IEEE Trans. Med. Imaging

1998

DOI: 10.1109/42.746624

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Quantitative analysis of ultrasound B-mode images of carotid atherosclerotic plaque: correlation with visual classification and histological examination

Jens E. Wilhjelm

¹

,

M.-L.M. Grønholdt

²

,

Britt Marie Wiebe

³

et al.

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Grønholdt Et Al Echolucent Carotid Plaques and Future Stroke1

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Cited by 127 publications

(68 citation statements)

References 34 publications

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“…6 We and others have confirmed these findings. 8,12 Thus, because echolucency is associated with lipid-rich carotid plaques 6 -8,14 and coronary plaques rich in lipid are thought to be most prone to rupturing and causing clinical events, 11 it seems possible that carotid echolucent plaques are those most prone to rupture and thus cause embolic stroke.…”

Section: Grønholdt Et Al Echolucent Carotid Plaques and Future Strokementioning

confidence: 99%

“…4 Therefore, noninvasive identification of plaque types prone to rupturing and causing embolic stroke would help to improve the effectiveness of this operation. Ultrasonic measurement of plaque echolucency, indicating plaques with lipid-rich cores, [5][6][7][8][9][10][11][12] is one such promising measurement; subjectively evaluated echolucency of carotid plaques on ultrasound B-mode imaging was associated with the presence or development of neurological events. 4,[13][14][15][16][17] The ability of objective computer-assisted ultrasound evaluation of plaque echolucency to predict stroke incidence, however, has not been reported in a prospective study.…”

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confidence: 99%

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Ultrasonic Echolucent Carotid Plaques Predict Future Strokes

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et al. 2001

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Background-We tested prospectively the hypothesis that stroke development can be predicted by echolucency of carotid atherosclerotic plaques in previously symptomatic and asymptomatic patients. Methods and Results-We followed incidence of ipsilateral ischemic strokes for 4.4 years in 111 asymptomatic and 135 symptomatic patients with Ն50% relevant carotid artery stenosis. At inclusion, echogenicity of carotid plaques and degree of stenosis were evaluated with high-resolution B-mode ultrasound with computer-assisted image processing and Doppler ultrasound, respectively. We observed 44 ipsilateral ischemic strokes. In symptomatic patients, relative risk of ipsilateral ischemic stroke for echolucent versus echorich plaques was 3.1 (95% CI, 1.3 to 7.3), whereas for 80% to 99% versus 50% to 79% stenosis, the relative risk was 1.4 (95% CI, 0.7 to 3.0). Relative to symptomatic patients with echorich 50% to 79% stenotic plaques, those with echorich 80% to 99% stenotic plaques, echolucent 50% to 79% stenotic plaques, and echolucent 80% to 99% stenotic plaques had relative risks of ipsilateral ischemic strokes of 3.1 (95%CI, 0.7 to 14), 4.2 (95% CI, 1.2 to 15), and 7.9 (95% CI, 2.1 to 30), equivalent to absolute risk increases of 11%, 18%, and 28%. This was not observed in previously asymptomatic patients. Conclusions-Echolucent

“…6 We and others have confirmed these findings. 8,12 Thus, because echolucency is associated with lipid-rich carotid plaques 6 -8,14 and coronary plaques rich in lipid are thought to be most prone to rupturing and causing clinical events, 11 it seems possible that carotid echolucent plaques are those most prone to rupture and thus cause embolic stroke.…”

Section: Grønholdt Et Al Echolucent Carotid Plaques and Future Strokementioning

confidence: 99%

“…4 Therefore, noninvasive identification of plaque types prone to rupturing and causing embolic stroke would help to improve the effectiveness of this operation. Ultrasonic measurement of plaque echolucency, indicating plaques with lipid-rich cores, [5][6][7][8][9][10][11][12] is one such promising measurement; subjectively evaluated echolucency of carotid plaques on ultrasound B-mode imaging was associated with the presence or development of neurological events. 4,[13][14][15][16][17] The ability of objective computer-assisted ultrasound evaluation of plaque echolucency to predict stroke incidence, however, has not been reported in a prospective study.…”

