The diagnostic accuracy of ex vivo MRI for human atherosclerotic plaque characterization
The diagnostic accuracy of ex vivo MRI for human atherosclerotic plaque characterization
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DOI：
10.1161/01.atv.19.11.2756
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发表时间：
1999-11-01
影响因子：
8.7
通讯作者：
Fuster, V
中科院分区：
文献类型：
--
作者：
Shinnar, M;Fallon, JT;Fuster, V
最近的证据表明，动脉粥样硬化斑块的类型，而不是血流阻塞的程度，是心血管并发症风险的重要决定因素。在以前的工作中，使用MRI的斑块成分的特性的可行性被证明，这项研究扩展了以前的工作，所有的斑块成分，并显示这种方法的准确性。对22例颈动脉内膜切除术标本进行了离体MRI和组织病理学检查。MRI和组织病理学之间匹配的66个横截面。在每个横截面中，在MRI图像上前瞻性地识别是否存在斑块成分。每种组织成分的总体灵敏度和特异性非常高，钙化和纤维细胞组织易于识别。脂质核心也可识别。然而，血栓是MRI灵敏度最低的斑块成分。创建了一种半自动算法来识别所有主要的动脉粥样硬化斑块成分。MRI对颈动脉斑块的诊断具有较高的敏感性和特异性。在不久的将来，这些结果在临床环境中的应用可能是可行的。
Recent evidence indicates that the type of atherosclerotic plaque, rather than the degree of obstruction to flow, is an important determinant of the risk of cardiovascular complications. In previous work, the feasibility of using MRI for the characterization of plaque components was shown, This study extends the previous work to all the plaque components and shows the accuracy of this method. Twenty-two human carotid endarterectomy specimens underwent ex vivo MRI and histopathological examination. Sixty-six cross sections were matched between MRI and histopathology. In each cross section, the presence or absence of plaque components were prospectively identified on the MRI images. The overall sensitivity and specificity for each tissue component were very high, Calcification and fibrocellular tissue were readily identified. Lipid core was also identifiable. However, thrombus was the plaque component for which MRI had the lowest sensitivity. A semiautomated algorithm was created to identify all major atherosclerotic plaque components. MRI can characterize carotid artery plaques with a high level of sensitivity and specificity. Application of these results in the clinical setting may be feasible in the near future.