Ts. Hatsukami et al., ECHOLUCENT REGIONS IN CAROTID PLAQUE - PRELIMINARY-ANALYSIS COMPARING3-DIMENSIONAL HISTOLOGIC RECONSTRUCTIONS TO SONOGRAPHIC FINDINGS, Ultrasound in medicine & biology, 20(8), 1994, pp. 743-749
Citations number
34
Categorie Soggetti
Radiology,Nuclear Medicine & Medical Imaging",Acoustics
This study compares sonographic and histologic findings within defined
spatial regions in carotid artery plaque, using computer generated th
ree-dimensional reconstructions. Twenty-four patients (14 asymptomatic
, 10 symptomatic) with angiographically documented 70% to 99% carotid
artery stenosis were examined with ultrasonic B-mode imaging prior to
endarterectomy. Using a standardized protocol for instrument set-up an
d scanning technique, echolucent regions in the plaque were identified
. After endarterectomy, each plaque was sectioned at 0.5 to 1.0 millim
eter increments throughout its length. Sites containing intraplaque he
morrhage, cholesterol clefts, foam cells, necrotic cores, dense calcif
ication and speckled calcification were identified. These areas were o
utlined on a template, digitized and imported into a computer program
that created three-dimensional reconstructions of the histologic findi
ngs. Each carotid plaque was divided into quadrants for analysis: (1)
lateral wall proximal to the common carotid bifurcation (flow divider)
; (2) medial wall proximal to the flow divider; (3) lateral wall dista
l to the dow divider; and (4) medial wall distal to the flow divider.
The odds of finding intraplaque hemorrhage, foam cells, necrotic cores
and speckled calcification were significantly higher in quadrants wit
h an echolucent region identified by ultrasonography (odds ratio (95%
confidence interval) for intraplaque hemorrhage = 3.5 (1.4-8.6); foam
cells = 4.0 (1.6-9.9); necrotic cores = 3.2 (1.2-8.4); speckled calcif
ication = 4.0 (1.6-9.8). This preliminary analysis demonstrates the po
tential of these newly developed techniques for comparing ultrasonic i
maging to histology.