The discrimination of stenosed carotid bifurcation models with smooth and irregular plaque surface. Part II. The multivariate statistical analysis of ultrasonic Doppler velocity data

Lesniak, B.; Kałużyński, K.; Liepsch, D.; Pałko, T.

doi:10.1016/s1350-4533(02)00025-5

Cited by 2 publications

(4 citation statements)

References 7 publications

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“…13 Hypoechoic carotid plaques present a higher risk of ipsilateral strokes than hyperechoic plaques. 6,14,15 Duplex sonography is essentially suitable for assessing the degree of stenosis and for visualizing the echogenicity and the surface attributes of the plaque. 16 However, endeavors to evaluate the structure of the plaque by means of different categories of echogenicity have failed because of the inadequate intraobserver and interobserver correlation.…”

Section: Gsm Analysismentioning

confidence: 99%

“…4,30 With the help of sonography, plaque surfaces can be characterized and ulceration recognized. 14,27 However, it has been shown that the reliability of evaluations of ulceration declines as the degree of stenosis rises. 31 In the cohort of stenoses Ͼ70% discussed here, there was very close agreement between the observers on the endoluminal surface analysis of the evaluable specimens.…”

Section: Plaque Surfacementioning

confidence: 99%

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Relative Value of Normalized Sonographic In Vitro Analysis of Arteriosclerotic Plaques of Internal Carotid Artery

Denzel

Balzer

Müller

et al. 2003

Stroke

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Background and Purpose-A close correlation between B-mode sonography and the histopathology and surface structure of plaque is rarely seen in vivo with high-grade stenoses of the extracranial carotid artery. The goal of this study was to determine whether normalized gray scale analysis and surface analysis of the plaque are capable of characterizing the attributes correctly. Methods-Optimized B-mode images of 107 carotid endarterectomy specimens were captured, and the gray scale median (GSM) was calculated. The specimens were classified histologically into 3 groups: (1) calcium-rich hard plaques, (2) lipid-rich soft plaques, and (3) combined plaques. The surfaces of the plaques were classified as smooth or rough on the basis of standardized reference samples. The endoluminal surface was digitally documented in vitro by videoendoscopy and again classified into the same categories. All stages of the investigation were performed by 2 observers at 2 different times. Results-Evaluation of the GSM showed close interobserver and intraobserver correlation (PϽ0.01, RϾ0.8). However, there was only 46% agreement between the GSM and the histopathological findings. In both in vitro angioscopy (ϭ0.936, PϽ0.001) and sonographic evaluation (ϭ0.842, PϽ0.001), there was a high correlation between the observers with regard to the evaluable specimens. In 73%, agreement was observed between the sonographic image and angioscopy. Conclusions-Normalized gray scale analysis and evaluation of the plaque surface in an in vitro study make possible observer-independent evaluation. The composition of the plaque cannot be visualized with sufficient accuracy by sonographic GSM analysis. This also applies to the correlation between sonography and actual surface composition of the plaque.

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Section: Gsm Analysismentioning

confidence: 99%

Section: Plaque Surfacementioning

confidence: 99%

Relative Value of Normalized Sonographic In Vitro Analysis of Arteriosclerotic Plaques of Internal Carotid Artery

Denzel

Balzer

Müller

et al. 2003

Stroke

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“…Mit Hilfe des Ultraschalls können Plaqueoberflä-chen charakterisiert und Ulzerationen erkannt werden(27,43).Tab.2 Wertigkeit der einzelnen Verfahren (Ultraschall, Computertomographie (CT), Kernspintomographie (MRT)) zur Erkennung ausgewählter Komponenten in vivo. Abb.1 Darstellung der Berechnung der medianen Grauwertverteilung einer Plaque der Arteria carotis interna im B-Bild durch ein Bildverarbeitungsprogramm.…”

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“…Weitere Studien müssen jedoch folgen, um zu klären, ob Oberflächenstruktur Die Gefahr der Entwicklung einer Embolisation ausgehend von hochgradig stenosierenden Plaques mit einer aufgerauhten, ulzerierten Oberfläche mit Intimaeinrissen sind signifikant höher als für Plaques mit einer unverletzten endoluminalen Oberfläche(37,43). Mit Hilfe des Ultraschalls können Plaqueoberflächen charakterisiert und Ulzerationen erkannt werden(27,43).Dtsch Med Wochenschr 2005; 130: 1267-1272 • C. Denzel et al, Diagnostik der Morphologie... kurzgefasst: Insgesamt kann der Ultraschall bei guter Vergleichbarkeit zwischen verschiedenen Untersuchern die Echogenität einer Plaque der Arteria carotis interna darstellen und damit klinisch relevante Aussagen über das individuelle Risiko zerebraler Symptome machen. Die Histologie einer Plaque kann alleine aus der Echogenität und Grauwertverteilung aber nicht sicher dargestellt werden.…”

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Diagnostik der Morphologie und Oberflächenstruktur von Plaques der Arteria carotis interna

Denzel¹,

Balzer²,

Müller³

et al. 2005

Dtsch med Wochenschr

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Methods of determining plaques in the extracranial internal carotid artery are ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI). The goal of this overview is to introduce these methods and discuss their diagnostic and clinical significance. Ultrasound has the capability of showing the echogenity of the plaques. This method seems to demonstrate a relationship with the incidence of hemispheric symptoms. A histological association could only rarely be seen. The surface structure can only be clearly and correctly evaluated in individual cases under optimal circumstances. Computed tomography is capable of showing the calcium content and specific site of the plaques. However, lipid content and fibrous tissue cannot be deduced reliably. The currently available image resolutions limit a detailed imaging of surface characteristics. Magnetic resonance imaging provides, in vitro, a correct rendering of plaque composition and endoluminal surface structure. In vivo it is possible to recognize both the fibrous cap and necrotic core as well as intraplaque hemorrhage. Because of certain artefacts more detailed images are difficult to interpret. In conclusion, further clinical trials should reveal, whether these methods can be set in clinical routine to detect plaque surface and morphology for stratifying patients at risk of hemispheric symptoms during the spontaneous course as well as during carotid interventions.

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The discrimination of stenosed carotid bifurcation models with smooth and irregular plaque surface. Part II. The multivariate statistical analysis of ultrasonic Doppler velocity data

Cited by 2 publications

References 7 publications

Relative Value of Normalized Sonographic In Vitro Analysis of Arteriosclerotic Plaques of Internal Carotid Artery

Relative Value of Normalized Sonographic In Vitro Analysis of Arteriosclerotic Plaques of Internal Carotid Artery

Diagnostik der Morphologie und Oberflächenstruktur von Plaques der Arteria carotis interna

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