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Sample records for carotid plaques correlation

  1. Improved Correlation of Strain Indices with Cognitive Dysfunction with Inclusion of Adventitial Layer with Carotid Plaque.

    Science.gov (United States)

    Wang, X; Mitchell, C C; Varghese, T; Jackson, D C; Rocque, B G; Hermann, B P; Dempsey, R J

    2016-05-01

    Plaque instability may lead to chronic embolization, which in turn may contribute to progressive cognitive decline. Accumulated strain tensor indices over a cardiac cycle within a pulsating carotid plaque may be viable biomarkers for the diagnosis of plaque instability. Using plaque-only carotid artery segmentations, we recently demonstrated that impaired cognitive function correlated significantly with maximum axial and lateral strain indices within a localized region of interest in plaque. Inclusion of the adventitial layer focuses our strain or instability measures on the vessel wall-plaque interface hypothesized to be a region with increased shearing forces and measureable instability. A hierarchical block-matching motion tracking algorithm developed in our laboratory was used to estimate accumulated axial, lateral, and shear strain distribution in plaques identified with the plaque-with-adventitia segmentation. Correlations of strain indices to the Repeatable Battery for the Assessment of Neuropsychological Status Total score were performed and compared with previous results. Overall, correlation coefficients (r) and significance (p) values improved for axial, lateral, and shear strain indices. Shear strain indices, however, demonstrated the largest improvement. The Pearson correlation coefficients for maximum shear strain and cognition improved from the previous plaque-only analyses of -0.432 and -0.345 to -0.795 and -0.717 with the plaque-with-adventitia segmentation for the symptomatic group and for all patients combined, respectively. Our results demonstrate the advantage of including adventitia for ultrasound carotid strain imaging providing improved association to parameters assessing cognitive impairment in patients. This supports theories of the importance of the vessel wall plaque interface in the pathophysiology of embolic disease. PMID:26025578

  2. Carotid plaque and bone density and microarchitecture in psoriatic arthritis: the correlation with soluble ST2.

    Science.gov (United States)

    Shen, Jiayun; Shang, Qing; Wong, Chun-Kwok; Li, Edmund K; Kun, Emily W; Cheng, Isaac T; Li, Martin; Li, Tena K; Zhu, Tracy Y; Yu, Cheuk-Man; Qin, Ling; Tam, Lai-Shan

    2016-01-01

    Psoriatic arthritis (PsA) patients have increased risk of both atherosclerosis and osteoporosis. Previous studies revealed that IL-33/ST2 axis may be related to both conditions; however, these associations were never evaluated in a single patients' group. Here we explored the association among plasma levels of IL-33 and its decoy receptor soluble ST2 (sST2), carotid plaque determined by ultrasound, and volumetric bone mineral density (vBMD)/microstructure of distal radius measured by high-resolution peripheral quantitative computed tomography (HR-pQCT) in 80 PsA patients (55% male; 53.0 ± 10.1 years). Plasma sST2 levels were significantly higher in 33 (41%) patients with carotid plaques (11.2 ± 4.5 vs 7.7 ± 3.7 ng/ml, P independent explanatory variable associated with carotid plaques (OR = 1.296, 95% CI: [1.091,1.540]; P = 0.003). After adjustment for the osteoporotic risk factors, sST2 was significantly associated with higher cortical porosity (β = 0.184, [0.042,0.325]; P = 0.012) and cortical pore volume (2.247, [0.434,4.060]; P = 0.016); and had a trend to be associated with lower cortical vBMD (-2.918, [-6.111,0.275]; P = 0.073). IL-33 was not associated with carotid plaque or vBMD/microstructure. In conclusion, plasma sST2 levels were independently correlated with both carotid plaque and compromised cortical vBMD/microstructure in PsA patients. IL-33/ST2 axis may be a link between accelerated atherosclerosis and osteoporosis in PsA. PMID:27554830

  3. Molecular pathology in vulnerable carotid plaques: correlation with [18]-fluorodeoxyglucose positron emission tomography (FDG-PET)

    DEFF Research Database (Denmark)

    Graebe, M; Pedersen, Sune Folke; Borgwardt, L;

    2008-01-01

    OBJECTIVES: Atherosclerosis is recognised as an inflammatory disease, and new diagnostic tools are warranted to evaluate plaque inflammatory activity and risk of cardiovascular events. We investigated [18]-fluorodeoxyglucose (FDG) uptake in vulnerable carotid plaques visualised by positron emission...

  4. Digital Image Analysis of Ultrasound B-mode images of Carotid Atherosclerotic Plaque: Correlation with Histological Examination

    DEFF Research Database (Denmark)

    Wilhjelm, Jens E.; Rosendal, Kim; Grønholdt, Marie-Louise Moes; Jespersen, Søren Kragh; Hansen, Lars Kai; Sillesen, Henrik

    This paper reports on a study of how well texture features extracted from B-mode images of atherosclerotic plaque correlates with histological results obtained from the same plaque after carotid endarterectomy. The study reveals that a few second order texture features (diagonal moment, standard...... deviation and autocorrelation) provide good correlation within the training set (p = 0.04); However, the correlation found so far is not so high, that the method can be used in clinical prediction of plaque constituents....

  5. Carotid plaque and bone density and microarchitecture in psoriatic arthritis: the correlation with soluble ST2

    Science.gov (United States)

    Shen, Jiayun; Shang, Qing; Wong, Chun-Kwok; Li, Edmund K.; Kun, Emily W.; Cheng, Isaac T.; Li, Martin; Li, Tena K.; Zhu, Tracy Y.; Yu, Cheuk-Man; Qin, Ling; Tam, Lai-Shan

    2016-01-01

    Psoriatic arthritis (PsA) patients have increased risk of both atherosclerosis and osteoporosis. Previous studies revealed that IL-33/ST2 axis may be related to both conditions; however, these associations were never evaluated in a single patients’ group. Here we explored the association among plasma levels of IL-33 and its decoy receptor soluble ST2 (sST2), carotid plaque determined by ultrasound, and volumetric bone mineral density (vBMD)/microstructure of distal radius measured by high-resolution peripheral quantitative computed tomography (HR-pQCT) in 80 PsA patients (55% male; 53.0 ± 10.1 years). Plasma sST2 levels were significantly higher in 33 (41%) patients with carotid plaques (11.2 ± 4.5 vs 7.7 ± 3.7 ng/ml, P < 0.001). In multivariate analysis, sST2 was an independent explanatory variable associated with carotid plaques (OR = 1.296, 95% CI: [1.091,1.540]; P = 0.003). After adjustment for the osteoporotic risk factors, sST2 was significantly associated with higher cortical porosity (β = 0.184, [0.042,0.325]; P = 0.012) and cortical pore volume (2.247, [0.434,4.060]; P = 0.016); and had a trend to be associated with lower cortical vBMD (−2.918, [−6.111,0.275]; P = 0.073). IL-33 was not associated with carotid plaque or vBMD/microstructure. In conclusion, plasma sST2 levels were independently correlated with both carotid plaque and compromised cortical vBMD/microstructure in PsA patients. IL-33/ST2 axis may be a link between accelerated atherosclerosis and osteoporosis in PsA. PMID:27554830

  6. Estimation of Ultrasound Strain Indices in Carotid Plaque and Correlation to Cognitive Dysfunction

    OpenAIRE

    Wang, X; Jackson, D. C.; Mitchell, C. C.; Varghese, T; Hermann, B.P.; Kliewer, M.A.; Dempsey, R J

    2014-01-01

    Carotid plaque prone to release emboli may be predicted by increased strain variations within plaque due to arterial pulsation over a cardiac cycle. Non-invasive ultrasound strain imaging may therefore be a viable surrogate to determine the risk of embolic stroke and possible cognitive impairment. Ultrasound strain imaging was performed on 24 human subjects with significant plaque, who also underwent standardized cognitive assessment (Repeatable Battery for the Assessment of Neuropsychologica...

  7. Ultrasound features of human carotid plaques

    OpenAIRE

    Östling, Gerd

    2013-01-01

    Atherosclerotic plaques in the carotid arteries are common in a middle-aged population. When a carotid plaque ruptures it may result in a cerebrovascular event. However, only a minor part of carotid plaques will eventually rupture. Finding those plaques is essential to decide the most appropriate treatment strategy. With non-invasive ultrasound the carotid plaques can be visualized for assessment of various features. Plaques that appear dark on the ultrasound image, i.e. echolucent plaques...

  8. Carotid plaque signal differences among four kinds of T1-weighted magnetic resonance imaging techniques: A histopathological correlation study

    International Nuclear Information System (INIS)

    Several magnetic resonance (MR) imaging techniques are used to examine atherosclerotic plaque of carotid arteries; however, the best technique for visualizing intraplaque characteristics has yet to be determined. Here, we directly compared four kinds of T1-weighted (T1W) imaging techniques with pathological findings in patients with carotid stenosis. A total of 31 patients who were candidates for carotid endarterectomy were prospectively examined using a 1.5-T MRI scanner, which produced four kinds of T1W images, including non-gated spin echo (SE), cardiac-gated black-blood (BB) fast-SE (FSE), magnetization-prepared rapid acquisition with gradient echo (MPRAGE), and source image of three-dimensional time-of-flight MR angiography (SI-MRA). The signal intensity of the carotid plaque was manually measured, and the contrast ratio (CR) against the adjacent muscle was calculated. CRs from the four imaging techniques were compared to each other and correlated with histopathological specimens. CRs of the carotid plaques mainly containing fibrous tissue, lipid/necrosis, and hemorrhage were significantly different with little overlaps (range: 0.92-1.15, 1.22-1.52, and 1.55-2.30, respectively) on non-gated SE. However, BB-FSE showed remarkable overlaps among the three groups (0.89-1.10, 1.07-1.23, and 1.01-1.42, respectively). MPRAGE could discriminate fibrous plaques from hemorrhagic plaques but not from lipid/necrosis-rich plaques: (0.77-1.07, 1.45-2.43, and 0.85-1.42, respectively). SI-MRA showed the same tendencies (1.01-1.39, 1.45-2.57, and 1.12-1.39, respectively). Among T1W MR imaging techniques, non-gated SE images can more accurately characterize intraplaque components in patients who underwent CEA when compared with cardiac-gated BB-FSE, MPRAGE, and SI-MRA images. (orig.)

  9. CD105 positive neovessels are prevalent in early stage carotid lesions, and correlate with the grade in more advanced carotid and coronary plaques

    Directory of Open Access Journals (Sweden)

    Luque Ana

    2009-09-01

    Full Text Available Abstract Background Previous studies have demonstrated that expression of CD105 is a sensitive marker and indicator of endothelial cell/microvessel activation and proliferation in aggressive solid tumour growth and atherosclerotic plaque lesions. Since intimal neovascularization contributes significantly to subsequent plaque instability, haemorrhage and rupture. Methods We have used immunohistochemical analysis to investigate the expression of CD105-positive vessels in both large (carotid and medium calibre (coronary and middle cerebral artery, MCAs diseased vessels in an attempt to identify any correlation with plaque growth, stage and complication/type. Results Here we show, that carotid arteries expressed intimal neovascularization associated with CD105-positive endothelial cells, concomitant with increased inflammation in early stage lesions, preatheroma (I-III whilst they were not present in coronary plaques of the same grade. Some of these CD105-positive neovessels were immature, thin walled and without smooth muscle cell coverage making them more prone to haemorrhage and rupture. In high-grade lesions, neovessel proliferation was similar in both arterial types and significantly higher numbers of CD105-positive vasa vasorum were associated with plaque regions in coronary arteries. In contrast, although the MCAs exhibited expanded intimas and established plaques, there were very few CD105 positive neovessels. Conclusion Our results show that CD105 is a useful marker of angiogenesis within adventitial and intimal vessels and suggest the existence of significant differences in the pathological development of atherosclerosis in separate vascular beds which may have important consequences when considering management and treatment of this disease.

  10. Correlation of high-sensitivity C-reactive protein and carotid plaques with coronary artery disease in elderly patients

    OpenAIRE

    LIANG, YANHONG; HOU, YUANPING; NIU, HONGYU; Lu, Mei; Xue, Lei; Sun, Qianmei

    2015-01-01

    The aim of this study was to explore the correlation of high-sensitivity C-reactive protein (hs-CRP) and carotid plaques with the severity of coronary artery disease (CAD). A total of 140 patients with angina who underwent coronary angiography were selected and divided into a single-vessel disease group (n=11), double-vessel disease group (n=18), multi-vessel disease group (n=71) and control group (n=40). Color Doppler ultrasound was applied to measure the intima-media thickness (IMT) of the ...

  11. Assessment of carotid plaque vulnerability using structural and geometrical determinants

    International Nuclear Information System (INIS)

    Because many acute cerebral ischemic events are caused by rupture of vulnerable carotid atheroma and subsequent thrombosis, the present study used both idealized and patient-specific carotid atheromatous plaque models to evaluate the effect of structural determinants on stress distributions within plaque. Using a finite element method, structural analysis was performed using models derived from in vivo high-resolution magnetic resonance imaging (MRI) of carotid atheroma in 40 non-consecutive patients (20 symptomatic, 20 asymptomatic). Plaque components were modeled as hyper-elastic materials. The effects of varying fibrous cap thickness, lipid core size and lumen curvature on plaque stress distributions were examined. Lumen curvature and fibrous cap thickness were found to be major determinants of plaque stress. The size of the lipid core did not alter plaque stress significantly when the fibrous cap was relatively thick. The correlation between plaque stress and lumen curvature was significant for both symptomatic (p=0.01; correlation coefficient: 0.689) and asymptomatic patients (p=0.01; correlation coefficient: 0.862). Lumen curvature in plaques of symptomatic patients was significantly larger than those of asymptomatic patients (1.50±1.0 mm-1 vs 1.25±0.75 mm-1; p=0.01). Specific plaque morphology (large lumen curvature and thin fibrous cap) is closely related to plaque vulnerability. Structural analysis using high-resolution MRI of carotid atheroma may help in detecting vulnerable atheromatous plaque and aid the risk stratification of patients with carotid disease. (author)

  12. Ultrasonic echolucent carotid plaques predict future strokes

    DEFF Research Database (Denmark)

    Grønholdt, Marie-Louise; Nordestgaard, B G; Schroeder, T V; Vorstrup, S; Sillesen, H

    2001-01-01

    We tested prospectively the hypothesis that stroke development can be predicted by echolucency of carotid atherosclerotic plaques in previously symptomatic and asymptomatic patients.......We tested prospectively the hypothesis that stroke development can be predicted by echolucency of carotid atherosclerotic plaques in previously symptomatic and asymptomatic patients....

  13. Dual energy computed tomography quantification of carotid plaques calcification: comparison between monochromatic and polychromatic energies with pathology correlation

    Energy Technology Data Exchange (ETDEWEB)

    Mannelli, Lorenzo [University of Washington, Departments of Radiology, Seattle, WA (United States); Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY (United States); MacDonald, Lawrence; Ferguson, Marina; Shuman, William P.; Xu, Dongxiang; Yuan, Chun; Mitsumori, Lee M. [University of Washington, Departments of Radiology, Seattle, WA (United States); Mancini, Marcello; Ragucci, Monica; Monti, Serena [IRCCS Fondazione SDN, Naples (Italy)

    2015-05-01

    We compared carotid plaque calcification detection sensitivity and apparent cross-sectional area on CT as a function of CT beam energy using conventional CT techniques and virtual mono-energetic CT images generated from dual-energy acquisitions. Five ex-vivo carotid endarterectomy (CEA) specimens were imaged with dual-energy computed tomography. Virtual monochromatic spectrum (VMS) CT images were reconstructed at energies between 40-140 keV. The same specimens were imaged using conventional polyenergetic spectrum (PS) CT with peak beam energies 80, 100, 120, and 140 kVp. The histological calcium areas on each corresponding CEA specimen were traced manually on digitized images of Toluidine-Blue/Basic-Fuchsin stained plastic sections. 40 keV VMS CT images provided high detection sensitivity (97 %) similar to conventional PS CT images (∝96 %). The calcification size measured on CT decreased systematically with increasing CT beam energy; the rate of change was larger for the VMS images than for PS images. From a single dual-energy CT, multiple VMS-CT images can be generated, yielding equivalent detection sensitivity and size correlations as conventional PS-CT in CEA calcification imaging. VMS-CT at 80-100 keV provided the most accurate estimates of calcification size, as compared to histology, but detection sensitivity was reduced for smaller calcifications on these images. (orig.)

  14. Fully automatic plaque segmentation in 3-D carotid ultrasound images.

    Science.gov (United States)

    Cheng, Jieyu; Li, He; Xiao, Feng; Fenster, Aaron; Zhang, Xuming; He, Xiaoling; Li, Ling; Ding, Mingyue

    2013-12-01

    Automatic segmentation of the carotid plaques from ultrasound images has been shown to be an important task for monitoring progression and regression of carotid atherosclerosis. Considering the complex structure and heterogeneity of plaques, a fully automatic segmentation method based on media-adventitia and lumen-intima boundary priors is proposed. This method combines image intensity with structure information in both initialization and a level-set evolution process. Algorithm accuracy was examined on the common carotid artery part of 26 3-D carotid ultrasound images (34 plaques ranging in volume from 2.5 to 456 mm(3)) by comparing the results of our algorithm with manual segmentations of two experts. Evaluation results indicated that the algorithm yielded total plaque volume (TPV) differences of -5.3 ± 12.7 and -8.5 ± 13.8 mm(3) and absolute TPV differences of 9.9 ± 9.5 and 11.8 ± 11.1 mm(3). Moreover, high correlation coefficients in generating TPV (0.993 and 0.992) between algorithm results and both sets of manual results were obtained. The automatic method provides a reliable way to segment carotid plaque in 3-D ultrasound images and can be used in clinical practice to estimate plaque measurements for management of carotid atherosclerosis. PMID:24063959

  15. Evaluation of Carotid Plaque Using Ultrasound Imaging

    Science.gov (United States)

    2016-01-01

    Traditional risk factors for predicting of cardiovascular disease are not always effective predictors for development of cardiovascular events. This review summarizes several newly developed noninvasive imaging techniques for evaluating carotid plaques and their role in cardiovascular disease risk.

  16. Carotid artery disease : plaque features and vulnerability

    OpenAIRE

    Jashari, Fisnik

    2015-01-01

    Background: Atherosclerosis is an important cause of stroke. Ultrasound offers the convenience of real-time and detailed assessment of carotid plaque features as well as arterial wall thickening and composition. Evaluation of these features is important for determining patients’ risk of suffering vascular events and also contributes to selecting the best treatment strategy. Methods: Using ultrasound data analysis we have determined plaque features in the bifurcation and internal carotid arter...

