In vivo characterization and quantification of atherosclerotic carotid plaque components with multidetector computed tomography and histopathological correlation
In vivo characterization and quantification of atherosclerotic carotid plaque components with multidetector computed tomography and histopathological correlation
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DOI：
10.1161/01.atv.0000240518.90124.57
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发表时间：
2006-10-01
影响因子：
8.7
通讯作者：
van der Lugt, Aad
中科院分区：
文献类型：
--
作者：
de Weert, Thomas T.;Ouhlous, Mohamed;van der Lugt, Aad
目的-在以前的体外研究中，我们已经证明，动脉粥样硬化斑块的成分可以用多探测器计算机断层扫描（MDCT）的基础上的差异，亨氏值（HV）的特点。现在，我们评估了使用MDCT在体内表征和量化动脉粥样硬化颈动脉斑块成分相比，组织学作为参考standard.Methods和Results -15个症状性颈动脉狭窄（> 70%）的患者进行MDCT血管造影颈动脉内膜切除术（CEA）之前。从每个CEA标本中选择3个组织切片和相应的MDCT图像。评估主要斑块成分的HV。钙化、纤维组织和脂质核心的HV测量值分别为657 +/-416 HU、88 +/-18 HU和25 +/-19 HU。区分脂质核心与纤维组织以及纤维组织与钙化的临界值基于这些测量值，并分别设定为60 HU和130 HU。回归图显示MDCT和组织学之间良好的相关性（R-2 > 0.73），除了脂质核心面积，其仅在轻度钙化（0%至10%）的斑块中具有良好的相关性（R-2 = 0.77）。脂质核心只能在轻度钙化斑块中充分定量。
Objective - In a previous in vitro study we have demonstrated that atherosclerotic plaque components can be characterized with multidetector computed tomography (MDCT) based on differences in Hounsfield values (HV). Now we evaluated the use of MDCT in vivo to characterize and quantify atherosclerotic carotid plaque components compared with histology as reference standard.Methods and Results - Fifteen symptomatic patients with carotid stenosis (> 70%) underwent MDCT angiography before carotid endarterectomy (CEA). From each CEA specimen 3 histological sections and corresponding MDCT images were selected. The HV of the major plaque components were assessed. The measured HV were: 657 +/- 416HU, 88 +/- 18HU, and 25 +/- 19HU for calcifications, fibrous tissue, and lipid core, respectively. The cut-off value to differentiate lipid core from fibrous tissue and fibrous tissue from calcifications was based on these measurements and set at 60 HU and 130 HU, respectively. Regression plots showed good correlations (R-2 > 0.73) between MDCT and histology except for lipid core areas, which had a good correlation (R-2 = 0.77) only in mildly calcified (0% to 10%) plaques.Conclusions - MDCT is able to quantify total plaque area, calcifications, and fibrous tissue in atherosclerotic carotid plaques in good correlation with histology. Lipid core can only be adequately quantified in mildly calcified plaques.