Virtual Histology-Intravascular Ultrasound as a diagnostic alternative for morphological characterization of carotid plaque: comparison with histology and High-Resolution Magnetic Resonance findings

Congress:

ECR 2013

Poster Number:

C-0814

Type:

Scientific Exhibit

Keywords:

CNS, Vascular, Head and neck, CT-Angiography, MR, Experimental, Catheters, Angioplasty, Stents, Arteriosclerosis

Authors:

R. Gandini, M. Chiocchi, A. Chiaravalloti, D. Morosetti, G. Loreni, S. Fabiano, G. Simonetti; Rome/IT

DOI:

10.1594/ecr2013/C-0814

DOI-Link:

https://dx.doi.org/10.1594/ecr2013/C-0814

Table 1: Tab. 1 Key baseline features of ex-vivo patients

Table 2: Table 2 Virtual histology-intravascular ultrasound: histology correlation

Table 3: Table 3 High-resolution magnetic resonance: virtual histology intravascular...

Fig. 2: Fig. 2 (a) Fibrolipid plaque with interruption of the fibrous cap reported on...

Purpose

Stroke is the third most common death cause and one of the most common cause of long-term disability in the western world [1]. Carotid plaque morphology is, more than the stenosis degree, the main predictor of cerebro-vascular accidents. Presence of ulcerated or ruptured plaque is a common morphological aspect of symptomatic lesions [2-3]. Several histological studies have demonstrated that atherosclerotic plaques associated to cerebral ischemia contain an abundant lipid core with a thin fibrous cap [4]. According to a study by Yuan etal, correlating clinical...

Methods and Materials

Exvivo VH-IVUS – Histology correlation Patients Data was acquired from six human carotid arteries explanted previous post mortem familial consent and after approval from our hospital’s ethic committee. Six single carotid arteries were explanted from six consecutive male patients with a mean age of 72.5 ± 5.79 years, with known history of cerebral ischemia, either Transient Ischemic Attack (TIA) or stroke [Table 1]. Patients with a previous endovascular or surgical revascularization were excluded. Ex vivo specimen preparation The time interval between death and specimen explantation...

Results

Ex vivo VH IVUS – Histology correlation Forty-two images of the 54 ex vivo VH-IVUS images obtained were used for correlation (8-10 sectional images obtained by 6 explanted carotid arteries) with histology. Twelve images were excluded either due to incomplete or jeopardized VH-IVUS data. The agreement between the two histopathologists, calculated using the Kendall’s W test, resulted in a W of 0.91. Sensitivity of VH-IVUS in characterizing fibrous tissue, fibro-lipid tissue, calcium and necrosis, considering histology as the reference standard, resulted respectively 98.7 %, 94.2%,...

Conclusion

The importance of plaque morphology and histology in carotid artery treatment has been largely demonstrated [5-8-18]. The composition assessment of atherosclerotic carotid artery plaque is thereby essential to identify patients at risk of an ischemic cerebrovascular event. The recent increase of the number of CAS procedures has raised the need for the identification of a diagnostic tool for plaque composition evaluation, which would provide information capable of improving the clinical approach to the disease and the indications for its treatment. Intravascular ultrasound (IVUS) is an...

References

1 Chu B, Ferguson MS, Chen H, et al. MRI features of the disruption-prone and the disrupted carotid plaque: a pictorial essay. JACC Cardiovasc Imaging 2009; 2:883–896. 2 Fuster V, Stein B, Ambrose JA, et al. Atherosclerotic plaque rupture and thrombosis: evolving concepts. Circulation 1990; 82 (suppl 3):II47–II59. 3 Libby P. The interface of atherosclerosis and thrombosis: basic mechanisms. Vasc Med 1998; 3:225–229. 4 Falk E, Shah PK, Fuster V. Coronary plaque disruption. Circulation 1995; 92:657–671. 5 Yuan C, Zhang Sx SX, Polissar NL, et...