound. .

Abstract

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 (> or = 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.

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Figures

Figure 1
Figure 1
Vulnerable carotid plaque: Left Panel – Ultrasound B-mode image of a hypoechoic and homogeneous plaque with the region of interest (ROI) delimiting the area to be analysed in Mid Panel; Mid Panel – Videodensitometric analysis showing the histogram and cooccurence matrix distribution along with continuous variables generated by CaPAS; Right Panel – Histological analysis: great necrosis area, lipid tissue and inflammatory infiltrate(dotted pink area).
Figure 2
Figure 2
Stable carotid plaque: Left Panel – Ultrasound B-mode image of a hyperechoic and heterogeneous plaque with the region of interest (ROI) delimiting the area to be analysed in Mid Panel; Mid Panel – Videodensitometric analysis showing the histogram and cooccurence matrix distribution along with continuous variables generated by CaPAS; Right Panel – Histological analysis: great area of fibrosis (blue area).
Figure 3
Figure 3
Mean Gray Level (MGL) and proportion of Fibrous Tissue.
See this image and copyright information in PMC

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