Key result
Videodensitometry links symptomatic patients to lower carotid plaque mean gray levels, indicating vulnerable lipid-rich lesions.
Why the study?
The correlation between quantitative B-mode ultrasound analysis of vulnerable carotid plaque and histological examination of surgically removed plaque was not established.
Does videodensitometric computer analysis of B-mode ultrasound images correlate with histological characteristics and symptomatology in patients with high-grade carotid stenosis?
Cross-Sectional (n=25)
Single-blind
Yes
Does videodensitometric computer analysis of B-mode ultrasound images correlate with histological characteristics and symptomatology in patients with high-grade carotid stenosis?
Videodensitometric analysis of carotid ultrasound images can distinguish symptomatic from asymptomatic plaques and correlates with histological fibrosis, offering a non-invasive method to identify vulnerable plaques.
Answers are grounded in this paper and cite their sources.
May support noninvasive vulnerability assessment in carotid stenosis; hypothesis-generating and should not yet change practice.
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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Baroncini et al. (2006) conducted a cross-sectional in Extracranial high-grade internal carotid artery stenosis (n=25). Symptomatic carotid artery stenosis vs. Asymptomatic carotid artery stenosis was evaluated on Mean gray level (MGL) of carotid plaque (p=0.04). Videodensitometric analysis revealed that symptomatic patients had significantly lower mean gray levels in carotid plaques compared to asymptomatic patients (p=0.04), indicating more vulnerable, lipid-rich lesions.
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