  17. Spiral computed tomographic imaging related to computerized ultrasonographic images of carotid plaque morphology and histology

    DEFF Research Database (Denmark)

    Grønholdt, Marie-Louise; Wagner, A; Wiebe, B M;

    2001-01-01

    Echolucency of carotid atherosclerotic plaques, as evaluated by computerized B-mode ultrasonographic images, has been associated with an increased incidence of brain infarcts on cerebral computed tomographic scans. We tested the hypotheses that characterization of carotid plaques on spiral computed...... tomographic images correlates with that on computerized B-mode ultrasonographic images and that spiral computed tomographic imaging predicts the histomorphometric plaque content....

  18. 18FDG PET and ultrasound echolucency in carotid artery plaques

    DEFF Research Database (Denmark)

    Graebe, Martin; Pedersen, Sune F; Højgaard, Liselotte;

    2010-01-01

    ultrasound and PET imaging. Plaque standardized gray scale medians (GSM) were measured in longitudinal ultrasound images to quantitate echolucency, and GSM values were compared with FDG PET uptake quantified by maximum standardized uptake values (SUV). Symptomatic plaques were compared with contralateral...... carotid artery plaques considered asymptomatic, and in 17 symptomatic patients, endarterectomized plaque specimens were analyzed for CD68 expression. RESULTS: There was a negative correlation between GSM and FDG SUV (r = -0.56, p < 0.01). Whereas echo-rich plaques tended to show low FDG uptake, echolucent...... plaques ranged from high to low inflammatory activity, as depicted with PET. Quantitative FDG SUV differentiated asymptomatic from symptomatic plaques, whereas GSM values did not. There was a positive correlation between CD68 expression and FDG uptake (r = 0.50, p = 0.04). CONCLUSIONS: Our results...

  19. Three-dimensional carotid ultrasound plaque texture predicts vascular events

    DEFF Research Database (Denmark)

    van Engelen, Arna; Wannarong, Thapat; Parraga, Grace;

    2014-01-01

    BACKGROUND AND PURPOSE: Carotid ultrasound atherosclerosis measurements, including those of the arterial wall and plaque, provide a way to monitor patients at risk of vascular events. Our objective was to examine carotid ultrasound plaque texture measurements and the change in carotid plaque...

  20. Reproducibility of Two 3-D Ultrasound Carotid Plaque Quantification Methods

    DEFF Research Database (Denmark)

    Graebe, Martin; Entrekin, Robert; Collet-Billon, Antoine; Harrison, Gerard; Sillesen, Henrik

    2014-01-01

    -sectional, 2-D freehand sweep and a mechanical 3-D ultrasound investigation of 62 carotid artery plaques is reported with intra-class correlation coefficients (with 95% confidence intervals). Inter-observer agreement was 0.60 (0.29-0.77) for the freehand method and 0.89 (0.83-0.93) for the mechanical 3-D...

  1. Association between carotid plaque composition assessed by multidetector computed tomography and cerebral embolism after carotid stenting

    Energy Technology Data Exchange (ETDEWEB)

    Uchiyama, Naoyuki [Kanazawa University, Department of Neurosurgery and Radiology, Graduate School of Medical Science, Kanazawa (Japan); Kanazawa University, Department of Neurosurgery, Division of Neuroscience, Graduate School of Medical Science, Kanazawa, Ishikawa (Japan); Misaki, Kouichi; Mohri, Masanao; Watanabe, Takuya; Hirota, Yuichi; Nakada, Mitsutoshi; Hayashi, Yutaka; Ueda, Fumiaki; Hamada, Jun-ichiro [Kanazawa University, Department of Neurosurgery and Radiology, Graduate School of Medical Science, Kanazawa (Japan)

    2012-05-15

    We aimed to assess the relationship between atherosclerotic carotid plaque composition analyzed using multidetector computed tomography (MDCT) and the appearance of new ischemic lesions detected by diffusion-weighted images (DWI) after carotid artery stenting (CAS). We quantitatively and qualitatively analyzed plaque characteristics in carotid arteries using MDCT before CAS in 19 patients. Carotid plaques were expediently subdivided into four components with Hounsfield unit (HU) values of <0, 0-60, 60-130, and >600. The incidence of distal embolism was evaluated with DWI. Pearson's correlation analyses were used to assess the association between plaque composition and the incidence of cerebral embolization. Fifteen patients (79%) demonstrated new DWI lesions after CAS. High-signal DWIs were noted as follows: one in six patients, 2{proportional_to}5 in five patients, 6{proportional_to}10 in two patients, and >10 in two patients. The mean volumes of the plaque components for HU < 0, 0-60, 60-130, and >600 were 5.4, 200, 260, and 59 mm{sup 3}, respectively. There was a strong correlation between the number of high-signal DWI lesions in the ipsilateral side and the plaque volume of HU < 0 (r = 0.927; P < 0.0001). There was a moderate correlation between the number of high-signal DWI lesions and the plaque volume of HU 0-60 (r = 0.568; P = 0.0099) and the sum total of HU < 0 and HU 0-60 (r = 0.609; P = 0.0047). Quantitative and qualitative tissue characterization of carotid plaques using MDCT might be a useful predictor for silent ischemic lesions after CAS. (orig.)

  2. Aterofisiol® in carotid plaque evolution

    Directory of Open Access Journals (Sweden)

    Amato B

    2015-07-01

    Full Text Available Bruno Amato,1,2,* Rita Compagna,1,2,* Maurizio Amato,2 Luca Gallelli,3 Stefano de Franciscis,1,4,* Raffaele Serra1–4,*1Interuniversity Center of Phlebolymphology (CIFL, International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Catanzaro, 2Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, 3Department of Health Sciences, University of Catanzaro, Catanzaro, 4Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy*These authors contributed equally to this workBackground: In patients with carotid stenosis, the risk of plaque rupture is related to the composition of the atherosclerotic plaque rather than to its magnitude. In this regard, we evaluated the effects of a supplement, Aterofisiol,® containing omega-3 (EPA [eicosapen acid] DHA [docosahexaenoic acid], vitamin K2, vitamin B6, vitamin B12, oligomeric proanthocyanidins (OPC and resveratrol on the composition of atherosclerotic plaque and on neurological symptoms in patients with carotid stenosis undergoing carotid endarterectomy.Methods: The study was randomized, prospective, and double-blinded. Eligible patients were of both sexes, with carotid stenosis >70% who underwent endarterectomy. Enrolled patients were randomly allocated to receive either one tablet of acetylsalicylic acid 100 mg (Cardioaspirin® + one tablet of Aterofisiol every 24 hours or one tablet of Cardioaspirin + one tablet of placebo every 24 hours. Each treatment was started 30 days before the surgery and was stopped 5 days before the surgery. The plaques were removed “en bloc” using standard surgical technique.Results: During the study period, 214 patients (135 men and 79 women were enrolled for intent-to-treat and randomized in two groups: Group A: 107 patients (68 men and 39 women were treated with Cardioaspirin + Aterofisiol. Group B: 107 patients (67 men and 40

  3. Dendritic Cells Expressing Triggering Receptor Expressed on Myeloid Cells-1 Correlate with Plaque Stability in Symptomatic and Asymptomatic Patients with Carotid Stenosis

    Science.gov (United States)

    Shao, Zhifei; Agrawal, Devendra K.

    2016-01-01

    Atherosclerosis is a chronic inflammatory disease with atherosclerotic plaques containing inflammatory cells, including T-lymphocytes, dendritic cells (DCs) and macrophages that are responsible for progression and destabilization of atherosclerotic plaques. Stressed cells undergoing necrosis release molecules that act as endogenous danger signals to alert and activate innate immune cells. In atherosclerotic tissue the number of DCs increases with the progression of the lesion and produce several inflammatory cytokines and growth factors. Triggering receptor expressed on myeloid cells (TREM)-1 plays a crucial role in inflammation. However, relationship of DCs and the role of TREM-1 with the stability of atherosclerotic plaques have not been examined. In this study, we investigated the heterogeneity of the plaque DCs, myeloid (mDC1 and mDC2) and plasmacytoid (pDCs), and examined the expression of TREM-1 and their co-localization with DCs in the plaques from symptomatic (S) and asymptomatic (AS) patients with carotid stenosis. We found increased expression of HLA-DR, fascin, and TREM-1 and decreased expression of TREM-2 and α-smooth muscle actin in S compared to AS atherosclerotic carotid plaques. Both TREM-1 and fascin were co-localized suggesting increased expression of TREM-1 in plaque DCs of S compared to AS patients. These data were supported by increased mRNA transcripts of TREM-1 and decreased mRNA transcripts of TREM-2 in carotid plaques of S compared to AS patients. There was higher density of both CD1c+ mDC1 and CD141+ mDC2 in the carotid plaques from AS compared to S patients, where as the density of CD303+ pDCs were higher in the carotid plaques of S compared to AS patients. These findings suggest a potential role of pDCs and TREM-1 in atherosclerotic plaque vulnerability. Thus, newer therapies could be developed to selectively block TREM-1 for stabilizing atherosclerotic plaques. PMID:27148736

  4. Mechanical Stresses in Carotid Plaques

    DEFF Research Database (Denmark)

    Samuel, Samuel Alberg

    af stenose. Den tredje artikel; “The Effect of Plaque Morphology on Fibrous Cap Stress Levels”, er en parametrisk analyse af den relative betydning af lipidkernens størrelse, den fibrøse kappes tykkelse, graden af forsnævring og lipidkernens placering for stress-niveauet i den fibrøse kappe. Alle...... patienter med aterosklerose i a. carotis kunne derfor med fordel ændres til at inkludere morfologiske markører. Nylige fremskridt indenfor hard- og software har muliggjort beregning af de kræfter, som påvirker plaques og de resulterende stress-niveauer. Jævnfør plaquerupturs traumatiske natur, regnes de...... mekaniske kræfter, som påvirker den fibrøse kappe, for at være en medvirkende årsag til plaqueruptur. Endvidere er stress-niveauerne i den fibrøse kappe en risikomarkør, som påvirkes af såvel den fibrøse kappetykkelse som lipid kerne størrelsen, blodtryk og graden af forsnævring. Imidlertid har hidtidige...

  5. Spectral CT of carotid atherosclerotic plaque: comparison with histology

    International Nuclear Information System (INIS)

    To distinguish components of vulnerable atherosclerotic plaque by imaging their energy response using spectral CT and comparing images with histology. After spectroscopic calibration using phantoms of plaque surrogates, excised human carotid atherosclerotic plaques were imaged using MARS CT using a photon-processing detector with a silicon sensor layer and microfocus X-ray tube (50 kVp, 0.5 mA) at 38-μm voxel size. The plaques were imaged, sectioned and re-imaged using four threshold energies: 10, 16, 22 and 28 keV; then sequentially stained with modified Von Kossa, Perl's Prussian blue and Oil-Red O, and photographed. Relative Hounsfield units across the energies were entered into a linear algebraic material decomposition model to identify the unknown plaque components. Lipid, calcium, iron and water-like components of plaque have distinguishable energy responses to X-ray, visible on spectral CT images. CT images of the plaque surface correlated very well with histological photographs. Calcium deposits (>1,000 μm) in plaque are larger than iron deposits (<100 μm), but could not be distinguished from each other within the same voxel using the energy range available. Spectral CT displays energy information in image form at high spatial resolution, enhancing the intrinsic contrast of lipid, calcium and iron within atheroma. (orig.)

  6. MR imaging in carotid artery atherosclerosis plaque characterization

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the potential role of carotid artery atherosclerosis plaque magnetic resonance (MR) microimaging as magnetic resonance imaging (MRI) marker, ex vivo MR images were acquired at optimized parameters on 9.4T Bruker animal imager for occluded tissue resected by carotid endarterectomy (CEA) and corresponding histopathological analysis was made. For imaging, CEA tissues of size 2-6 cm long and 0.5-1.5 cm wide, were transferred to 15 ml co-polymer laboratory culture tubes containing either 10% formalin in phosphate buffered saline (PBS) or in 50% glycerol in PBS. Imaging protocol was set at echo time (TE)=30 ms, repetition time (TR)=1.5 s, matrix size=265 x 512, number of excitations (NEX)=128, slice thickness=1 mm and in-plane resolution=0.1 mm for total sample size 2.5 cm. Soon after imaging done, carotid artery tissues were cut into 5-mm segments and processed for histological section for successive 5-micrometer slices. To compare morphology of 5 μm thin CEA section with that of 1 mm MR slices, registration was obtained between histologic sections and MR slices. Contrast and magnetic resonance relaxation characteristics were analyzed. Total carotid artery area computed by MR imaging was correlated with areas determined from histologic sections (r2=0.989, p=0.0001). For the lumen area, the correlation between MR images and histologic area was (r2 0.942, p=0.0001). Relaxation times and T2 parametric images of different plaque components were determinant for contrast resolution. Scan parameters were optimized for fibrous cap and atheroma. Scan parameters were characteristic for comparison at 1.5T and 9.4T MR imagers. The observed correlation validated MR microimaging to assess morphological features of carotid artery plaques and contrast resolution highlighted the potential of in vivo MR imaging as non-invasive MRI marker to monitor carotid artery plaque morphometry and plaque composition. (author)

  7. Optical detection of structural changes in human carotid atherosclerotic plaque

    Science.gov (United States)

    Korol, R. M.; Canham, P. B.; Finlay, H. M.; Hammond, R. R.; Quantz, M.; Ferguson, G. G.; Liu, L. Y.; Lucas, A. R.

    2005-08-01

    Background: Arterial bifurcations are commonly the sites of developing atherosclerotic plaque that lead to arterial occlusions and plaque rupture (myocardial infarctions and strokes). Laser induced fluorescence (LIF) spectroscopy provides an effective nondestructive method supplying spectral information on extracellular matrix (ECM) protein composition, specifically collagen and elastin. Purpose: To investigate regional differences in the ECM proteins -- collagen I, III and elastin in unstable plaque by analyzing data from laser-induced fluorescence spectroscopy of human carotid endarterectomy specimens. Methods: Gels of ECM protein extracts (elastin, collagen types I & III) were measured as reference spectra and internal thoracic artery segments (extra tissue from bypass surgery) were used as tissue controls. Arterial segments and the endarterectomy specimens (n=21) were cut into 5mm cross-sectional rings. Ten fluorescence spectra per sampling area were then recorded at 5 sites per ring with argon laser excitation (357nm) with a penetration depth of 200 μm. Spectra were normalized to maximum intensity and analyzed using multiple regression analysis. Tissue rings were fixed in formalin (within 3 hours of surgery), sectioned and stained with H&E or Movat's Pentachrome for histological analysis. Spectroscopy data were correlated with immunohistology (staining for elastin, collagen types I, III and IV). Results: Quantitative fluorescence for the thoracic arteries revealed a dominant elastin component on the luminal side -- confirmed with immunohistology and known artery structure. Carotid endarterectomy specimens by comparison had a significant decrease in elastin signature and increased collagen type I and III. Arterial spectra were markedly different between the thoracic and carotid specimens. There was also a significant elevation (pcarotid specimens. Conclusion: Fluorescence spectroscopy is an effective method for evaluating ECM (collagen and elastin) associated

  8. Multimodality imaging of carotid atherosclerotic plaque: Going beyond stenosis

    OpenAIRE

    Divyata Hingwala; Chandrasekharan Kesavadas; Sylaja, Padmavathy N; Bejoy Thomas; Tirur Raman Kapilamoorthy

    2013-01-01

    Apart from the degree of stenosis, the morphology of carotid atherosclerotic plaques and presence of neovascularization are important factors that may help to evaluate the risk and ′vulnerability′ of plaques and may also influence the choice of treatment. In this article, we aim to describe the techniques and imaging findings on CTA, high resolution MRI and contrast enhanced ultrasound in the evaluation of carotid atherosclerotic plaques. We also discuss a few representative cases from our in...

  9. Quantitative analysis of ultrasound B-mode images of carotid atherosclerotic plaque: correlation with visual classification and histological examination

    DEFF Research Database (Denmark)

    Wilhjelm, Jens E.; Grønholdt, Marie-Louise; Wiebe, Brit;

    1998-01-01

    regions of the plaque in still ultrasound images from three orthogonal scan planes and finally a histological analysis of the surgically removed plaque. The quantitative comparison was made with the linear model and with separation of the available data into training and test sets. The comparison of...... subjective classification with features from still ultrasound images revealed an overall agreement of 60 % for classification of echogenicity and 70 % for classification of structure. Comparison of the histologically determined relative volume of soft materials with features from the still images revealed a...... soft materials for individual patients. Reasons for this is discussed in the paper, together with suggestions for improvements....

  10. MRI-based Biomechanical Modeling of Carotid Atherosclerotic Plaques: The stable plaque paradigm

    OpenAIRE

    Nieuwstadt, Harm

    2015-01-01

    markdownabstract__Abstract__ Carotid atherosclerosis is a common cause of acute ischemic stroke and places a major burden on worldwide health-related quality of life. The currently-used stenosis-degree guidelines to decide on surgical intervention through carotid endarterectomy in order to prevent a future event are imperfect. This is because they insufficiently target plaque vulnerability. To provide an alternative carotid plaque vulnerability assessment, one can compute the biomechanical pe...

  11. Tensile and compressive properties of fresh human carotid atherosclerotic plaques.

    LENUS (Irish Health Repository)

    Maher, Eoghan

    2009-12-11

    Accurate characterisation of the mechanical properties of human atherosclerotic plaque is important for our understanding of the role of vascular mechanics in the development and treatment of atherosclerosis. The majority of previous studies investigating the mechanical properties of human plaque are based on tests of plaque tissue removed following autopsy. This study aims to characterise the mechanical behaviour of fresh human carotid plaques removed during endarterectomy and tested within 2h. A total of 50 radial compressive and 17 circumferential tensile uniaxial tests were performed on samples taken from 14 carotid plaques. The clinical classification of each plaque, as determined by duplex ultrasound is also reported. Plaques were classified as calcified, mixed or echolucent. Experimental data indicated that plaques were highly inhomogeneous; with variations seen in the mechanical properties of plaque obtained from individual donors and between donors. The mean behaviour of samples for each classification indicated that calcified plaques had the stiffest response, while echolucent plaques were the least stiff. Results also indicated that there may be a difference in behaviour of samples taken from different anatomical locations (common, internal and external carotid), however the large variability indicates that more testing is needed to reach significant conclusions. This work represents a step towards a better understanding of the in vivo mechanical behaviour of human atherosclerotic plaque.

