Comparison between degree of carotid stenosis observed at angiography and in histological examination
Comparison between degree of carotid stenosis observed at angiography and in histological examination
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DOI：
10.1007/s00701-004-0279-3
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发表时间：
2004-07-01
影响因子：
2.4
通讯作者：
Kramár, F
中科院分区：
文献类型：
--
作者：
Benes, V;Netuka, D;Kramár, F
背景颈动脉内膜切除术的普遍接受的适应症是颈动脉的临床表现和狭窄程度。尽管定义了狭窄测量，但方法差异很大。特殊方法的相关性，特别是血管造影和双功超声，已被反复证明。然而，任何技术和真正的解剖狭窄之间的相关性，如对手术标本的评价，一直只是传闻。在颈动脉内膜切除术中，动脉粥样硬化斑块被整块取出，随后储存并进行组织学处理。在光学显微镜下评价组织学载玻片，扫描并使用平面测量程序确定具有最大狭窄的载玻片。测量最小管腔面积和整个斑块的面积。使用平面法计算狭窄。在最大狭窄层面上测量斑块的最小直径和整个斑块的直径。根据NASCET和ECST标准，扫描血管造影图像并重新测量狭窄百分比。在147例病例中，获得了所有上述参数。使用配对样本的学生t检验来评估结果。发现。t检验表明，在解剖标本上测量的狭窄百分比与血管造影片上测量的狭窄百分比之间存在显著差异（p
Background. The generally accepted indications for carotid endarterectomy are the clinical picture and degree of per cent stenosis of the carotid artery. Despite the fact that stenosis measurement is defined, the methods vary considerably. The correlation of particular methods, especially angiography and duplex sonography, has been repeatedly demonstrated. However, the correlation between any technique and true anatomical stenosis, as evaluated on the surgical specimen, has been only anecdotally reported.Method. During carotid endarterectomy, the atherosclerotic plaque was removed in one piece and subsequently stored and histologically processed. The histological slides were evaluated under an optical microscope, scanned and the slide with maximum stenosis was determined using a planimetric program. Both the minimal lumen area and the area of the whole plaque were measured. The stenosis was calculated using the planimetric method. On the maximum stenosis slice, the minimal diameter and the diameter of the whole plaque were also measured. Angiographic images were scanned and the per cent stenoses were remeasured, according to the NASCET and ECST criteria. In total, of 147 cases, all above-mentioned parameters were obtained. Student's t tests for paired samples were used to evaluate the results.Findings. The t-tests indicated significant differences between the per cent stenosis as measured on the anatomical specimen and on the angiogram (p