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Plaque Elasticity and Intraplaque Neovascularisation on Carotid Artery Ultrasound: A Comparative Histological Study.
- Source :
-
European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery [Eur J Vasc Endovasc Surg] 2021 Sep; Vol. 62 (3), pp. 358-366. - Publication Year :
- 2021
-
Abstract
- Objective: Plaque elasticity and intraplaque neovascularisation are strongly suggestive of vulnerable plaque. This study aimed to investigate the relationship between intraplaque neovascularisation and plaque elasticity, and to compare the ultrasound findings with histopathological changes.<br />Methods: Patients enrolled in this study presented with symptomatic carotid stenosis (> 70%) and later underwent both pre-operative ultrasonography and endarterectomy. Contrast enhanced ultrasound (CEUS) and shear wave elastography (SWE) were used to measure the neovascularisation and elasticity of the plaque, respectively. After removal, plaques were histologically assessed to determine the microvessel density (MVD), matrix metalloproteinase (MMP)-9 expression, and type I/type III collagen ratio using immunohistochemistry staining and morphometry. A correlation analysis was used to establish the relationship among the aforementioned quantitative parameters. Inter- and intra-observer consistency evaluations were performed using the intraclass correlation coefficient and Bland-Altman plots.<br />Results: Ninety-four symptomatic patients with 98 plaques were included. The area under the curve (AUC) of the carotid plaque detected using CEUS correlated with its shear wave velocity (SWV) (r = -.714; p < .001), MVD (r = .842; p < .001), collagen type I/III ratio (r = -.833; p < .001), and MMP-9 (r = .738; p < .001). SWE was positively correlated with the type I/III collagen ratio (r = .805; p < .001). The overall interexaminer consistency of the SWE was acceptable (r = .638; p < .001). The interobserver correlation coefficient of the AUC, time to peak (TP), mean transit time (MTT), and SWV were .719, .756, .733, and .686, respectively. The intra-observer variability values of the AUC, TP, MTT, and SWV were .826, .845, .633, and .748, respectively.<br />Conclusion: SWE and CEUS can comprehensively evaluate the vulnerability of the carotid plaque by assessing the elasticity of the plaque and neovascularisation within it. The negative correlation between the intraplaque neovascularisation and elasticity, further validated by histological findings, suggests that the more abundant the neovascularisation, the less elasticity.<br /> (Copyright © 2021 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Adult
Aged
Area Under Curve
Carotid Arteries pathology
Carotid Stenosis pathology
Contrast Media
Female
Humans
Male
Middle Aged
Neovascularization, Pathologic pathology
Observer Variation
Plaque, Atherosclerotic pathology
Risk Assessment
Carotid Arteries diagnostic imaging
Carotid Stenosis diagnostic imaging
Elasticity
Elasticity Imaging Techniques
Neovascularization, Pathologic diagnostic imaging
Plaque, Atherosclerotic diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2165
- Volume :
- 62
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 34266763
- Full Text :
- https://doi.org/10.1016/j.ejvs.2021.05.026