  12. The relationship between the angiographic findings and the clinical features of carotid artery plaque.

    Science.gov (United States)

    Kim, D I; Lee, S J; Lee, B B; Kim, Y I; Chung, C S; Seo, D W; Lee, K H; Ko, Y H; Kim, D K; Do, Y S; Byun, H S

    2000-01-01

    The purpose of this study was to investigate the histological characteristics of atheromatous carotid plaque, and to analyze the relationship between the angiographic findings and the clinical features. We retrospectively reviewed 55 cases of carotid endarterectomy for extracranial internal carotid artery stenosis, who were treated at our institute from January 1995 to December 1997. The histological examination included hematoxylin-eosin staining, Masson-trichrome staining, and immunostaining for antismooth muscle antibody and anti-CD68 antibody. The main compositions of the carotid plaque included synthetic type vascular smooth muscle cells and extracellular matrix. The histological findings showed ulceration in 49 (89.1%) cases, calcium deposits in 42 (76.4%) cases, and an inflammatory reaction in 44 (80.0%) cases. Neurological abnormalities were strongly associated with plaque ulceration (P = 0.045) and an inflammatory reaction (P = 0.013), whereas no correlation existed regarding calcium deposits (P = 0.173). The angiographic findings showed ulceration in 46 (83.6%) cases. Plaque ulceration in the angiography findings showed no statistically significant correlation with the histologic findings (P = 0.410) and preoperative neurologic abnormalities (P = 0.059). All of the atherosclerotic risk factors such as hypertension, smoking, diabetes mellitus, hyperlipidemia, and myocardial infarction had no statistically significant correlation with the histological features of the carotid plaque. In conclusion, the main compositions of carotid plaque were synthetic-type vascular smooth muscle cells and extracellular matrix. The histological ulceration and inflammatory reaction of the plaque showed a statistically significant correlation with the preoperative neurologic symptoms, whereas no correlation was seen in the calcium deposits. Angiographic ulceration showed no correlation with the histological findings or preoperative neurologic abnormalities. In addition, the

  13. Carotid plaque burden as a measure of subclinical atherosclerosis

    DEFF Research Database (Denmark)

    Sillesen, Henrik; Muntendam, Pieter; Adourian, Aram; Entrekin, Robert; Garcia, Mario; Falk, Erling; Fuster, Valentin

    2012-01-01

    The purpose of this study was to compare carotid plaque burden, carotid intima-media thickness (cIMT), ankle-brachial index (ABI), and abdominal aortic diameter (AAD) to coronary artery calcium score (CACS) in people without known cardiovascular disease....

  14. Contemporary carotid imaging: from degree of stenosis to plaque vulnerability.

    Science.gov (United States)

    Brinjikji, Waleed; Huston, John; Rabinstein, Alejandro A; Kim, Gyeong-Moon; Lerman, Amir; Lanzino, Giuseppe

    2016-01-01

    Carotid artery stenosis is a well-established risk factor of ischemic stroke, contributing to up to 10%-20% of strokes or transient ischemic attacks. Many clinical trials over the last 20 years have used measurements of carotid artery stenosis as a means to risk stratify patients. However, with improvements in vascular imaging techniques such as CT angiography and MR angiography, ultrasonography, and PET/CT, it is now possible to risk stratify patients, not just on the degree of carotid artery stenosis but also on how vulnerable the plaque is to rupture, resulting in ischemic stroke. These imaging techniques are ushering in an emerging paradigm shift that allows for risk stratifications based on the presence of imaging features such as intraplaque hemorrhage (IPH), plaque ulceration, plaque neovascularity, fibrous cap thickness, and presence of a lipid-rich necrotic core (LRNC). It is important for the neurosurgeon to be aware of these new imaging techniques that allow for improved patient risk stratification and outcomes. For example, a patient with a low-grade stenosis but an ulcerated plaque may benefit more from a revascularization procedure than a patient with a stable 70% asymptomatic stenosis with a thick fibrous cap. This review summarizes the current state-of-the-art advances in carotid plaque imaging. Currently, MRI is the gold standard in carotid plaque imaging, with its high resolution and high sensitivity for identifying IPH, ulceration, LRNC, and inflammation. However, MRI is limited due to time constraints. CT also allows for high-resolution imaging and can accurately detect ulceration and calcification, but cannot reliably differentiate LRNC from IPH. PET/CT is an effective technique to identify active inflammation within the plaque, but it does not allow for assessment of anatomy, ulceration, IPH, or LRNC. Ultrasonography, with the aid of contrast enhancement, is a cost-effective technique to assess plaque morphology and characteristics, but it is

  15. Chlamydia pneumoniae in atherosclerotic carotid artery plaques: high prevalence among heavy smokers.

    Science.gov (United States)

    Dobrilovic, N; Vadlamani, L; Meyer, M; Wright, C B

    2001-06-01

    This study was designed to determine the prevalence of Chlamydia pneumoniae in carotid artery plaques. Although there have been numerous studies evaluating coronary plaques for this bacterium fewer studies have assessed noncoronary vasculature. In addition we wished to evaluate whether correlation exists between the presence of C. pneumoniae in carotid plaques and established risk factors for atherosclerosis. Sixty intact carotid artery plaques removed during surgery (carotid endarterectomy) were formalin-fixed and paraffin-embedded according to conventional techniques. These samples were evaluated by polymerase chain reaction analysis to detect presence of C. pneumoniae DNA. Results were tabulated and compared against established risk factors for atherosclerosis: diabetes, hypertension, hyperlipidemia, age, and smoking. Forty-two (70.0%) of the 60 plaques that were evaluated tested positive for the presence of C. pneumoniae DNA by polymerase chain reaction analysis. In the sample defined as being from heavy smokers (greater than 15-pack-year history) 33 (94.3%) of 35 plaques tested positive whereas two (5.7%) tested negative. This correlation demonstrated statistical significance (P = 1.36 x 10(-6), two-tailed Fisher exact test). Presence of C. pneumoniae in carotid plaques demonstrated no statistically significant correlation with diabetes, hypertension, or hyperlipidemia. Age as a risk factor was examined but not statistically evaluated because of the narrow range within our patient sample. Analysis of the data reveals that C. pneumoniae is present in large numbers of atheromatous plaques as is consistent with emerging data. What is interesting though is that 33 (94.3%) of the 35 smokers had plaques that tested positive for the bacterium as opposed to only nine (36.0%) of the 25 nonsmokers. Identification of specific populations exhibiting a high prevalence of C. pneumoniae may serve to focus future studies. Ongoing investigation will seek to determine whether C

  16. Multimodality imaging of carotid atherosclerotic plaque: Going beyond stenosis

    Science.gov (United States)

    Hingwala, Divyata; Kesavadas, Chandrasekharan; Sylaja, Padmavathy N; Thomas, Bejoy; Kapilamoorthy, Tirur Raman

    2013-01-01

    Apart from the degree of stenosis, the morphology of carotid atherosclerotic plaques and presence of neovascularization are important factors that may help to evaluate the risk and ‘vulnerability’ of plaques and may also influence the choice of treatment. In this article, we aim to describe the techniques and imaging findings on CTA, high resolution MRI and contrast enhanced ultrasound in the evaluation of carotid atherosclerotic plaques. We also discuss a few representative cases from our institute with the related clinical implications. PMID:23986615

  17. Multimodality imaging of carotid atherosclerotic plaque: Going beyond stenosis

    Directory of Open Access Journals (Sweden)

    Divyata Hingwala

    2013-01-01

    Full Text Available Apart from the degree of stenosis, the morphology of carotid atherosclerotic plaques and presence of neovascularization are important factors that may help to evaluate the risk and ′vulnerability′ of plaques and may also influence the choice of treatment. In this article, we aim to describe the techniques and imaging findings on CTA, high resolution MRI and contrast enhanced ultrasound in the evaluation of carotid atherosclerotic plaques. We also discuss a few representative cases from our institute with the related clinical implications.

  18. The Influence of Various Morphologic and Hemodynamic Carotid Plaque Characteristics on Neurological Events Onset and Deaths

    Directory of Open Access Journals (Sweden)

    Milan D. Brajovic

    2009-01-01

    Full Text Available A group of 72 patients with 111 asymptomatic carotid stenoses (ACS, mean age 65.42 ± 9.21, and a group of 36 patients with 58 symptomatic carotid stenoses (SCS, mean age 67.63 ± 8.79, were analyzed prospectively during a 3-year follow-up period. All patients underwent color duplex scan sonography (CDS, carotid arteriography, computed tomography (CT scan, and neurological examination. The aim of the study was to analyze the correlation between echo plaque morphology (degree and plaque quality, local hemodynamic plaque characteristics, ischemic CT findings, and onset of new neurological events and deaths. The results analysis showed significantly more ACS in the group of 30–49% stenosis (p < 0.001, but significantly more SCS in the group of 70–89% (p < 0.0001 and ≥90% stenosis (p < 0.05. Fibrous plaque was more frequent in the ACS group (p < 0.001, while ulcerated and mixed plaques were more frequent in the SCS group (both p < 0.0001. In the SCS group, a significantly higher frequency of increased peak systolic and end diastolic velocities was noted at the beginning and end of the study (both p < 0.01, as well as for contralateral common (CCA or internal carotid artery (ICA occlusion (p < 0.05 and p < 0.01, respectively, but reduced carotid blood flow volume (p < 0.05 only at the end of the study. In the ACS group, the best correlation with new neurological events and deaths was shown with positive CT findings, peak systolic flow velocity over 210 cm/sec, end diastolic flow velocity over 110 cm/sec, plaque stenosis ≥70%, plaque ulceration, mixed plaque (all p < 0.0001; stenosis ≥50% (p < 0.001; and reduced carotid blood flow volume (p < 0.05.

  19. Noninvasive carotid plaque characterization by black blood MRI

    International Nuclear Information System (INIS)

    Management of atherosclerotic carotid arteries requires both plaque characterization and determination of the degree of stenosis, especially when carotid stenting (GAS) is being considered for severe carotid stenosis. Recent studies have demonstrated that high-resolution MRI can identify plaque components, such as the lipid-rich necrotic core, intraplaque hemorrhage, fibrous tissue, and the calcification present in human carotid atherosclerosis. The purpose of this study was to assess the feasibility of black blood MRI (BB-MRI) for accurately identifying the plaque components in vivo. Twenty-six consecutive patients scheduled for carotid endarterectomy (CEA) underwent a BB-MRI examination within 2 weeks before the surgical procedure using a 1.5-T Philips scanner with a protocol that generated 2 contrast weightings (T1 and T2). The MR images were acquired using cardiac gating to minimize motion artifact and fat suppression to reduce MR signals from subcutaneous fatty tissue. The plaque evaluations obtained by BB-MRI were compared with the intra-operative video recordings, the excised specimens, and the histological sections. With BB-MRI, the combination of the signal intensities in the T1- and T2- weighted images for each component (lipid deposits, intra-plaque hemorrhage, fibrous plaque, and calcification) showed findings that corresponded with the excised specimens. Complex morphological features could also be assessed by BB-MRI. BB-MRI is a useful method for noninvasively imaging and characterizing atherosclerotic carotid arteries. This MRI technique can provide valuable information that can be used to decide whether to perform a CEA or a GAS in patients with severe carotid stenosis. Furthermore, BB-MRI appears to be a useful tool for the investigation of the pathogenesis and natural history of carotid atherosclerosis. (author)

  20. Contrast-enhanced ultrasound imaging of the vasa vasorum of carotid artery plaque

    Institute of Scientific and Technical Information of China (English)

    Ze-Zhou; Song; Yan-Ming; Zhang

    2015-01-01

    The vasa vasorum of carotid artery plaque is a novel marker of accurately evaluating the vulnerability of carotid artery plaque, which was associated with symptomatic cerebrovascular and cardiovascular disease. The presence of ultrasound contrast agents in carotid artery plaque represents the presence of the vasa vasorum in carotid artery plaque because the ultrasoundcontrast agents are strict intravascular tracers. Therefore, contrast-enhanced ultrasound(CEUS) is a novel and safe imaging modality for evaluating the vasa vasorum in carotid artery plaque. However, there are some issues that needs to be assessed to embody fully the clinical utility of the vasa vasorum in carotid artery plaque with CEUS.

  1. The influence of inaccuracies in carotid MRI segmentation on atherosclerotic plaque stress computations.

    Science.gov (United States)

    Nieuwstadt, Harm A; Speelman, Lambert; Breeuwer, Marcel; van der Lugt, Aad; van der Steen, Anton F W; Wentzel, Jolanda J; Gijsen, Frank J H

    2014-02-01

    Biomechanical finite element analysis (FEA) based on in vivo carotid magnetic resonance imaging (MRI) can be used to assess carotid plaque vulnerability noninvasively by computing peak cap stress. However, the accuracy of MRI plaque segmentation and the influence this has on FEA has remained unreported due to the lack of a reliable submillimeter ground truth. In this study, we quantify this influence using novel numerical simulations of carotid MRI. Histological sections from carotid plaques from 12 patients were used to create 33 ground truth plaque models. These models were subjected to numerical computer simulations of a currently used clinically applied 3.0 T T1-weighted black-blood carotid MRI protocol (in-plane acquisition voxel size of 0.62 × 0.62 mm2) to generate simulated in vivo MR images from a known underlying ground truth. The simulated images were manually segmented by three MRI readers. FEA models based on the MRI segmentations were compared with the FEA models based on the ground truth. MRI-based FEA model peak cap stress was consistently underestimated, but still correlated (R) moderately with the ground truth stress: R = 0.71, R = 0.47, and R = 0.76 for the three MRI readers respectively (p carotid plaques with thin caps, the current clinically used in-plane acquisition voxel size (∼0.6 mm) is inadequate. FEA plaque stress computations would be considerably more reliable if they would be used to identify thick-cap carotid plaques with low stresses instead. PMID:24317274

  2. Color doppler ultrasonography and multislice computer tomography angiography in carotid plaque detection and characterization

    Directory of Open Access Journals (Sweden)

    Vučaj-Ćirilović Viktorija

    2011-01-01

    Full Text Available Beckground/Aim. Cerebrovascular diseases are the third leading cause of mortality in the world, following malignant and cardiovascular diseases. Therefore, their timely and precise diagnostics is of great importance. The aim of this study was to compare duplex scan Color Doppler ultrasonography (CDU with multislice computed tomography angiography (MSCTA in detection of morphological and functional disorders at extracranial level of carotid arteries. Methods. The study included 75 patients with 150 carotid arteries examined in the period from January 2008 to April 2009. The patients were firstly examined by CDU, then MSCTA, followed by the surgery of extracranial segment of carotid arteries. In 10 patients, the obtained material was referred for histopathological (HP examination. We used both CDU and MSCT in the analysis of: plaque surface, plaque structure, degree of stenosis, and the presence of intraplaque hemorrhage. Results. The results obtained by CDU and MSCTA were first compared between themselves, and then to intraoperative findings. Retrospective analysis showed that MSCTA is more sensitive than CDU in assessment of plaque surface (for smooth plaques CDU 89% : MSCTA 97%; for plaques with irregular surface CDU 75% : MSCTA 87%; for ulcerations CDU 54% : MSCTA 87%. Regarding determination of plaque structure (mixed plaque CDU 66% : MSCTA 70%; correlation with HP findings CDU 94% : MSCTA 96% and localization (CDU 63% : MSCTA 65%, and in terms of sensitivity and specificity, both methods showed almost the same results. Also, there is no statistical difference between these two methods for the degree of stenosis (CDU 96% : MSCTA 98%. Conclusion. Atherosclerotic disease of extracranial part of carotid arteries primarily affects population of middle-aged and elderly, showing more associated risk factors. Sensitivity and specificity of CDU and MSCTA regarding plaque composition, the degree of stenosis and plaque localization are almost the same

  3. Common carotid artery intima-media thickness, carotid plaques, and walking speed.

    OpenAIRE

    Elbaz, Alexis; Ripert, Mahaut; Tavernier, Béatrice; Février, Benoît; Zureik, Mahmoud; Gariépy, Jérôme; Alpérovitch, Annick; Tzourio, Christophe

    2005-01-01

    BACKGROUND AND PURPOSE: Gait dysfunction is an important cause of disability among the elderly and may be, in part, of vascular origin. We studied the association between carotid ultrasound parameters and measures of gait and balance in subjects 65 to 85 years of age who participated in the baseline phase of the Three-City Study in the Dijon center. METHODS: The study population comprised 2572 noninstitutionalized individuals. Carotid plaques and common carotid artery intima-media thickness (...

  4. Data on TREM-1 activation destabilizing carotid plaques.

    Science.gov (United States)

    Rao, Velidi H; Rai, Vikrant; Stoupa, Samantha; Subramanian, Saravanan; Agrawal, Devendra K

    2016-09-01

    The data described herein are related to the article entitled "Tumor necrosis factor-α regulates triggering receptor expressed on myeloid cells-1-dependent matrix metalloproteinases in the carotid plaques of symptomatic patients with carotid stenosis" (Rao et al., 2016) [1]. Additional data are provided on the dose-response effect of TNF-α, TREM-1 antibody and recombinant rTREM-1/Fc fusion chimera (TREM-1/FC) on the expression of MMP-1 and MMP-9 in vascular smooth muscle cells (VSMCs) isolated from human carotid endarterectomy tissues. Data are also presented on the distribution of CD86+ M1- and CD206+ M2-macrophages and their co-localization with TREM-1 in symptomatic carotid plaques as visualized by dual immunofluorescence. The interpretation of this data and further extensive insights can be found in Rao et al. (2016) [1]. PMID:27331093

  5. Carotid plaque, intima-media thickness, and incident aortic stenosis

    DEFF Research Database (Denmark)

    Martinsson, Andreas; Östling, Gerd; Persson, Margaretha;

    2014-01-01

    OBJECTIVE: Aortic stenosis (AS) shares risk factors with atherosclerotic vascular disease. Carotid intima-media thickness (IMT) and plaque may reflect the cumulative damage from exposure to different atherosclerotic risk factors. We examined the relationship of carotid IMT and plaque with incident...... risk factors for incident AS were studied in age- and sex-adjusted and expanded multivariable-adjusted Cox regression models. A total of 69 (1.4%) participants developed AS during up to 20 years of follow-up. Significant risk factors for AS in age- and sex-adjusted analyses were (P<0.05) body mass...