mentioning

confidence: 99%

Ultrasonic Echolucent Carotid Plaques Predict Future Strokes

¹

,

²

,

³

et al. 2001

View full text Add to dashboard Cite

Background-We tested prospectively the hypothesis that stroke development can be predicted by echolucency of carotid atherosclerotic plaques in previously symptomatic and asymptomatic patients. Methods and Results-We followed incidence of ipsilateral ischemic strokes for 4.4 years in 111 asymptomatic and 135 symptomatic patients with Ն50% relevant carotid artery stenosis. At inclusion, echogenicity of carotid plaques and degree of stenosis were evaluated with high-resolution B-mode ultrasound with computer-assisted image processing and Doppler ultrasound, respectively. We observed 44 ipsilateral ischemic strokes. In symptomatic patients, relative risk of ipsilateral ischemic stroke for echolucent versus echorich plaques was 3.1 (95% CI, 1.3 to 7.3), whereas for 80% to 99% versus 50% to 79% stenosis, the relative risk was 1.4 (95% CI, 0.7 to 3.0). Relative to symptomatic patients with echorich 50% to 79% stenotic plaques, those with echorich 80% to 99% stenotic plaques, echolucent 50% to 79% stenotic plaques, and echolucent 80% to 99% stenotic plaques had relative risks of ipsilateral ischemic strokes of 3.1 (95%CI, 0.7 to 14), 4.2 (95% CI, 1.2 to 15), and 7.9 (95% CI, 2.1 to 30), equivalent to absolute risk increases of 11%, 18%, and 28%. This was not observed in previously asymptomatic patients. Conclusions-Echolucent

“…These tissue areas-while realistic sizes when dealing with carotid plaque [14]-might be somewhat too small to ensure statistically stable estimates in all circumstances; In another phantom study by us [8], a region of seemed sufficient. This could be an additional explanation (additional to the angle-dependence), that the maximal contrast of 0.97 was found in line 4 of Table I and not line 1.…”

Section: Limitationsmentioning

confidence: 98%

Visual and Quantitative Evaluation of Selected Image Combination Schemes in Ultrasound Spatial Compound Scanning

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et al. 2004

IEEE Trans. Med. Imaging

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= 7, the highest SNR is obtained for the mem, rms, and geometric mean operators, while the lowest SNR is obtained for the maximum operator. When comparing SNR for adipose and fibrous tissue, the level is close to 1.91 for adipose tissue but only 1.7 for fibrous tissue which contain relatively few organized scattering structures.

“…Analysis of digital images of carotid plaques allows assessment of plaque texture. First and second order statistical features extracted from carotid plaques may provide useful information about the correlation between texture and plaque composition [4].…”

Section: Introductionmentioning

confidence: 99%

“…Analysis of digital images of carotid plaques allows assessment of plaque texture. First and second order statistical features extracted from carotid plaques may provide useful information about the correlation between texture and plaque composition [4].In addition, the texture of biological tissues may be characterised using the fractal dimension [5]. For an image, the fractal dimension is a non-integer number between 2 and 3 and is a measure of the roughness of its intensity surface.…”

mentioning

confidence: 99%

Fractal analysis of ultrasound images of carotid atherosclerotic plaque

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et al.

2001 Conference Proceedings of the 23rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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Abstract-In this paper, we investigate the possibility of using the fractal dimension to characterise carotid atheromatous plaques from B-mode ultrasound images. The images were obtained from ten symptomatic and nine asymptomatic subjects. Symptomatic subjects included patients with previous history of cerebral events, whereas asymptomatic ones had no evidence of any cerebral symptoms prior to the time of the investigation. For each subject, a sequence of images was collected corresponding to 2-3 cardiac cycles. The boundary of the atheromatous plaque was defined by an expert in three different images of each sequence, corresponding to systole, diastole and a random phase of the cardiac cycle. The fractal dimension of each plaque was estimated using a new method, namely the k-th nearest neighbour method. The results showed that the values of the fractal dimension in the symptomatic group were significantly higher than those in the asymptomatic group. These results suggested that the fractal dimension, estimated from B-mode ultrasound images, could be used to discriminate between symptomatic and asymptomatic carotid atheromatous plaques. Keywords -B-mode ultrasound, carotid, atherosclerotic plaque, fractal dimension, kth nearest neighbour method I. INTRODUCTIONUltrasound imaging of the carotid artery is widely used in the diagnosis of carotid atherosclerosis as it allows noninvasive assessment of the degree of stenosis as well as of plaque morphology, including plaque homogeneity/ heterogeneity, plaque echogenicity/echolucency, plaque texture and plaque surface characteristics. It has been demonstrated that the possibility that a carotid plaque produces a cerebral event (symptom), i.e. its instability, may be determined by the degree of stenosis [1], with plaques causing high degrees of stenosis more likely to produce symptoms.However, carotid plaques with relatively small degrees of stenosis have been reported to cause symptoms. Furthermore, due to the fact that the majority of symptoms occur in previously asymptomatic subjects, it is important to study additional parameters that may contribute to recognise and treat subjects (especially asymptomatic ones) at high risk of cerebral events.Plaque morphology, determined from ultrasound images of the carotid artery, may be related to the risk of clinical events. Homogeneous plaques are characterised by uniformly high-or medium-level echoes and are associated with stable plaques; heterogeneous plaques are associated with advanced stages of carotid plaque lesion [2]. Echogenic plaques reflect strongly the ultrasound signal, whereas echolucent ones have less reflecting ability. It has been shown that echolucent plaques, as evaluated by B-mode ultrasound, are more likely to lead to the development of neurological events than echogenic ones [3]. Analysis of digital images of carotid plaques allows assessment of plaque texture. First and second order statistical features extracted from carotid plaques may provide useful information about the correlation between texture an...

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