Non-invasive in vivo characterization of human carotid plaques with acoustic radiation force impulse ultrasound: comparison with histology after endarterectomy.
Non-invasive in vivo characterization of human carotid plaques with acoustic radiation force impulse ultrasound: comparison with histology after endarterectomy.
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DOI：
10.1016/j.ultrasmedbio.2014.09.016
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发表时间：
2015-03
影响因子：
2.9
通讯作者：
Gallippi, Caterina M.
中科院分区：
文献类型：
--
作者：
Czernuszewicz, Tomasz J.;Homeister, Jonathon W.;Caughey, Melissa C.;Farber, Mark A.;Fulton, Joseph J.;Ford, Peter F.;Marston, William A.;Vallabhaneni, Raghuveer;Nichols, Timothy C.;Gallippi, Caterina M.
关键词：
血栓栓塞性缺血性卒中与颈动脉粥样硬化性疾病有关，无症状患者倾向于药物治疗。目前通过测量管腔狭窄的非侵入性成像技术来诊断疾病的程度，但已有研究表明，斑块的形态和组成是确定未来血栓栓塞症事件风险的更好的生物标志物。具体地说，由被薄纤维帽覆盖的机械柔软的脂质/坏死区组成的斑块最容易破裂。一种被称为声辐射力脉冲(ARFI)的非侵入性询问软组织机械特性的超声技术已经被开发为一种利用模体和动脉粥样硬化猪来表征动脉粥样硬化斑块的新方法，但该技术尚未在人体内得到验证。在这项初步研究中，四名接受临床指征的颈动脉内膜切除术的患者以病例研究的形式展示了体内ARFI成像，并与组织学进行了比较。在两种类型的Va斑块中，病灶区域的平均ARFI位移高于周围斑块材料，提示斑块内有较硬的层覆盖，其特征是脂质/坏死核被纤维帽覆盖。在两种以重度钙化为特征的VB斑块中，平均ARFI峰位移相对于周围斑块和动脉壁较低，提示组织僵硬。这项初步研究论证了经皮ARFI通过人体体内的机械特性来表征颈动脉粥样硬化斑块的材料和结构组成的可行性和挑战。
Ischemic stroke from thromboembolic sources is linked to carotid artery atherosclerotic disease with a trend toward medical management in asymptomatic patients. Extent of disease is currently diagnosed by noninvasive imaging techniques that measure luminal stenosis, but it has been suggested that a better biomarker for determining risk of future thromboembolic events is plaque morphology and composition. Specifically, plaques that are composed of mechanically-soft lipid/necrotic regions covered by thin fibrous caps are the most vulnerable to rupture. An ultrasound technique that noninvasively interrogates the mechanical properties of soft tissue, called acoustic radiation force impulse (ARFI) imaging, has been developed as a new modality for atherosclerotic plaque characterization using phantoms and atherosclerotic pigs, but the technique has yet to be validated in vivo in humans. In this preliminary study, in vivo ARFI imaging is presented in a case-study format from four patients undergoing clinically-indicated carotid endarterectomy and compared to histology. In two type Va plaques, characterized by lipid/necrotic cores covered by fibrous caps, mean ARFI displacements in focal regions were high relative to the surrounding plaque material, suggesting soft features covered by stiffer layers within the plaques. In two type Vb plaques, characterized by heavy calcification, mean ARFI peak displacements were low relative to the surrounding plaque and arterial wall, suggesting stiff tissue. This pilot study demonstrates the feasibility and challenges of transcutaneous ARFI for characterizing the material and structural composition of carotid atherosclerotic plaques via mechanical properties, in humans, in vivo.
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影响因子：
20.3
作者：
Chan, Hua-Chen;Ke, Liang-Yin;Chen, Chu-Huang
通讯作者：
Chen, Chu-Huang
影响因子：
2.4
作者：
Bernal, Miguel;Nenadic, Ivan;Greenleaf, James F.
通讯作者：
Greenleaf, James F.
DOI：
10.1109/tuffc.2009.1126
发表时间：
2009-05-01
影响因子：
3.6
作者：
Dumont, Douglas;Dahl, Jeremy;Trahey, Gregg
通讯作者：
Trahey, Gregg
影响因子：
2.9
作者：
Behler, Russell H.;Nichols, Timothy C.;Gallippi, Caterina M.
通讯作者：
Gallippi, Caterina M.
影响因子：
4.3
作者：
Gronholdt, MLM;Nordestgaard, BG;Sillesen, H
通讯作者：
Sillesen, H