  6. Multimodal Image Analysis for Carotid Artery Plaque Characterization

    OpenAIRE

    Engelen, Arna

    2014-01-01

    markdownabstract__Abstract__ Atherosclerosis of the carotid artery is a main cause of ischemic cerebrovascular events. There is evidence that the composition of the vessel wall is more strongly related to plaque vulnerability and subsequent events than luminal stenosis, which is currently used for risk stratification in clinical practice. Noninvasive imaging can characterize the composition of the vessel wall. In order to incorporate measures of plaque composition into clinical practice, accu...

  7. Carotid plaque age is a feature of plaque stability inversely related to levels of plasma insulin.

    Directory of Open Access Journals (Sweden)

    Sara Hägg

    Full Text Available BACKGROUND: The stability of atherosclerotic plaques determines the risk for rupture, which may lead to thrombus formation and potentially severe clinical complications such as myocardial infarction and stroke. Although the rate of plaque formation may be important for plaque stability, this process is not well understood. We took advantage of the atmospheric (14C-declination curve (a result of the atomic bomb tests in the 1950s and 1960s to determine the average biological age of carotid plaques. METHODOLOGY/PRINCIPAL FINDING: The cores of carotid plaques were dissected from 29 well-characterized, symptomatic patients with carotid stenosis and analyzed for (14C content by accelerator mass spectrometry. The average plaque age (i.e. formation time was 9.6±3.3 years. All but two plaques had formed within 5-15 years before surgery. Plaque age was not associated with the chronological ages of the patients but was inversely related to plasma insulin levels (p = 0.0014. Most plaques were echo-lucent rather than echo-rich (2.24±0.97, range 1-5. However, plaques in the lowest tercile of plaque age (most recently formed were characterized by further instability with a higher content of lipids and macrophages (67.8±12.4 vs. 50.4±6.2, p = 0.00005; 57.6±26.1 vs. 39.8±25.7, p<0.0005, respectively, less collagen (45.3±6.1 vs. 51.1±9.8, p<0.05, and fewer smooth muscle cells (130±31 vs. 141±21, p<0.05 than plaques in the highest tercile. Microarray analysis of plaques in the lowest tercile also showed increased activity of genes involved in immune responses and oxidative phosphorylation. CONCLUSIONS/SIGNIFICANCE: Our results show, for the first time, that plaque age, as judge by relative incorporation of (14C, can improve our understanding of carotid plaque stability and therefore risk for clinical complications. Our results also suggest that levels of plasma insulin might be involved in determining carotid plaque age.

  8. In-vivo Attenuation and Equivalent Scatterer size parameters for Atherosclerotic Carotid Plaque: Preliminary Results

    OpenAIRE

    Shi, Hairong; Varghese, Tomy; Mitchell, Carol C; McCormick, Matthew; Dempsey, Robert J; Kliewer, Mark A.

    2009-01-01

    We have previously reported on the equivalent scatterer size, attenuation coefficient, and axial strain properties of atherosclerotic plaque ex-vivo. Since plaque structure and composition may be damaged during a carotid endarterectomy procedure, characterization of in-vivo properties of atherosclerotic plaque is essential. The relatively shallow depth of the carotid artery and plaque enables non-invasive evaluation of carotid plaque utilizing high frequency linear array transducers. We inves...

  9. Semi-automated segmentation of carotid artery total plaque volume from three dimensional ultrasound carotid imaging

    Science.gov (United States)

    Buchanan, D.; Gyacskov, I.; Ukwatta, E.; Lindenmaier, T.; Fenster, A.; Parraga, G.

    2012-03-01

    Carotid artery total plaque volume (TPV) is a three-dimensional (3D) ultrasound (US) imaging measurement of carotid atherosclerosis, providing a direct non-invasive and regional estimation of atherosclerotic plaque volume - the direct determinant of carotid stenosis and ischemic stroke. While 3DUS measurements of TPV provide the potential to monitor plaque in individual patients and in populations enrolled in clinical trials, until now, such measurements have been performed manually which is laborious, time-consuming and prone to intra-observer and inter-observer variability. To address this critical translational limitation, here we describe the development and application of a semi-automated 3DUS plaque volume measurement. This semi-automated TPV measurement incorporates three user-selected boundaries in two views of the 3DUS volume to generate a geometric approximation of TPV for each plaque measured. We compared semi-automated repeated measurements to manual segmentation of 22 individual plaques ranging in volume from 2mm3 to 151mm3. Mean plaque volume was 43+/-40mm3 for semi-automated and 48+/-46mm3 for manual measurements and these were not significantly different (p=0.60). Mean coefficient of variation (CV) was 12.0+/-5.1% for the semi-automated measurements.

  10. Association of circulating omentin-1 level with arterial stiffness and carotid plaque in type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Yoo Hye

    2011-11-01

    Full Text Available Abstract Background Adipokines contribute directly to the atherosclerotic process, connecting metabolic disorders such as obesity and diabetes to cardiovascular disease. Omentin-1 is a recently discovered novel adipokine, so data about the relationship of this adipokine to vascular health in type 2 diabetes is limited. Methods We enrolled 60 people with type 2 diabetes, with or without carotid plaque, and 30 participants with normal glucose tolerance. We measured serum omentin-1, high-sensitivity C-reactive protein (hsCRP levels, and the homeostasis model assessment of insulin resistance (HOMA-IR, as well as other cardiovascular risk factors. Vascular health was assessed by brachial ankle pulse wave velocity (baPWV and carotid intima-media thickness (IMT. Results Serum omentin-1 levels were significantly decreased in type 2 diabetes patients compared to normal glucose controls and was further reduced in type 2 diabetes patients with carotid plaque compared to those without carotid plaque. Multiple stepwise regression analysis showed that age, systolic blood pressure, history of use of statins, angiotensin receptor blockers or angiotensin-converting enzyme inhibitors, and serum omentin-1 level were independent factors determining baPWV in people with type 2 diabetes (r2 = 0.637. Furthermore, in multivariate logistic regression analysis, circulating omentin-1 level was an independent decisive factor for the presence of carotid plaque in type 2 diabetes patients, even after adjusting for age, gender, body mass index, systolic blood pressure, fasting blood glucose, low density lipoprotein cholesterol, and history of smoking and medication (odds ratio, 0.621; 95% confidence interval, 0.420-0.919; P = 0.017. Conclusions Circulating omentin-1 level was independently correlated with arterial stiffness and carotid plaque in type 2 diabetes, even after adjusting for other cardiovascular risk factors and detailed medication history.

  11. Usefulness of contrast-enhanced ultrasound for detection of carotid plaque ulceration in patients with symptomatic carotid atherosclerosis.

    Science.gov (United States)

    ten Kate, Gerrit L; van Dijk, Anouk C; van den Oord, Stijn C H; Hussain, Burhan; Verhagen, Hence J M; Sijbrands, Eric J G; van der Steen, Antonius F W; van der Lugt, Aad; Schinkel, Arend F L

    2013-07-15

    Previous data have indicated that carotid plaque ulceration is a strong predictor of cerebrovascular events. Standard ultrasound and color Doppler ultrasound (CDUS) scans have poor diagnostic accuracy for the detection of carotid plaque ulceration. The aim of the present prospective study was to assess the value of contrast-enhanced ultrasound (CEUS) scans for the detection of carotid plaque ulceration. The Institutional Ethics Committee approved the study protocol, and all patients provided informed consent. The patients had symptomatic stenosis of the internal carotid artery and underwent carotid computed tomographic angiography as part of their clinical evaluation. All patients underwent a CDUS examination in conjunction with CEUS. Carotid plaque ulceration was defined as the presence of ≥1 disruptions in the plaque-lumen border ≥1 × 1 mm. Carotid computed tomographic angiography was used as reference technique. The study population consisted of 20 patients (mean age 64 ± 9 years, 80% men), and 39 carotid arteries were included in the present analysis. Computed tomographic angiography demonstrated that the plaque surface was smooth in 15 (38%), irregular in 7 (18%) and ulcerated in 17 (44%) carotid arteries. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CDUS for the detection of ulceration was 29%, 73%, 54%, 46%, and 57%, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CEUS for the detection of ulceration was 88%, 59%, 72%, 63%, and 87%, respectively. CEUS had superior sensitivity and diagnostic accuracy for the assessment of carotid plaque ulceration compared with CDUS. CEUS improved the intrareader and inter-reader variability for the assessment of carotid plaque ulceration compared with CDUS. In conclusion, CEUS could be an additional method for the detection of carotid plaque ulceration. The role of CDUS for the assessment of carotid plaque

  12. Statistical segmentation of carotid plaque neovascularization

    Science.gov (United States)

    Akkus, Zeynettin; Bosch, Johan G.; Sánchez-Ferrero, Gonzalo V.; Carvalho, Diego D. B.; Renaud, Guillaume; van den Oord, Stijn C. H.; ten Kate, Gerrit L.; Schinkel, Arend F. L.; de Jong, Nico; van der Steen, Antonius F. W.

    2013-03-01

    In several studies, intraplaque neovascularization (IPN) has been linked with plaque vulnerability. The recent development of contrast enhanced ultrasound enables IPN detection, but an accurate quantification of IPN is a big challenge due to noise, motion, subtle contrast response, blooming of contrast and artifacts. We present an algorithm that automatically estimates the location and amount of contrast within the plaque over time. Plaque pixels are initially labeled through an iterative expectation-maximization (EM) algorithm. The used algorithm avoids several drawbacks of standard EM. It is capable of selecting the best number of components in an unsupervised way, based on a minimum message length criterion. Next, neighborhood information using a 5×5 kernel and spatiotemporal behavior are combined with the known characteristics of contrast spots in order to group components, identify artifacts and finalize the classification. Image sequences are divided into 3-seconds subgroups. A pixel is relabeled as an artifact if it is labeled as contrast for more than 1.5 seconds in at least two subgroups. For 10 plaques, automated segmentation results were validated with manual segmentation of contrast in 10 frames per clip. Average Dice index and area ratio were 0.73+/-0.1 (mean+/-SD) and 98.5+/-29.6 (%) respectively. Next, 45 atherosclerotic plaques were analyzed. Time integrated IPN surface area was calculated. Average area of IPN was 3.73+/-3.51 mm2. Average area of 45 plaques was 11.6+/-8.6 mm2. This method based on EM contrast segmentation provides a new way of IPN quantification.

  13. CAROTID PLAQUE CLASSIFICATION USING CONTOURLET FEATURES AND SUPPORT VECTOR MACHINES

    Directory of Open Access Journals (Sweden)

    M. Thangavel

    2014-01-01

    Full Text Available The aim of this study is to propose a suitable and reliable system for better diagnosis and treatment of carotid diseases. In this study, Computer Aided Diagnosis (CAD system has been proposed for classifying carotid artery plaques using Contourlet features. Carotid images have been acquired for 124 subjects with symptoms (Amaurosis Fugax, Stroke or Transient Ischemic Attack and 133 subjects with no symptoms in the recent past. Images were normalized and plaque regions have been manually segmented by experts and these Region Of Interests (ROI have been used for further processing. Four level Contourlet transform has been applied to all ROIs and subimages were produced at different scales and orientations. Energy, Entropy, Mean and Standard deviation features were extracted from all the subimages. The feature selection has been done to select significant features and to ignore insignificant ones. Support Vector Machine classifier (SVM and Adaboost classifier have been applied to the selected features and plaques were classified as symptomatic or asymptomatic plaques. The contourlet features with Support vector machine classifier produced classification accuracy of 85.6% compared to 81.3% accuracy in Adaboost classifier. The classification results were compared with curvelet transform features and wavelet packet features. The contourlet with SVM classifier yielded better performance compared to curvelet and wavelet packet."

  14. Computerized texture analysis of carotid plaque ultrasonic images can identify unstable plaques associated with ipsilateral neurological symptoms.

    Science.gov (United States)

    Kakkos, Stavros K; Nicolaides, Andrew N; Kyriacou, Efthyvoulos; Daskalopoulou, Stella S; Sabetai, Michael M; Pattichis, Constantinos S; Geroulakos, George; Griffin, Maura B; Thomas, Dafydd

    2011-05-01

    We estimated the value of objective, computerized texture analysis of ultrasonic images in distinguishing carotid plaques associated with neurological ipsilateral symptoms (amaurosis fugax [AmF; n = 30], transient ischemic attack [TIA; n = 52], and stroke [n = 55]) from asymptomatic plaques (n = 51). We performed 3 case-control studies (1/symptom with asymptomatic plaques as control). On logistic regression, AmF was independently associated with severity of stenosis, percentage of pixels with gray levels 0 to 10 (PPCS1; measure of echolucency), and spatial gray level dependence matrices (SGLDM) information measure of correlation (IMC-1; texture); TIAs with PPCS1 (echolucency), SGLDM correlation, and skewness (both texture); and stroke with PPCS1, SGLDM correlation, and percentage of pixels with gray levels 11 to 20 (PPCS2; echolucency). The area under the curve of the regression-derived predicted probability for AmF, TIA, and stroke was 0.92, 0.82, and 0.85, respectively (all P < .001). Texture analysis can identify carotid plaques associated with a neurological event, improving the diagnostic value of echolucency measures. Texture analyses could be applied to natural history studies. PMID:21474467

  15. Gene expression and 18FDG uptake in atherosclerotic carotid plaques

    DEFF Research Database (Denmark)

    Pedersen, Sune Folke; Græbe, Martin; Hag, Anne Mette Fisker;

    2010-01-01

    PURPOSE: Metabolic assessment of vascular inflammation by 2-[F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG)-PET is a promising new approach for the evaluation of the vulnerability of atherosclerotic plaques. Quantitative real-time PCR allows measurement of gene expression of markers...... of atherosclerotic plaque vulnerability. These techniques were applied in advanced atherosclerotic disease to relate metabolism and inflammatory activity to the gene expression profile of the vulnerable atherosclerotic plaque. METHODS: Seventeen patients with clinical symptoms of cerebral vascular...... subsequently recovered by carotid endarterectomy. The gene expression of markers of vulnerability - CD68, IL-18, matrix metalloproteinase 9, cathepsin K, GLUT-1, and hexokinase type II (HK2) - were measured in plaques by quantitative PCR. RESULTS: In a multivariate linear regression model, GLUT-1, CD68...

  16. Characterization of plaque in the internal carotid artery. Comparison neuroradiological findings with pathological findings

    International Nuclear Information System (INIS)

    We evaluate the morphology of the carotid plaque using echogram, CT scan and MRI and compare those neuroradiological findings with histological findings of the plaque. We evaluated 14 cases operated with carotid endoarterectomy for carotid stenosis. We estimated the findings of the echogram, enhanced CT scan and black blood MRI (BB MRI), in comparison with the histological findings of the carotid plaque. Echogram, enhanced CT scan and MRI clearly demonstrated the plaque in cervical carotid stenosis. In most cases, echograms could show the plaque, but in some cases could not due to the back shadow caused by plaque calcification. Enhanced CT scan clearly demonstrated the calcification and the neovasculization in plaque. BB MRI clearly showed the carotid plaque. Low-intensity lesions in T1 and T2 weighted images showed hard and fibrous plaque. High-intensity lesions in T1 and T2 weighted images showed soft plaque with lipoprotein and/or hemorrhage. This study demonstrates the potential of a systemic approach to atherosclerotic plaque with enhanced CT scan and BB MRI compared with histological findings of the carotid plaque. These estimations elucidate the growth mechanism of carotid plaque. (author)

  17. Evaluating intensity normalization for multispectral classification of carotid atherosclerotic plaque

    Science.gov (United States)

    Gao, Shan; van't Klooster, Ronald; van Wijk, Diederik F.; Nederveen, Aart J.; Lelieveldt, Boudewijn P. F.; van der Geest, Rob J.

    2015-03-01

    Intensity normalization is an important preprocessing step for automatic plaque analysis in MR images as most segmentation algorithms require the images to have a standardized intensity range. In this study, we derived several intensity normalization approaches with inspiration from expert manual analysis protocols, for classification of carotid vessel wall plaque from in vivo multispectral MRI. We investigated intensity normalization based on a circular region centered at lumen (nCircle); based on sternocleidomastoid muscle (nSCM); based on intensity scaling (nScaling); based on manually classified fibrous tissue (nManuFibrous) and based on automatic classified fibrous tissue (nAutoFibrous). The proposed normalization methods were evaluated using three metrics: (1) Dice similarity coefficient (DSC) between manual and automatic segmentation obtained by classifiers using different normalizations; (2) correlation between proposed normalizations and normalization used by expert; (3) Mahalanobis Distance between pairs of components. In the performed classification experiments, features of normalized image, smoothed, gradient magnitude and Laplacian images at multi-scales, distance to lumen, distance to outer wall, wall thickness were calculated for each vessel wall (VW) pixel. A supervised pattern recognition system, based on a linear discriminate classifier, was trained using the manual segmentation result to classify each VW pixel to be one of the four classes: fibrous tissue, lipid, calcification, and loose matrix according to the highest posterior probability. We evaluated our method on image data of 23 patients. Compared to the result of conventional square region based intensity normalizatio n, nScaling resulted in significant increase in DSC for lipid (p = 0.006) and nAutoFibrous resulted in significant increase in DSC for calcification (p = 0.004). In conclusion, it was demonstrated that the conventional region based normalization approach is not optimal and n

  18. The effect of serum MMP-9 and IL-6 on the vulnerability of carotid atherosclerotic plaque

    Directory of Open Access Journals (Sweden)

    WANG Wei

    2012-04-01

    Full Text Available Objective To explore the relationship of MMP-9 and IL-6 and the vulnerability of carotid atherosclerotic plaque. Methods According to the plaque vulnerability, 69 patients with acute cerebral infarction were divided into vulnerable plaque group (n = 35 and unvulnerable plaque group (n = 34. Twenty healthy subjects were selected as controls (control group. The levels of serum IL-6 and MMP-9 were examined. Results The level of MMP-9 and IL-6 in the unvulnerable plaque group was significantly higher than that in control group (P = 0.000, for all. The level of MMP-9 and IL-6 in the vulnerable plaque group was higher than that in the unvulnerable plaque group and control group (P = 0.000, for all. A positive correlation was observed between the expression of MMP-9 and IL-6 plaque (r = 0.836, P = 0.043. Conclusion MMP-9 and IL-6 are important factors for the promotion of vulnerable plaque. IL-6 may up-regulate the expression of MMP-9.

  19. Assessment of carotid plaque composition using fast-kV switching dual-energy CT with gemstone detector: comparison with extracorporeal and virtual histology-intravascular ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Shinohara, Yuki; Kuya, Keita; Ohta, Yasutoshi; Fujii, Shinya; Ogawa, Toshihide [Tottori University, Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Yonago (Japan); Sakamoto, Makoto; Watanabe, Takashi [Tottori University, Division of Neurosurgery, Department of Neurological Sciences, Faculty of Medicine, Yonago (Japan); Kishimoto, Junichi; Iwata, Naoki [Tottori University Hospital, Division of Clinical Radiology, Yonago (Japan)

    2015-09-15

    The present study compares the applicability of CT carotid plaque imaging using effective Z maps using gemstone spectral imaging (GSI) with that of conventional extracorporeal carotid ultrasound (US) and virtual histology-intravascular ultrasound (VH-IVUS). We assessed stenosis in 31 carotid arteries of 30 patients. All patients underwent carotid CTA using GSI (Discovery CT750 HD, GE Healthcare). US and IVUS were examined with 25 and 8 vessels, respectively. We compared the effective Z values at noncalcified carotid plaque with the plaque components identified by US. We defined the plaque with low or low to iso intensity on US as vulnerable plaque and the plaque with iso, iso to high, and high intensity on US as stable plaque. We also performed visual assessment of color-coded effective Z maps in comparison with VH-IVUS and compared effective Z values with plaque components generated by VH-IVUS. The effective Z values at noncalcified carotid plaque were significantly lower for a group with vulnerable plaque, than with stable plaque on US (p < 0.05). Receiver operating curve analysis showed that AUC of effective Z values was 0.882 concerning the differentiation of these two groups on US. The interpretation of color-coded effective Z maps was essentially compatible with that of VH-IVUS for carotid plaque in all vessels. Effective Z values at noncalcified plaque showed significant negative correlation with the areas of fibro-fatty components generated by VH-IVUS (ρ = -0.874, p < 0.05). Effective Z maps generated by GSI can detect vulnerable carotid plaque materials. (orig.)

  20. Assessment of carotid plaque composition using fast-kV switching dual-energy CT with gemstone detector: comparison with extracorporeal and virtual histology-intravascular ultrasound

    International Nuclear Information System (INIS)

    The present study compares the applicability of CT carotid plaque imaging using effective Z maps using gemstone spectral imaging (GSI) with that of conventional extracorporeal carotid ultrasound (US) and virtual histology-intravascular ultrasound (VH-IVUS). We assessed stenosis in 31 carotid arteries of 30 patients. All patients underwent carotid CTA using GSI (Discovery CT750 HD, GE Healthcare). US and IVUS were examined with 25 and 8 vessels, respectively. We compared the effective Z values at noncalcified carotid plaque with the plaque components identified by US. We defined the plaque with low or low to iso intensity on US as vulnerable plaque and the plaque with iso, iso to high, and high intensity on US as stable plaque. We also performed visual assessment of color-coded effective Z maps in comparison with VH-IVUS and compared effective Z values with plaque components generated by VH-IVUS. The effective Z values at noncalcified carotid plaque were significantly lower for a group with vulnerable plaque, than with stable plaque on US (p < 0.05). Receiver operating curve analysis showed that AUC of effective Z values was 0.882 concerning the differentiation of these two groups on US. The interpretation of color-coded effective Z maps was essentially compatible with that of VH-IVUS for carotid plaque in all vessels. Effective Z values at noncalcified plaque showed significant negative correlation with the areas of fibro-fatty components generated by VH-IVUS (ρ = -0.874, p < 0.05). Effective Z maps generated by GSI can detect vulnerable carotid plaque materials. (orig.)

  1. Association of carotid atherosclerotic plaque features with acute ischemic stroke: A magnetic resonance imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Huilin [Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127 (China); Zhao, Xihai [Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 100084 (China); Liu, Xiaosheng; Cao, Ye [Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127 (China); Hippe, Daniel S.; Sun, Jie [Department of Radiology, University of Washington, Seattle, WA 98109 (United States); Li, Feiyu [Department of Radiology, Peking University First Hospital, Beijing 100034 (China); Xu, Jianrong, E-mail: renjixjr@yahoo.com.cn [Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127 (China); Yuan, Chun [Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing 100084 (China); Department of Radiology, University of Washington, Seattle, WA 98109 (United States)

    2013-09-15

    Background and purpose: It remains unclear whether direct vessel wall imaging can identify carotid high-risk lesions in symptomatic subjects and whether carotid plaque characteristics are more effective indicators for cerebral infarct severity than stenosis. This study sought to determine the associations of carotid plaque characteristics by MR imaging with stenosis and acute cerebral infarct (ACI) sizes on diffusion weighted imaging (DWI). Materials and methods: One hundred and fourteen symptomatic patients underwent carotid and brain MRI. ACI volume was determined from symptomatic internal carotid artery territory on DWI images. Ipsilateral carotid plaque morphological and compositional characteristics, and stenosis were also determined. The relationships between carotid plaque characteristics, stenosis and ACIs size were then evaluated. Results: In carotid arteries with 30–49% stenosis, 86.7% and 26.7% were found to have lipid-rich necrotic core (LRNC) and intraplaque hemorrhage, respectively. Furthermore, 45.8% of carotid arteries with 0–29% stenosis developed LRNCs. Carotid morphological measurements, such as % wall volume, and the LRNC size were significantly associated with ipsilateral ACIs volume before and after adjustment for significant demographic factors (age and LDL) or stenosis in patients with carotid plaque (all p < 0.05). Conclusions: A substantial number of high-risk plaques characterized by vessel wall imaging exist in carotid arteries with lower grade stenosis. In addition, carotid plaque characteristics, particularly the % wall volume and LRNC size, are independently associated with cerebral infarction as measured by DWI lesions. Our findings indicate that characterizing atherosclerotic plaque by MR vessel wall imaging might be useful for stratification of plaque risk and infarction severity.

  2. The Frequency of Proximal ICA Plaques in Ischemic Symptom-Free Patients with Incidentally Detected Carotid Siphon Calcification

    OpenAIRE

    Sepideh Sefidbakht; Mohsen Khalili; Afshin Borhani haghighi; Reza Jalli

    2009-01-01

    Introduction: Following the wide popularity of coronary artery Calcium scoring, efforts have been made to determine clinical significance of cavernous carotid calcification in relation to the risk of stroke. In this study we aimed to determine the correlation of carotid siphon calcification incidentally detected in head CT scans done for non-ischemic causes with presence and severity of bifurcation region plaques. "nMaterials and Methods: Overall 52 patients (29 male and 23 female, age r...

  3. Plaque inflammation and unstable morphology are associated with early stroke recurrence in symptomatic carotid stenosis.

    LENUS (Irish Health Repository)

    Marnane, Michael

    2014-03-01

    Although symptomatic carotid stenosis is associated with 3-fold increased risk of early stroke recurrence, the pathophysiologic mechanisms of high early stroke risk have not been established. We aimed to investigate the relationship between early stroke recurrence after initial symptoms and histological features of plaque inflammation and instability in resected carotid plaque.

  4. High shear stress relates to intraplaque haemorrhage in asymptomatic carotid plaques

    DEFF Research Database (Denmark)

    Tuenter, A; Selwaness, M; Arias Lorza, A;

    2016-01-01

    Study, all with carotid atherosclerosis assessed on ultrasound, underwent carotid MRI. Multiple MRI sequences were used to evaluate the presence of IPH, LRNC and/or calcifications in plaques in the carotid arteries. Images were automatically segmented for lumen and outer wall to obtain a 3D...

  5. Reliability of digital panoramic radiographs in detecting calcified carotid artery atheromatous plaques: A clinical study

    OpenAIRE

    Neha Khambete; Rahul Kumar; Mukund Risbud; Anil Joshi

    2014-01-01

    Objectives: The objective of this study was to determine whether digital panoramic radiography is a reliable method to detect calcified carotid artery atheromatous plaques (CCAAP) as compared with ultrasonography. Study Design: Digital panoramic radiographs were obtained from 50 patients who also underwent carotid ultrasound examination. The images were interpreted by trained maxillofacial radiologist for the presence or absence of calcified atheromatous plaques. The extent of carotid cal...

  6. The accuracy of noninvasive imaging techniques in diagnosis of carotid plaque morphology

    International Nuclear Information System (INIS)

    The stroke is leading cause of death and severe disability worldwide. Atherosclerosis is responsible for over 30% of all ischemic strokes. It has been recently discovered that plaque morphology may help predict the clinical behavior of carotid atherosclerosis and determine the risk of stroke. The noninvasive imaging techniques have been developed to evaluate the vascular wall in an attempt to identify 'vulnerable plaques'. The purpose of the study is to investigate the diagnostic accuracy of ultrasound, multidetector computed tomography and magnetic resonance imaging in the identification of plaque components associated with plaque vulnerability. One hundred patients were admitted for carotid endarterectomy for high grade carotid stenosis. We defined the diagnostic value of B-mode ultrasound of carotid plaque in a half, and the accuracy of multidetector computed tomography and magnetic resonance imaging, in the other group, for detection of unstable carotid plaque. The reference standard was histology. Sensitivity of ultrasound, multidetector computed tomography and magnetic resonance imaging is 94%, 83% and 100%, and the specificity is 93%, 73% and 89% for detection of unstable carotid plaque. The ultrasound has high accuracy for diagnostics of carotid plaque morphology, magnetic resonance imaging has high potential for tissue differentiation and multidetector computed tomography determines precisely degree of stenosis and presence of ulceration and calcifications. The three noninvasive imaging modalities are complementary for optimal evaluation of the morphology of carotid plaque. This will help to determine the risk of stroke and to decide on the best treatment - carotid endarterectomy or carotid stenting. (authors) Key words: STROKE. NONINVASiVE IMAGING. VULNERABLE PLAQUE

  7. Symptomatic vs. asymptomatic plaque classification in carotid ultrasound.

    Science.gov (United States)

    Acharya, Rajendra U; Faust, Oliver; Alvin, A P C; Sree, S Vinitha; Molinari, Filippo; Saba, Luca; Nicolaides, Andrew; Suri, Jasjit S

    2012-06-01

    Quantitative characterization of carotid atherosclerosis and classification into symptomatic or asymptomatic type is crucial in both diagnosis and treatment planning. This paper describes a computer-aided diagnosis (CAD) system which analyzes ultrasound images and classifies them into symptomatic and asymptomatic based on the textural features. The proposed CAD system consists of three modules. The first module is preprocessing, which conditions the images for the subsequent feature extraction. The feature extraction stage uses image texture analysis to calculate Standard deviation, Entropy, Symmetry, and Run Percentage. Finally, classification is performed using AdaBoost and Support Vector Machine for automated decision making. For Adaboost, we compared the performance of five distinct configurations (Least Squares, Maximum- Likelihood, Normal Density Discriminant Function, Pocket, and Stumps) of this algorithm. For Support Vector Machine, we compared the performance using five different configurations (linear kernel, polynomial kernel configurations of different orders and radial basis function kernels). SVM with radial basis function kernel for support vector machine presented the best classification result: classification accuracy of 82.4%, sensitivity of 82.9%, and specificity of 82.1%. We feel that texture features coupled with the Support Vector Machine classifier can be used to identify the plaque tissue type. An Integrated Index, called symptomatic asymptomatic carotid index (SACI), is proposed using texture features to discriminate symptomatic and asymptomatic carotid ultrasound images using just one index or number. We hope this SACI can be used as an adjunct tool by the vascular surgeons for daily screening. PMID:21243411

  8. The Potential Role of Optical Coherence Tomography in the Evaluation of Vulnerable Carotid Atheromatous Plaques: A Pilot Study

    International Nuclear Information System (INIS)

    Purpose. The decision to intervene surgically in patients with carotid artery disease is based on the presence of symptoms, along with the severity of carotid artery stenosis as assessed by ultrasound or X-ray computed tomography (CT). Optical coherence tomography (OCT) is a relatively new imaging technique that offers potential in the identification of, as well as the distinction between, stable and unstable atherosclerotic plaques. The purpose of our study was to evaluate whether OCT can be used as a noninvasive diagnostic tool to reveal the morphology of carotid stenosis from the adventitial surface of the carotid artery. To achieve this aim, excised atheromatous plaques were scanned by OCT from the external surface. Methods. Plaques removed at carotid endarterectomy were scanned by OCT from the external surface within 72 hr of surgery and then examined histologically. The images of the histologic slides and the scans were then compared. Results. We examined 10 carotid endarterectomy specimens and were able to identify calcification, cholesterol crystal clefts, and lipid deposits in the OCT images with histologic correlation. The strong light scattering from the calcified tissue and cholesterol crystal clefts limited the depth of light penetration, making observation of the intimal surface and the detail of the fibrous cap difficult. However, we were able to confidently identify the absence of an atherosclerotic plaque by OCT scans even from the external surface. Conclusion. The results of this pilot study demonstrate that OCT can reveal the main features of carotid stenosis but that plaque vulnerability cannot be reliably and precisely assessed if scanned from the external surface with OCT in its present form

  9. MRI plaque imaging reveals high-risk carotid plaques especially in diabetic patients irrespective of the degree of stenosis

    Directory of Open Access Journals (Sweden)

    Holzer K

    2010-11-01

    Full Text Available Abstract Background Plaque imaging based on magnetic resonance imaging (MRI represents a new modality for risk assessment in atherosclerosis. It allows classification of carotid plaques in high-risk and low-risk lesion types (I-VIII. Type 2 diabetes mellitus (DM 2 represents a known risk factor for atherosclerosis, but its specific influence on plaque vulnerability is not fully understood. This study investigates whether MRI-plaque imaging can reveal differences in carotid plaque features of diabetic patients compared to nondiabetics. Methods 191 patients with moderate to high-grade carotid artery stenosis were enrolled after written informed consent was obtained. Each patient underwent MRI-plaque imaging using a 1.5-T scanner with phased-array carotid coils. The carotid plaques were classified as lesion types I-VIII according to the MRI-modified AHA criteria. For 36 patients histology data was available. Results Eleven patients were excluded because of insufficient MR-image quality. DM 2 was diagnosed in 51 patients (28.3%. Concordance between histology and MRI-classification was 91.7% (33/36 and showed a Cohen's kappa value of 0.81 with a 95% CI of 0.98-1.15. MRI-defined high-risk lesion types were overrepresented in diabetic patients (n = 29; 56.8%. Multiple logistic regression analysis revealed association between DM 2 and MRI-defined high-risk lesion types (OR 2.59; 95% CI [1.15-5.81], independent of the degree of stenosis. Conclusion DM 2 seems to represent a predictor for the development of vulnerable carotid plaques irrespective of the degree of stenosis and other risk factors. MRI-plaque imaging represents a new tool for risk stratification of diabetic patients. See Commentary: http://www.biomedcentral.com/1741-7015/8/78/abstract

  10. Association of carotid plaque Lp-PLA(2 with macrophages and Chlamydia pneumoniae infection among patients at risk for stroke.

    Directory of Open Access Journals (Sweden)

    Berna Atik

    Full Text Available BACKGROUND: We previously showed that the burden of Chlamydia pneumoniae in carotid plaques was significantly associated with plaque interleukin (IL-6, and serum IL-6 and C-reactive protein (CRP, suggesting that infected plaques contribute to systemic inflammatory markers in patients with stroke risk. Since lipoprotein-associated phospholipase A2 (Lp-PLA(2 mediates inflammation in atherosclerosis, we hypothesized that serum Lp-PLA(2 mass and activity levels and plaque Lp-PLA(2 may be influenced by plaque C. pneumoniae infection. METHODOLOGY/PRINCIPAL FINDINGS: Forty-two patients underwent elective carotid endarterectomy. Tissue obtained at surgery was stained by immunohistochemistry for Lp-PLA(2 grade, macrophages, IL-6, C. pneumoniae and CD4+ and CD8+ cells. Serum Lp-PLA(2 activity and mass were measured using the colorimetric activity method (CAM and ELISA, respectively. Serum homocysteine levels were measured by HPLC. Eleven (26.2% patients were symptomatic with transient ischemic attacks. There was no correlation between patient risk factors (smoking, coronary artery disease, elevated cholesterol, diabetes, obesity, hypertension and family history of genetic disorders for atherosclerosis and serum levels or plaque grade for Lp-PLA(2. Plaque Lp-PLA(2 correlated with serum homocysteine levels (p = 0.013, plaque macrophages (p<0.01, and plaque C. pneumoniae (p<0.001, which predominantly infected macrophages, co-localizing with Lp-PLA(2. CONCLUSIONS: The significant association of plaque Lp-PLA(2 with plaque macrophages and C. pneumoniae suggests an interactive role in accelerating inflammation in atherosclerosis. A possible mechanism for C. pneumoniae in the atherogenic process may involve infection of macrophages that induce Lp-PLA(2 production leading to upregulation of inflammatory mediators in plaque tissue. Additional in vitro and in vivo research will be needed to advance our understanding of specific C. pneumoniae and Lp-PLA(2

  11. High reproducibility of histological characterization by whole virtual slide quantification; an example using carotid plaque specimens.

    Directory of Open Access Journals (Sweden)

    Joyce E P Vrijenhoek

    Full Text Available Tissue biobanks are an important source for discovery and validation studies aiming for new proteins that are causally related with disease development. There is an increasing demand for accurate and reproducible histological characterization, especially for subsequent analysis and interpretation of data in association studies. We assessed reproducibility of one semiquantative and two quantitative methods for histological tissue characterization. We introduce a new automated method for whole digital slide quantification. Carotid atherosclerotic plaques were used to test reproducibility.50 atherosclerotic plaques that were obtained during carotid endarterectomy were analysed. For the semiquantitative analysis, 6 different plaque characteristics were scored in categories by two independent observers, and Cohen's κ was used to test intra- and interobserver reproducibility. The computer-aided method (assessed by two independent observers and automated method were tested on CD68 (for macrophages and α smooth muscle actin (for smooth muscle cells stainings. Agreement for these two methods (done on a continuous scale was assessed by intraclass correlation coefficients (ICCs.For the semiquantitative analysis, κ values ranged from 0.55 to 0.69 for interobserver variability, and were slightly higher for intraobserver reproducibility in both observers. The computer-aided method yielded intra- and interobserver ICCs between 0.6 and 0.9. The new automated method performed most optimal regarding reproducibility, with ICCs ranging from 0.92 to 0.97.The analysis of performance of three methods for histological slide characterization on carotid atherosclerotic plaques showed high precision and agreement in repeated measurements for the automated method for whole digital slide quantification. We suggest that this method can fulfill the need for reproducible histological quantification.

  12. When to image carotid plaque inflammation with FDG PET/CT

    DEFF Research Database (Denmark)

    Græbe, Martin; Borgwardt, Lise; Højgaard, Liselotte; Sillesen, Henrik Hegaard; Kjær, Andreas

    2010-01-01

    Quantification of 18-fluorodeoxyglucose (FDG) uptake in inflamed high-risk carotid atherosclerotic plaques is challenged by the spatial resolution of positron emission tomography (PET) and luminal blood activity. Late acquisition protocols have been used to overcome these challenges to enhance th...... methods of FDG uptake in carotid artery plaques between early and late PET scans.......Quantification of 18-fluorodeoxyglucose (FDG) uptake in inflamed high-risk carotid atherosclerotic plaques is challenged by the spatial resolution of positron emission tomography (PET) and luminal blood activity. Late acquisition protocols have been used to overcome these challenges to enhance the...

  13. The relationship of hydroxyeicosatetraenoic acids and F2-isoprostanes to plaque instability in human carotid atherosclerosis

    OpenAIRE

    Mallat, Ziad; Nakamura, Tatsuji; Ohan, Jeanny; Lesèche, Guy; Tedgui, Alain; Maclouf, Jacques; Murphy, Robert C.

    1999-01-01

    Evidence for increased oxidant stress has been reported in human atherosclerosis. However, no information is available about the importance of in situ oxidant stress in relation to plaque stability. This information is relevant because the morbidity and mortality of atherosclerosis are essentially the consequences of acute ischemic syndromes due to unstable plaques. We studied 30 carotid atherosclerotic plaques retrieved by endarterectomy from 18 asymptomatic (stable plaques) and 12 symptomat...

  14. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors

    International Nuclear Information System (INIS)

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk factors. One hundred patients with cerebrovascular symptoms underwent CT angiography. We measured plaque volume (PV) and the relative contribution of plaque components (calcifications, fibrous tissue, and lipid) in the symptomatic artery. The contribution of different components was measured as the number of voxels within defined ranges of HU values (calcification >130 HU, fibrous tissue 60-130 HU, lipid core <60 HU). Fifty-seven patients had atherosclerotic plaque in the symptomatic carotid artery. The severity of stenosis and PV were moderately correlated. Age and smoking were independently related to PV. Patients with hypercholesterolemia had significantly less lipid and more calcium in their plaques than patients without hypercholesterolemia. Other cardiovascular risk factors were not significantly related to PV or plaque composition. Luminal stenosis of the carotid artery partly reflects the amount of atherosclerotic carotid disease. Plaque volume and plaque composition are associated with cardiovascular risk factors. (orig.)

  15. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Rozie, S.; Weert, T.T. de; Monye, C. de; Homburg, P.J.; Tanghe, H.L.J.; Lugt, A. van der [Erasmus MC, University Medical Center Rotterdam, Departments of Radiology, Rotterdam (Netherlands); Dippel, D.W.J. [Erasmus MC, University Medical Center Rotterdam, Department of Neurology, PO Box 2040, Rotterdam (Netherlands)

    2009-09-15

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk factors. One hundred patients with cerebrovascular symptoms underwent CT angiography. We measured plaque volume (PV) and the relative contribution of plaque components (calcifications, fibrous tissue, and lipid) in the symptomatic artery. The contribution of different components was measured as the number of voxels within defined ranges of HU values (calcification >130 HU, fibrous tissue 60-130 HU, lipid core <60 HU). Fifty-seven patients had atherosclerotic plaque in the symptomatic carotid artery. The severity of stenosis and PV were moderately correlated. Age and smoking were independently related to PV. Patients with hypercholesterolemia had significantly less lipid and more calcium in their plaques than patients without hypercholesterolemia. Other cardiovascular risk factors were not significantly related to PV or plaque composition. Luminal stenosis of the carotid artery partly reflects the amount of atherosclerotic carotid disease. Plaque volume and plaque composition are associated with cardiovascular risk factors. (orig.)

  16. Relationship between serum hypoxia-inducible factor-1α and carotid plaque in patients with type 2 diabetes mellitus

    International Nuclear Information System (INIS)

    Objective: To observe the changes of type 2 diabetes mellitus (T2DM) patients' serum hypoxia inducible factor-1α (HIF-1α), and evaluate the relationship between serum HIF-1α and vascular lesions of atherosclerosis. Methods: The serum level of HIF-1α in 32 T2DM with carotid plaques (T2DM+CP group), 24 T2DM without macrovascular complications (T2DM group), and 24 controls was studied with ELISA method. Results: The serum HIF-1α level in T2DM with and without carotid plaque group was significantly higher than that in the controls (all P<0.01). Furthermore, among T2DM, the level of HIF-1α was higher in patients with carotid plaque than that without carotid plaque (P<0.05) . The serum HIF-1α was positively correlated with fasting plasma glucose, HbAlc and HOMA-IR (all P<0.05). Multiple linear stepwise regression analysis showed that HbAlc was the independent determinants of HIF-1α. Conclusion: High level of serum HIF-1α in T2DM patients concerns with blood glucose and insulin resistance, which plays an important role in the development of macrovascular complications. (authors)

  17. Carotid and cerebrovascular disease in symptomatic patients with type 2 diabetes: assessment of prevalence and plaque morphology by dual-source computed tomography angiography

    OpenAIRE

    Deng Wen; Shao Heng; Dong Zhi-hui; Chu Zhi-gang; Yang Zhi-gang; He Ci; Chen Jing; Peng Li-qing; Tang Si-shi; Xiao Jia-he

    2010-01-01

    Abstract Background Plaque morphology directly correlates with risk of embolism and the recently developed dual-source computed tomography angiography (DSCTA) may help to detect plaques more precisely. The aim of our study was to evaluate the prevalence and morphology of carotid and cerebrovascular atherosclerotic plaques in patients with symptomatic type 2 diabetes mellitus (DM) by DSCTA. Methods From July 2009 to August 2010, DSCTA was prospectively performed in 125 consecutive patients wit...

  18. Assessment of 320-slice computed tomography angiography in distinguishing hemorrhage in carotid atherosclerotic plaques

    Directory of Open Access Journals (Sweden)

    Xiao-jie ZHANG

    2014-01-01

    Full Text Available Objective To assess the value of 320⁃slice computed tomography angiography (CTA in distinguishing hemorrhage/thrombus from lipid-rich necrotic core (LRNC in atherosclerotic plaques of carotid artery. Methods Thirty-seven subjects who prepared to perform carotid endarterectomy (CEA, with stenosis rate about 50%-99% in at least unilateral carotid artery detected by ultrasound, were enrolled in this study. Both 320-slice CTA and 3.0T high-resolution MRI were conducted within one week before operation. CTA, MRI and pathological sections were matched with the carotid bifurcation and calcification features as the mark. According to American Heart Association (AHA modified classification, CT slices were selected and divided into 2 groups: Type Ⅳ -Ⅴ (lipid plaques and Type Ⅵ (hemorrhage plaques, and the density difference between lipid plaques and hemorrhage/thrombus plaques was analyzed. Results A total of 217 slices were included in final analysis, including 88 slices of Type Ⅳ -Ⅴ (lipid plaques and 129 slices of Type Ⅵ (hemorrhage plaques. There was statistically significant difference in CT value between 2 groups. The mean CT value of lipid necrosis core in Type Ⅳ -Ⅴ and hemorrhage/thrombus in Type Ⅵ was (28.07 ± 26.84 and (97.17 ± 35.82 HU respectively, and the former was significantly lower than the latter (t = 16.141, P = 0.000. Conclusions CTA can distinguish hemorrhage/thrombus from lipid-rich necrotic core in carotid atherosclerotic plaques.

  19. Correlating cognitive impairment with carotid atherosclerosis and carotid artery stenosis in patients with acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Yamei Cai; Xiaoming Wang; Xin Liu; Liting Cao

    2008-01-01

    BACKGROUND: Studies have demonstrated that carotid atherosclerosis and carotid artery stenosis are closely associated with cognitive impairment in patients with and without clinically evident cerebrovascular disease.OBJECTIVE: To investigate the correlation between the degree of pathological changes in carotid atherosclerosis, carotid artery stenosis, and cognitive impairment in patients with acute cerebral infarction through the use of color Doppler imaging.DESIGN, TIME AND SETTING: The present concurrent, non-randomized, controlled experiment was performed at the Departments of Neurology and Ultrasound, Affiliated Hospital of North Sichuan Medical College between November 2006 and August 2007.PARTICIPANTS: Fifty-five patients with cerebral infarction, consisting of 35 males and 20 females, aged 50-82 years, were admitted to the hospital between November 2006 and August 2007 and recruited for this study, An additional 30 subjects consisting of 18 males and 12 females, aged 47-78 years, that concurrently received a health examination at the same hospital, were also included as normal controls.METHODS: Intima-media thickness (IMT), plaque shape, size, and echo intensity of all subjects were detected by color Doppler flow imaging. Assessment criteria: IMT > 1.0 mm was considered to be intimal thickening, and IMT > 1.2 mm was determined to be formed atherosclerotic plaques. In the position of the largest plaque, the degree of carotid artery stenosis was determined by the following formula:(1-cross-sectional area of residual vascular luminal area/vascular cross-sectional area) x 100%. Less than 30% exhibited mild stenosis, 30%-40% moderate stenosis, and > 50% severe stenosis.MAIN OUTCOME MEASURES: IMT and the degree of carotid artery stenosis were evaluated by color Doppler flow imaging. The Mini-Mental State Examination (MMSE), as well as the clinical memory scale,was compared between patients with cerebral infarction and normal controls.RESULTS: In the cerebral

  20. Vascular endothelial growth factor (VEGF and monocyte chemoattractant protein (MCP-1 levels unaltered in symptomatic atherosclerotic carotid plaque patients from North India

    Directory of Open Access Journals (Sweden)

    Dheeraj eKhurana

    2013-04-01

    Full Text Available We aimed to identify the role of vascular endothelial growth factor(VEGF and monocyte chemoattractant protein(MCP-1 as a serum biomarker of symptomatic carotid atherosclerotic plaque in North Indian population. Individuals with symptomatic carotid atherosclerotic plaque have high risk of ischemic stroke. Previous studies from western countries have shown an association between VEGF and MCP-1 levels and the incidence of ischemic stroke. In this study, venous blood from 110 human subjects was collected, 57 blood samples of which were obtained from patients with carotid plaques, 38 neurological controls without carotid plaques and another 15 healthy controls who had no history of serious illness. Serum VEGF and MCP-1 levels were measured using commercially available enzyme-linked immunosorbent assay(ELISA. We also correlated the data clinically and carried out risk factor analysis based on the detailed questionnaire obtained from each patient. For risk factor analysis, a total of 70 symptomatic carotid plaque cases and equal number of age and sex matched healthy controls were analyzed. We found that serum VEGF levels in carotid plaque patients did not show any significant change when compared to either of the controls. Similarly, there was no significant upregulation of monocyte chemoattractant protein-1 in the serum of these patients. The risk factor analysis revealed that hypertension, diabetes, and physical inactivity were the main correlates of carotid atherosclerosis(p<0.05. Prevalence of patients was higher residing in urban areas as compared to rural region. We also found that patients coming from mountaineer region were relatively less vulnerable to cerebral atherosclerosis as compared to the ones residing at plain region. We conclude that the pathogenesis of carotid plaques may progress independent of these inflammatory molecules. In parallel, risk factor analysis indicates hypertension, diabetes and sedentary lifestyle as the most

  1. Bayes Clustering and Structural Support Vector Machines for Segmentation of Carotid Artery Plaques in Multicontrast MRI

    OpenAIRE

    Qiu Guan; Bin Du; Zhongzhao Teng; Jonathan Gillard; Shengyong Chen

    2012-01-01

    Accurate segmentation of carotid artery plaque in MR images is not only a key part but also an essential step for in vivo plaque analysis. Due to the indistinct MR images, it is very difficult to implement the automatic segmentation. Two kinds of classification models, that is, Bayes clustering and SSVM, are introduced in this paper to segment the internal lumen wall of carotid artery. The comparative experimental results show the segmentation performance of SSVM is better than Bayes.

  2. Carotid and femoral atherosclerotic plaques show different morphology. : Patterns of Peripheral Arterial Disease

    OpenAIRE

    Herisson, Fanny; Heymann, Marie-Françoise; Chétiveaux, Maud; Charrier, Céline; Battaglia, Séverine; Pilet, Paul; Rouillon, Thierry; Krempf, Michel; Lemarchand, Patricia; Heymann, Dominique; Gouëffic, Yann

    2011-01-01

    OBJECTIVE: Results of endovascular repair vary according to the arterial bed. We hypothesized that these differences may be related to the plaque features. To explore this hypothesis, we designed a prospective study that compared carotid and femoral atheroma. METHODS AND RESULTS: Patients that underwent femoral or carotid endarterectomy were included in our study. Demographic data and blood sampling were obtained prior to surgery. Plaques were evaluated for AHA grading, calcification and lipi...

  3. Low carotid calcium score is associated with higher levels of glycosaminoglycans, tumor necrosis factor-alpha, and parathyroid hormone in human carotid plaques.

    OpenAIRE

    Edsfeldt, Andreas; Dias, Nuno; Elmståhl, Barbara; Müller, Markus; Olofsson, Katarina; Nitulescu, Mihaela; Persson, Ana; Ekberg, Olle; Goncalves, Isabel

    2011-01-01

    BACKGROUND AND PURPOSE: Computed tomography (CT) is used to study coronary artery plaques, but little is known about its potential to characterize plaque composition. This study assesses the relation between carotid calcium score (CCS) by CT and plaque composition, namely extracellular matrix, inflammatory mediators, and calcium metabolites. METHODS: Thirty patients with significant carotid stenosis underwent preoperative CT. CCS was quantified by Agaston calcium score. Plaqu...

  4. Carotid plaque regression following 6-month statin therapy assessed by 3T cardiovascular magnetic resonance: comparison with ultrasound intima media thickness

    Directory of Open Access Journals (Sweden)

    Migrino Raymond Q

    2011-08-01

    Full Text Available Abstract Background Cardiovascular magnetic resonance (CMR allows volumetric carotid plaque measurement that has advantage over 2-dimensional ultrasound (US intima-media thickness (IMT in evaluating treatment response. We tested the hypothesis that 6-month statin treatment in patients with carotid plaque will lead to plaque regression when measured by 3 Tesla CMR but not by IMT. Methods Twenty-six subjects (67 ± 2 years, 7 females with known carotid plaque (> 1.1 mm and coronary or cerebrovascular atherosclerotic disease underwent 3T CMR (T1, T2, proton density and time of flight sequences and US at baseline and following 6 months of statin therapy (6 had initiation, 7 had increase and 13 had maintenance of statin dosing. CMR plaque volume (PV was measured in the region 12 mm below and up to 12 mm above carotid flow divider using software. Mean posterior IMT in the same region was measured. Baseline and 6-month CMR PV and US IMT were compared. Change in lipid rich/necrotic core (LR/NC and calcification plaque components from CMR were related to change in PV. Results Low-density lipoprotein cholesterol decreased (86 ± 6 to 74 ± 4 mg/dL, p = 0.046. CMR PV decreased 5.8 ± 2% (1036 ± 59 to 976 ± 65 mm3, p = 0.018. Mean IMT was unchanged (1.12 ± 0.06 vs. 1.14 ± 0.06 mm, p = NS. Patients with initiation or increase of statins had -8.8 ± 2.8% PV change (p = 0.001 while patients with maintenance of statin dosing had -2.7 ± 3% change in PV (p = NS. There was circumferential heterogeneity in CMR plaque thickness with greatest thickness in the posterior carotid artery, in the region opposite the flow divider. Similarly there was circumferential regional difference in change of plaque thickness with significant plaque regression in the anterior carotid region in region of the flow divider. Change in LR/NC (R = 0.62, p = 0.006 and calcification (R = 0.45, p = 0.03 correlated with PV change. Conclusions Six month statin therapy in patients with

  5. Atherosclerotic plaque component segmentation in combined carotid MRI and CTA data incorporating class label uncertainty

    OpenAIRE

    Engelen, Arna; Niessen, Wiro; Klein, Stefan; Groen, Harald; Verhagen, Hence; Wentzel, Jolanda; van der Lugt, Aad; de Bruijne, Marleen

    2014-01-01

    textabstractAtherosclerotic plaque composition can indicate plaque vulnerability. We segment atherosclerotic plaque components from the carotid artery on a combination of in vivo MRI and CT-angiography (CTA) data using supervised voxelwise classification. In contrast to previous studies the ground truth for training is directly obtained from 3D registration with histology for fibrous and lipid-rich necrotic tissue, and with μCT for calcification. This registration does, however, not provide a...

  6. Atherosclerotic Plaque Component Segmentation in Combined Carotid MRI and CTA Data Incorporating Class Label Uncertainty

    OpenAIRE

    van Engelen, A.; Niessen, W.J.; Klein, S.; Groen, H. C.; Verhagen, H. J. M.; Wentzel, J.J.; van der Lugt, A.; De Bruijne, M.

    2014-01-01

    Atherosclerotic plaque composition can indicate plaque vulnerability. We segment atherosclerotic plaque components from the carotid artery on a combination of in vivo MRI and CT-angiography (CTA) data using supervised voxelwise classification. In contrast to previous studies the ground truth for training is directly obtained from 3D registration with histology for fibrous and lipid-rich necrotic tissue, and with CT for calcification. This registration does, however, not provide accurate voxel...

  7. Atherosclerotic plaque component segmentation in combined carotid MRI and CTA data incorporating class label uncertainty

    OpenAIRE

    2014-01-01

    Atherosclerotic plaque composition can indicate plaque vulnerability. We segment atherosclerotic plaque components from the carotid artery on a combination of in vivo MRI and CT-angiography (CTA) data using supervised voxelwise classification. In contrast to previous studies the ground truth for training is directly obtained from 3D registration with histology for fibrous and lipid-rich necrotic tissue, and with [Formula: see text]CT for calcification. This registration does, however, not pro...

  8. Characterising human atherosclerotic carotid plaque tissue composition and morphology using combined spectroscopic and imaging modalities

    OpenAIRE

    Barrett, Hilary E; Mulvihill, John J.; Cunnane, Eoghan M; Walsh, Michael T

    2015-01-01

    Calcification is a marked pathological component in carotid artery plaque. Studies have suggested that calcification may induce regions of high stress concentrations therefore increasing the potential for rupture. However, the mechanical behaviour of the plaque under the influence of calcification is not fully understood. A method of accurately characterising the calcification coupled with the associated mechanical plaque properties is needed to better understand the impact of ...

  9. Repeatability of in vivo quantification of atherosclerotic carotid artery plaque components by supervised multispectral classification

    OpenAIRE

    Gao, Shan; van ’t Klooster, Ronald; van Wijk, Diederik F.; Nederveen, Aart J.; Lelieveldt, Boudewijn P.F.; van der Geest, Rob J.

    2015-01-01

    Objective To evaluate the agreement and scan–rescan repeatability of automated and manual plaque segmentation for the quantification of in vivo carotid artery plaque components from multi-contrast MRI. Materials and methods Twenty-three patients with 30–70 % stenosis underwent two 3T MR carotid vessel wall exams within a 1 month interval. T1w, T2w, PDw and TOF images were acquired around the region of maximum vessel narrowing. Manual delineation of the vessel wall and plaque components (lipid...

  10. 3D Isotropic MR Culprit Plaque Visualization of Carotid Plaque Edema and Hemorrhage with Motion Sensitized Blood Suppression

    DEFF Research Database (Denmark)

    Søvsø Szocska Hansen, Esben; Pedersen, Steen Fjord; Bloch, Lars Ø.;

    2014-01-01

    hemorrhage and plaque edema may represent advanced stages of atherosclerosis[1, 2]. In this study, we present a novel multi-contrast 3D motion sensitized black-blood CMR imaging sequence, which detects both plaque edema and hemorrhage with positive contrast. Subjects and Methods The 3D imaging sequence was...... lumen was 39.74±6.75. Discussion/Conclusion In conclusion, the proposed 3D isotropic multi-contrast CMR technique detects plaque edema and hemorrhage with positive contrast and excellent black-blood contrast, which may facilitate evaluation of carotid atherosclerosis. Ongoing studies will include CMR...

  11. The analysis of the connection between plaque morphology of the asymptomatic carotid stenosis and ischemic brain lesions

    OpenAIRE

    Milošević Đorđe; Pasternak Janko; Popović Vladan; Nikolić Dragan; Milošević Pavle; Manojlović Vladimir

    2013-01-01

    Background/Aim. A certain percentage of patients with asymptomatic carotid stenosis have an unstable carotid plaque. For these patients it is possible to register by modern imaging methods the existence of lesions of the brain parenchyma - the silent brain infarction. These patients have a greater risk of ischemic stroke. The aim of this study was to analyze the connection between the morphology of atherosclerotic carotid plaque in patients with asymptomatic carotid stenosis and the man...

  12. Identification of carotid plaque tissue properties using an experimental-numerical approach.

    Science.gov (United States)

    Heiland, Vincent M; Forsell, Caroline; Roy, Joy; Hedin, Ulf; Gasser, T Christian

    2013-11-01

    A biomechanical stress analysis could help to identify carotid plaques that are vulnerable to rupture, and hence reduce the risk of thrombotic strokes. Mechanical stress predictions critically depend on the plaque's constitutive properties, and the present study introduces a concept to derive viscoelastic parameters through an experimental-numerical approach. Carotid plaques were harvested from two patients during carotid endarterectomy (CEA), and, in total, nine test specimens were investigated. A novel in-vitro mechanical testing protocol, which allows for dynamic testing, keeping the carotid plaque components together, was introduced. Macroscopic pictures overlaid by histological stains allowed for the segmentation of plaque tissues, in order to develop high-fidelity and low-fidelity Finite Element Method (FEM) models of the test specimens. The FEM models together with load-displacement data from the mechanical testing were used to extract constitutive parameters through inverse parameter estimation. The applied inverse parameter estimation runs in stages, first addressing the hyperelastic parameters then the viscoelastic ones. Load-displacement curves from the mechanical testing showed strain stiffening and viscoelasticity, as is expected for both normal and diseased carotid tissue. The estimated constitutive properties of plaque tissue were comparable to previously reported studies. Due to the highly non-linear elasticity of vascular tissue, the applied parameter estimation approach is, as with many similar approaches, sensitive to the initial guess of the parameters. PMID:23790614

  13. Characterising human atherosclerotic carotid plaque tissue composition and morphology using combined spectroscopic and imaging modalities.

    Science.gov (United States)

    Barrett, Hilary E; Mulvihill, John J; Cunnane, Eoghan M; Walsh, Michael T

    2015-01-01

    Calcification is a marked pathological component in carotid artery plaque. Studies have suggested that calcification may induce regions of high stress concentrations therefore increasing the potential for rupture. However, the mechanical behaviour of the plaque under the influence of calcification is not fully understood. A method of accurately characterising the calcification coupled with the associated mechanical plaque properties is needed to better understand the impact of calcification on the mechanical behaviour of the plaque during minimally invasive treatments. This study proposes a comparison of biochemical and structural characterisation methods of the calcification in carotid plaque specimens to identify plaque mechanical behaviour. Biochemical analysis, by Fourier Transform Infrared (FTIR) spectroscopy, was used to identify the key components, including calcification, in each plaque sample. However, FTIR has a finite penetration depth which may limit the accuracy of the calcification measurement. Therefore, this FTIR analysis was coupled with the identification of the calcification inclusions located internally in the plaque specimen using micro x-ray computed tomography (μX-CT) which measures the calcification volume fraction (CVF) to total tissue content. The tissue characterisation processes were then applied to the mechanical material plaque properties acquired from experimental circumferential loading of human carotid plaque specimen for comparison of the methods. FTIR characterised the degree of plaque progression by identifying the functional groups associated with lipid, collagen and calcification in each specimen. This identified a negative relationship between stiffness and 'lipid to collagen' and 'calcification to collagen' ratios. However, μX-CT results suggest that CVF measurements relate to overall mechanical stiffness, while peak circumferential strength values may be dependent on specific calcification geometries. This study

  14. The Frequency of Proximal ICA Plaques in Ischemic Symptom-Free Patients with Incidentally Detected Carotid Siphon Calcification

    Directory of Open Access Journals (Sweden)

    Sepideh Sefidbakht

    2009-01-01

    Full Text Available Introduction: Following the wide popularity of coronary artery Calcium scoring, efforts have been made to determine clinical significance of cavernous carotid calcification in relation to the risk of stroke. In this study we aimed to determine the correlation of carotid siphon calcification incidentally detected in head CT scans done for non-ischemic causes with presence and severity of bifurcation region plaques. "nMaterials and Methods: Overall 52 patients (29 male and 23 female, age range 67.8±10.76 with head CT scans done for non-ischemic causes were included. They included 40 patients with carotid siphon calcification detectable in the CT scan and 12 patients without cavernous carotid calcification included as control cases. All patients were evaluated for evidence of recent or previous ischemic events and atherosclerotic risk factors including blood pressure, BMI, history of smoking and cholesterol levels. All patients underwent color Doppler ultrasound of the cervical carotid artery by a single examiner blinded to the CT scan results. Calcification in the cavernous carotid region was semi-quantitatively graded according to Woodcock et al to no, mild, moderate and severe calcification. The degree of narrowing of the proximal ICA was graded to normal, narrowings <50%, 50-69%, ≥70% to near occlusion, near occlusion and total occlusion according to the Society of Radiologists in ultrasound consensus conference. Presence and degree of siphon calcification was correlated with presence and degree of bifurcation plaques using Mann-Whitney test. "nResults: Age range and atherosclerotic risk factors were not significantly different between case and control groups. Among 40 patients with siphon calcification of various degrees in the brain CT, 32 (75% were found to have at least mild narrowing plaques in color Doppler ultrasound. 7 out of 12 patients (58% with no calcification in CT were also found to have at least mildly narrowing plaques. The

  15. The role of contrast-enhanced ultrasound (CEUS) in visualizing atherosclerotic carotid plaque vulnerability: Which injection protocol? Which scanning technique?

    Energy Technology Data Exchange (ETDEWEB)

    Iezzi, Roberto, E-mail: roberto.iezzi@rm.unicatt.it [Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital—Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Petrone, Gianluigi [Institute of Pathology, “A. Gemelli” Hospital—Catholic University, L.go A Gemelli 8, 00168, Rome (Italy); Ferrante, Angela [Department of Vascular Surgery, “A. Gemelli” Hospital—Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Lauriola, Libero [Institute of Pathology, “A. Gemelli” Hospital—Catholic University, L.go A Gemelli 8, 00168, Rome (Italy); Vincenzoni, Claudio [Department of Vascular Surgery, “A. Gemelli” Hospital—Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Torre, Michele Fabio la [Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital—Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Snider, Francesco [Department of Vascular Surgery, “A. Gemelli” Hospital—Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Rindi, Guido [Institute of Pathology, “A. Gemelli” Hospital—Catholic University, L.go A Gemelli 8, 00168, Rome (Italy); Bonomo, Lorenzo [Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital—Catholic University, L.go A Gemelli 8, 00168 Rome (Italy)

    2015-05-15

    Highlights: • CEUS is a safe and efficacious technique for the identification and characterization of carotid plaque. • CEUS represents a diagnostic tool for the management of patients with carotid plaque, particularly in asymptomatic patients. • Improved diagnostic performance is achieved with the injection of 4 mL bolus of contrast-medium. • Improved diagnostic performance is achieved with the use of Dynamic Imaging rather than late-phase imaging. - Abstract: Purpose: To correlate the degree of plaque vulnerability as determined by contrast-enhanced ultrasound (CEUS) with histological findings. Secondary objectives were to optimize the CEUS acquisition technique and image evaluation methods. Materials and methods: Fifty consecutive patients, either symptomatic and asymptomatic referring to our department in order to perform carotid endarterectomy (TEA), were enrolled. Each patient provided informed consent before undergoing CEUS. Ultrasound examination was performed using high-frequency (8–14 MHz) linear probe and a non-linear pulse inversion technique (mechanical index: 0.09–1.3). A double contrast media injection (Sonovue, 2 mL and 4 mL; Bracco, Italy) was performed. Two videotapes were recorded for every injection: early “dynamic” phase and late “flash” phase, performed with 6 high mechanical index impulses. Movies were quantitatively and qualitatively evaluated. Qualitative and quantitative evaluation were statistically compared to immunohistological diagnosis of vulnerable plaque, considered as gold standard. Results: Qualitative CEUS evaluation obtained high statistical results when compared to immunohistological results, with values of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of 94%, 68%, 87%, 85% and 86%, respectively, which became higher if considering only asymptomatic patient, with a NPV of 91%. Nevertheless, quantitative software evaluation proved less

  16. The role of contrast-enhanced ultrasound (CEUS) in visualizing atherosclerotic carotid plaque vulnerability: Which injection protocol? Which scanning technique?

    International Nuclear Information System (INIS)

    Highlights: • CEUS is a safe and efficacious technique for the identification and characterization of carotid plaque. • CEUS represents a diagnostic tool for the management of patients with carotid plaque, particularly in asymptomatic patients. • Improved diagnostic performance is achieved with the injection of 4 mL bolus of contrast-medium. • Improved diagnostic performance is achieved with the use of Dynamic Imaging rather than late-phase imaging. - Abstract: Purpose: To correlate the degree of plaque vulnerability as determined by contrast-enhanced ultrasound (CEUS) with histological findings. Secondary objectives were to optimize the CEUS acquisition technique and image evaluation methods. Materials and methods: Fifty consecutive patients, either symptomatic and asymptomatic referring to our department in order to perform carotid endarterectomy (TEA), were enrolled. Each patient provided informed consent before undergoing CEUS. Ultrasound examination was performed using high-frequency (8–14 MHz) linear probe and a non-linear pulse inversion technique (mechanical index: 0.09–1.3). A double contrast media injection (Sonovue, 2 mL and 4 mL; Bracco, Italy) was performed. Two videotapes were recorded for every injection: early “dynamic” phase and late “flash” phase, performed with 6 high mechanical index impulses. Movies were quantitatively and qualitatively evaluated. Qualitative and quantitative evaluation were statistically compared to immunohistological diagnosis of vulnerable plaque, considered as gold standard. Results: Qualitative CEUS evaluation obtained high statistical results when compared to immunohistological results, with values of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of 94%, 68%, 87%, 85% and 86%, respectively, which became higher if considering only asymptomatic patient, with a NPV of 91%. Nevertheless, quantitative software evaluation proved less

  17. Carotid plaque is a new risk factor for peripheral vestibular disorder: a retrospective cohort study

    Science.gov (United States)

    Wada, Masaoki; Takeshima, Taro; Nakamura, Yosikazu; Nagasaka, Shoichiro; Kamesaki, Toyomi; Kajii, Eiji

    2016-01-01

    Abstract Many chronic diseases are associated with dizziness or vertigo, as is peripheral vestibular disorder (PVD). Although carotid plaque development is linked to atherosclerosis, it is unclear whether such plaques can lead to the development of PVD. We therefore conducted this study to investigate the presence of an association between carotid plaque and new PVD events. In this retrospective study, we consecutively enrolled 393 patients ≥20 years old who had been treated for chronic diseases such as hypertension, dyslipidemia, and diabetes mellitus for ≥6 months at a primary care clinic (Oki Clinic, Japan) between November 2011 and March 2013. Carotid plaque presence was measured with high-resolution ultrasonography for all patients. During a 1-year follow-up period, an otorhinolaryngologist diagnosed and reported any new PVD events (the main end point). Hazard ratios (HRs) and 95% confidence intervals (CIs) for new PVD occurrence were estimated using the Cox proportional hazard regression model. The mean age of the participants was 65.5 years; 33.8% were men, and 12.7%, 82.4%, and 93.1% had diabetes mellitus, hypertension, and dyslipidemia, respectively. There were 76 new PVD events; patients with carotid plaque had a greater risk of such events (crude HR: 3.25; 95% CI: 1.62–6.52) compared to those without carotid plaque. This risk was even higher after adjusting for traditional risk factors for atherosclerosis (adjusted HR: 4.41; 95% CI: 1.75–11.14). Carotid plaques are associated with an increased risk of new PVD events. PMID:27495105

  18. Carotid plaque is a new risk factor for peripheral vestibular disorder: a retrospective cohort study.

    Science.gov (United States)

    Wada, Masaoki; Takeshima, Taro; Nakamura, Yosikazu; Nagasaka, Shoichiro; Kamesaki, Toyomi; Kajii, Eiji

    2016-08-01

    Many chronic diseases are associated with dizziness or vertigo, as is peripheral vestibular disorder (PVD). Although carotid plaque development is linked to atherosclerosis, it is unclear whether such plaques can lead to the development of PVD. We therefore conducted this study to investigate the presence of an association between carotid plaque and new PVD events.In this retrospective study, we consecutively enrolled 393 patients ≥20 years old who had been treated for chronic diseases such as hypertension, dyslipidemia, and diabetes mellitus for ≥6 months at a primary care clinic (Oki Clinic, Japan) between November 2011 and March 2013. Carotid plaque presence was measured with high-resolution ultrasonography for all patients. During a 1-year follow-up period, an otorhinolaryngologist diagnosed and reported any new PVD events (the main end point). Hazard ratios (HRs) and 95% confidence intervals (CIs) for new PVD occurrence were estimated using the Cox proportional hazard regression model.The mean age of the participants was 65.5 years; 33.8% were men, and 12.7%, 82.4%, and 93.1% had diabetes mellitus, hypertension, and dyslipidemia, respectively. There were 76 new PVD events; patients with carotid plaque had a greater risk of such events (crude HR: 3.25; 95% CI: 1.62-6.52) compared to those without carotid plaque. This risk was even higher after adjusting for traditional risk factors for atherosclerosis (adjusted HR: 4.41; 95% CI: 1.75-11.14).Carotid plaques are associated with an increased risk of new PVD events. PMID:27495105

  19. Comparison of MRI and DSA in assessment of carotid artery stenosis and atherosclerotic plaque

    International Nuclear Information System (INIS)

    Objective: To compare the efficacy of MRI and DSA in assessment of carotid artery stenosis and atherosclerotic plaque. Methods: Forty-six patients with carotid plaque detected by ultrasound were enrolled in this study, and 89 carotid arteries were evaluated by MRI and DSA. MRI examination was acquired with 3.0 T MR scanner and 8 channel phase-array surface coil. The MRI sequences consisted of pre-and post-contrast T1WI, T2WI, PDWI, TOF. Anterior-posterior and lateral views of carotid artery were performed on DSA. The degree of carotid artery stenosis was evaluated by the NASCET standard. Fibrous cap rupture, intraplaque hemorrhage, and calcification were also evaluated on MRI and DSA. Statistical comparison was performed with the Kappa value and paired Chi-square test. Results: The degree of carotid artery stenosis was 50% (16%-78%) on MRI and 47% (7%-73%) on DSA. Two imaging modalities were in good consistency in evaluation of the degree of stenosis (Kappa = 0.882, P2 =20.346, P<0.01). Furthermore, thirty-seven vessels with intraplaque hemorrhage and 71 vessels with calcification in the plaque were found on MRI but none on DSA. Conclusion: MRI is a reliable tool in assessment of the degree of the carotid stenosis and it is superior to DSA in detecting fibrous cap rupture, intraplaque hemorrhage, and calcification. (authors)

  20. The impact of carotid plaque presence and morphology on mortality outcome in cardiological patients

    Directory of Open Access Journals (Sweden)

    Pasanisi Emilio

    2006-03-01

    Full Text Available Abstract Background Carotid plaque severity and morphology can affect cardiovascular prognosis. We evaluate both the importance of echographically assessed carotid artery plaque geometry and morphology as predictors of death in hospitalised cardiological patients. Methods 541 hospitalised patients admitted in a cardiological division (age = 66 ± 11 years, 411 men, have been studied through ultrasound Duplex carotid scan and successively followed-up for a median of 34 months. Echo evaluation assessed plaque severity and morphology (presence of heterogeneity and profile. Results 361 patients showed carotid stenosis (67% with 70% stenosis, 4% with near occlusion and 2% with total occlusion. During the follow-up period, there were 83 all-cause deaths (15% of the total population. Using Cox's proportional hazard model, age (RR 1.06, 95% CI 1.03–1.09, p = 0.000, ejection fraction > 50% (RR = 0.62, 95% CI 0.4–0.96, p = 0.03, treatment with statins (RR = 0.52, 95% CI 0.29–0.95, p = 0.34 and the presence of a heterogeneous plaque (RR 1.6; 95% CI, 1.2 to 2.14, p = 0.002 were independent predictors of death. Kaplan – Meier survival estimates have shown the best outcome in patients without plaque, intermediate in patients with homogeneous plaques and the worst outcome in patients with heterogeneous plaques (90% vs 79% vs 73%, p = 0.0001. Conclusion In hospitalised cardiological patients, carotid plaque presence and morphology assessed by ultrasound are independent predictors of death.

  1. Image Analysis for Contrast Enhanced Ultrasound Carotid Plaque Imaging

    NARCIS (Netherlands)

    Z. Akkus (Zeynettin)

    2014-01-01

    markdownabstract__Abstract__ Intraplaque neovascularization (IPN) has been presented as an important biomarker for progressive atherosclerotic disease and plaque vulnerability in several pathological studies. Therefore, quantification of IPN may allow early prediction of plaque at risk of rupture a

  2. High-resolution multicontrast-weighted MR imaging from human carotid endarterectomy specimens to assess carotid plaque components

    International Nuclear Information System (INIS)

    The American Heart Association modified classification for atherosclerotic plaque lesions has defined vulnerable plaques as those prone to rupture. The aim of our study was to assess the sensitivity and specificity of 1.5-T magnetic resonance imaging (MRI) in the evaluation of the characteristics of plaque components. Twelve carotid endarterectomy specimens were imaged by ex-vivo high-resolution 1.5-T MRI. Thirty-four cross-section axial images were selected for pixel-by-pixel basis analysis to demonstrate the most significant tissue features. Data were then submitted for histopathological examination and each specimen analysed in the light of the histological components (lipid core, fibrous tissue, fibrous/loose connective tissue, calcifications). The overall sensitivity and specificity rates for each tissue type were, respectively, 92% and 74% for the lipid core, 82% and 94% for the fibrous tissue, 72% and 87% for the fibrous/loose connective tissue, and 98% and 99% for calcification. The use of 1.5-T MRI appears to be a reliable tool to characterise plaque components and could help in the screening of patients with high risk of plaque rupture. The possibility of applying MRI in clinical daily practice may change the non-invasive approach to carotid artery diagnostic imaging, thus allowing an early identification of patients with vulnerable plaques. (orig.)

  3. High-resolution multicontrast-weighted MR imaging from human carotid endarterectomy specimens to assess carotid plaque components

    Energy Technology Data Exchange (ETDEWEB)

    Fabiano, Sebastiano; Mancino, Stefano; Stefanini, Matteo; Chiocchi, Marcello; Simonetti, Giovanni [University ' ' Tor Vergata' ' , Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology, Nuclear Medicine and Radiotherapy, Rome (Italy); Mauriello, Alessandro; Spagnoli, Luigi Giusto [University ' ' Tor Vergata' ' , Department of Biopathology and Image Diagnostics, Institute of Anatomic Pathology, Rome (Italy)

    2008-12-15

    The American Heart Association modified classification for atherosclerotic plaque lesions has defined vulnerable plaques as those prone to rupture. The aim of our study was to assess the sensitivity and specificity of 1.5-T magnetic resonance imaging (MRI) in the evaluation of the characteristics of plaque components. Twelve carotid endarterectomy specimens were imaged by ex-vivo high-resolution 1.5-T MRI. Thirty-four cross-section axial images were selected for pixel-by-pixel basis analysis to demonstrate the most significant tissue features. Data were then submitted for histopathological examination and each specimen analysed in the light of the histological components (lipid core, fibrous tissue, fibrous/loose connective tissue, calcifications). The overall sensitivity and specificity rates for each tissue type were, respectively, 92% and 74% for the lipid core, 82% and 94% for the fibrous tissue, 72% and 87% for the fibrous/loose connective tissue, and 98% and 99% for calcification. The use of 1.5-T MRI appears to be a reliable tool to characterise plaque components and could help in the screening of patients with high risk of plaque rupture. The possibility of applying MRI in clinical daily practice may change the non-invasive approach to carotid artery diagnostic imaging, thus allowing an early identification of patients with vulnerable plaques. (orig.)

  4. An assessment of the vulnerability of carotid plaques: a comparative study between intraplaque neovascularization and plaque echogenicity

    International Nuclear Information System (INIS)

    Carotid plaque echolucency as detected by Color Doppler ultrasonography (CDUS) has been used as a potential marker of plaque vulnerability. However, contrast-enhanced ultrasound (CEUS) has recently been shown to be a valuable method to evaluate the vulnerability and neovascularization within carotid atherosclerotic plaques. The aim of this study was to compare CEUS and CDUS in the assessment of plaque vulnerability using transcranial color Doppler (TCD) monitoring of microembolic signals (MES) as a reference technique. A total of 46 subjects with arterial stenosis (≥ 50%) underwent a carotid duplex ultrasound, TCD monitoring of MES and CEUS (SonoVue doses of 2.0 mL) within a span of 3 days. The agreement between the CEUS, CDUS, and MES findings was assessed with a chi-square test. A p-value less than 0.05 was considered statistically significant. Neovascularization was observed in 30 lesions (44.4%). The vascular risk factors for stroke were similar and there were no age or gender differences between the 2 groups. Using CEUS, MES were identified in 2 patients (12.5%) within class 1 (non-neovascularization) as opposed to 15 patients (50.0%) within class 2 (neovascularization) (p = 0.023). CDUS revealed no significant differences in the appearance of the MES between the 2 groups (hyperechoic and hypoechoic) (p = 0.237). This study provides preliminary evidence to suggest that intraplaque neovascularization detected by CEUS is associated with the presence of MESs, where as plaque echogenicity on traditional CDUS does not. These findings argue that CEUS may better identify high-risk plaques

  5. Carotid bifurcation calcium and correlation with percent stenosis of the internal carotid artery on CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    McKinney, Alexander M.; Casey, Sean O.; Teksam, Mehmet; Truwit, Charles L.; Kieffer, Stephen [University of Minnesota Medical School, Departments of Radiology, Minneapolis, MN (United States); Lucato, Leandro T. [Clinics Hospital, University of Sao Paulo, Sao Paulo (Brazil); Smith, Maurice [Johns Hopkins University, Department of Biomedical Engineering, Baltimore, MD (United States)

    2005-01-01

    The aim of this paper was to determine the correlation between calcium burden (expressed as a volume) and extent of stenosis of the origin of the internal carotid artery (ICA) by CT angiography (CTA). Previous studies have shown that calcification in the coronary arteries correlates with significant vessel stenosis, and severe calcification (measured by CT) in the carotid siphon correlates with significant (greater than 50% stenosis) as determined angiographically. Sixty-one patients (age range 50-85 years) underwent CT of the neck with intravenous administration of iodinated contrast for a variety of conditions. Images were obtained with a helical multidetector array CT scanner and reviewed on a three-dimensional workstation. A single observer manipulated window and level to segment calcified plaque from vascular enhancement in order to quantify vascular calcium volume (cc) in the region of the bifurcation of the common carotid artery/ICA origin, and to measure the extent of ICA stenosis near the origin. A total of 117 common carotid artery bifurcations were reviewed. A ''significant'' stenosis was defined arbitrarily as >40% (to detect lesions before they become hemodynamically significant) of luminal diameter on CTA using NASCET-like criteria. All ''significant'' stenoses (21 out of 117 carotid bifurcations) had measurable calcium. We found a relatively strong correlation between percent stenosis and the calcium volume (Pearson's r= 0.65, P<0.0001). We also found that there was an even stronger correlation between the square root of the calcium volume and the percent stenosis as measured by CTA (r= 0.77, P<0.0001). Calcium volumes of 0.01, 0.03, 0.06, 0.09 and 0.12 cc were used as thresholds to evaluate for a ''significant'' stenosis. A receiver operating characteristic (ROC) curve demonstrated that thresholds of 0.06 cc (sensitivity 88%, specificity 87%) and 0.03 cc (sensitivity 94%, specificity

  6. Carotid bifurcation calcium and correlation with percent stenosis of the internal carotid artery on CT angiography

    International Nuclear Information System (INIS)

    The aim of this paper was to determine the correlation between calcium burden (expressed as a volume) and extent of stenosis of the origin of the internal carotid artery (ICA) by CT angiography (CTA). Previous studies have shown that calcification in the coronary arteries correlates with significant vessel stenosis, and severe calcification (measured by CT) in the carotid siphon correlates with significant (greater than 50% stenosis) as determined angiographically. Sixty-one patients (age range 50-85 years) underwent CT of the neck with intravenous administration of iodinated contrast for a variety of conditions. Images were obtained with a helical multidetector array CT scanner and reviewed on a three-dimensional workstation. A single observer manipulated window and level to segment calcified plaque from vascular enhancement in order to quantify vascular calcium volume (cc) in the region of the bifurcation of the common carotid artery/ICA origin, and to measure the extent of ICA stenosis near the origin. A total of 117 common carotid artery bifurcations were reviewed. A ''significant'' stenosis was defined arbitrarily as >40% (to detect lesions before they become hemodynamically significant) of luminal diameter on CTA using NASCET-like criteria. All ''significant'' stenoses (21 out of 117 carotid bifurcations) had measurable calcium. We found a relatively strong correlation between percent stenosis and the calcium volume (Pearson's r= 0.65, P<0.0001). We also found that there was an even stronger correlation between the square root of the calcium volume and the percent stenosis as measured by CTA (r= 0.77, P<0.0001). Calcium volumes of 0.01, 0.03, 0.06, 0.09 and 0.12 cc were used as thresholds to evaluate for a ''significant'' stenosis. A receiver operating characteristic (ROC) curve demonstrated that thresholds of 0.06 cc (sensitivity 88%, specificity 87%) and 0.03 cc (sensitivity 94%, specificity 76%) generated the best combinations of sensitivity and

  7. Plaque hemorrhage in carotid artery disease: Pathogenesis, clinical and biomechanical considerations

    OpenAIRE

    Teng, Zhongzhao; Sadat, Umar; Brown, Adam J.; Gillard, Jonathan H.

    2014-01-01

    Stroke remains the most prevalent disabling illness today, with internal carotid artery luminal stenosis due to atheroma formation responsible for the majority of ischemic cerebrovascular events. Severity of luminal stenosis continues to dictate both patient risk stratification and the likelihood of surgical intervention. But there is growing evidence to suggest that plaque morphology may help improve pre-existing risk stratification criteria. Plaque components such a fibrous tissue, lipid ri...

  8. Assessment of 320-slice computed tomography angiography in distinguishing hemorrhage in carotid atherosclerotic plaques

    OpenAIRE

    Zhang, Xiao-Jie; Yu, Wei; Tao BI; Zi-xu YAN; Feng-ru SHI; SUN, Li-yuan; Zhao-qi ZHANG

    2014-01-01

    Objective To assess the value of 320⁃slice computed tomography angiography (CTA) in distinguishing hemorrhage/thrombus from lipid-rich necrotic core (LRNC) in atherosclerotic plaques of carotid artery. Methods Thirty-seven subjects who prepared to perform carotid endarterectomy (CEA), with stenosis rate about 50%-99% in at least unilateral carotid artery detected by ultrasound, were enrolled in this study. Both 320-slice CTA and 3.0T high-resolution MRI were conducted within one week before o...

  9. MRI plaque imaging detects carotid plaques with a high risk for future cerebrovascular events in asymptomatic patients.

    Directory of Open Access Journals (Sweden)

    Lorena Esposito-Bauer

    Full Text Available PURPOSE: The aim of this study was to investigate prospectively whether MRI plaque imaging can identify patients with asymptomatic carotid artery stenosis who have an increased risk for future cerebral events. MRI plaque imaging allows categorization of carotid stenosis into different lesion types (I-VIII. Within these lesion types, lesion types IV-V and VI are regarded as rupture-prone plaques, whereas the other lesion types represent stable ones. METHODS: Eighty-three consecutive patients (45 male (54.2%; age 54-88 years (mean 73.2 years presenting with an asymptomatic carotid stenosis of 50-99% according to ECST-criteria were recruited. Patients were imaged with a 1.5-T scanner. T1-, T2-, time-of-flight-, and proton-density weighted studies were performed. The carotid plaques were classified as lesion type I-VIII. Clinical endpoints were ischemic stroke, TIA or amaurosis fugax. Survival analysis and log rank test were used to ascertain statistical significance. RESULTS: Six out of 83 patients (7.2% were excluded: 4 patients had insufficient MR image quality; 1 patient was lost-to-follow-up; 1 patient died shortly after the baseline MRI plaque imaging. The following results were obtained by analyzing the remaining 77 patients. The mean time of follow-up was 41.1 months. During follow-up, n = 9 (11.7% ipsilateral ischemic cerebrovascular events occurred. Only patients presenting with the high-risk lesion types IV-V and VI developed an ipsilateral cerebrovascular event versus none of the patients presenting with the stable lesion types III, VII, and VIII (n = 9 (11.7% vs. n = 0 (0% during follow-up. Event-free survival was higher among patients with the MRI-defined stable lesion types (III, VII, and VIII than in patients with the high-risk lesion types (IV-V and VI (log rank test P<0.0001. CONCLUSIONS: MRI plaque imaging has the potential to identify patients with asymptomatic carotid stenosis who are particularly at risk of

  10. Bacteria Present in Carotid Arterial Plaques Are Found as Biofilm Deposits Which May Contribute to Enhanced Risk of Plaque Rupture

    OpenAIRE

    Lanter, Bernard B.; Sauer, Karin; Davies, David G

    2014-01-01

    ABSTRACT Atherosclerosis, a disease condition resulting from the buildup of fatty plaque deposits within arterial walls, is the major underlying cause of ischemia (restriction of the blood), leading to obstruction of peripheral arteries, congestive heart failure, heart attack, and stroke in humans. Emerging research indicates that factors including inflammation and infection may play a key role in the progression of atherosclerosis. In the current work, atherosclerotic carotid artery explants...

  11. Echolucency of computerized ultrasound images of carotid atherosclerotic plaques are associated with increased levels of triglyceride-rich lipoproteins as well as increased plaque lipid content

    DEFF Research Database (Denmark)

    Grønholdt, Marie-Louise M.; Nordestgaard, Børge; Wiebe, Britt M.; Wilhjelm, Jens Erik; Sillesen, Henrik

    1998-01-01

    Background-Echo-lucency of carotid atherosclerotic plaques on computerized ultrasound B-mode images has been associated with a high incidence of brain infarcts as evaluated on CT scans. We tested the hypotheses that triglyceride-rich lipoproteins in the fasting and postprandial state predict......-rich lipoproteins predict echo-lucency of carotid plaques, which is associated with increased plaque Lipid content, Because echo-lucency has been associated with a high incidence of brain infarcts on CT scans, triglyceride-rich lipoproteins may predict a plaque type particularly vulnerable to rupture....

  12. Anti‐Inflammatory Immune Skewing Is Atheroprotective: Apoe−/−FcγRIIb−/− Mice Develop Fibrous Carotid Plaques

    OpenAIRE

    Harmon, Erin Y.; Van Fronhofer; Keller, Rebecca S.; Feustel, Paul J.; Zhu, Xinmei; Xu, Hao; Avram, Dorina; David M Jones; Nagarajan, Shanmugam; Lennartz, Michelle R.

    2014-01-01

    Background Stroke, caused by carotid plaque rupture, is a major cause of death in the United States. Whereas vulnerable human plaques have higher Fc receptor (FcγR) expression than their stable counterparts, how FcγR expression impacts plaque histology is unknown. We investigated the role of FcγRIIb in carotid plaque development and stability in apolipoprotein (Apo)e−/− and Apoe−/−FcγRIIb−/− double knockout (DKO) animals. Methods and Results Plaques were induced by implantation of a shear str...

  13. Multi-scale AM-FM motion analysis of ultrasound videos of carotid artery plaques

    Science.gov (United States)

    Murillo, Sergio; Murray, Victor; Loizou, C. P.; Pattichis, C. S.; Pattichis, Marios; Barriga, E. Simon

    2012-03-01

    An estimated 82 million American adults have one or more type of cardiovascular diseases (CVD). CVD is the leading cause of death (1 of every 3 deaths) in the United States. When considered separately from other CVDs, stroke ranks third among all causes of death behind diseases of the heart and cancer. Stroke accounts for 1 out of every 18 deaths and is the leading cause of serious long-term disability in the United States. Motion estimation of ultrasound videos (US) of carotid artery (CA) plaques provides important information regarding plaque deformation that should be considered for distinguishing between symptomatic and asymptomatic plaques. In this paper, we present the development of verifiable methods for the estimation of plaque motion. Our methodology is tested on a set of 34 (5 symptomatic and 29 asymptomatic) ultrasound videos of carotid artery plaques. Plaque and wall motion analysis provides information about plaque instability and is used in an attempt to differentiate between symptomatic and asymptomatic cases. The final goal for motion estimation and analysis is to identify pathological conditions that can be detected from motion changes due to changes in tissue stiffness.

  14. Intracranial carotid calcification on CT images as an indicator of atheromatous plaque. Analysis of high-resolution CTA images using a 64-multidetector scanner

    International Nuclear Information System (INIS)

    Intracranial arterial wall calcifications are frequently observed on routine head computed tomography (CT) images. The purpose of this study was to evaluate whether calcification of the intracranial carotid artery on CT images could predict atheromatous plaque and luminal stenosis. A total of 259 patients were examined using three-dimensional CT angiography using high-resolution 64 detector scanners. We examined patients from the petrous portion to the top of the internal carotid arteries. We evaluated the existence of calcification and atheromatous plaque based on our criteria retrospectively. The thickness of calcification was measured in each vessel, and the shape of calcification was classified into three types. There was low correlation between the thickness of the calcification and luminal stenosis, but the shape of the calcification corresponded well to the stenosis. The population of patients with >50% stenosis of the intracranial carotid artery differed statistically significantly for each calcification shape. There was a high negative predictive value (97.7%) in the correlation between the existence of calcification and atheromatous plaque on the multidetector CT images. Calcification of the intracranial carotid artery on CT images shows a high negative predictive value for the existence of atheromatous plaque in the same artery. The thickness of the calcification did not correlate well with luminal stenosis, but its shape seemed to predict luminal stenosis. (author)

  15. Fully automated carotid plaque segmentation in combined contrast-enhanced and B-mode ultrasound.

    Science.gov (United States)

    Akkus, Zeynettin; Carvalho, Diego D B; van den Oord, Stijn C H; Schinkel, Arend F L; Niessen, Wiro J; de Jong, Nico; van der Steen, Antonius F W; Klein, Stefan; Bosch, Johan G

    2015-02-01

    Carotid plaque segmentation in B-mode ultrasound (BMUS) and contrast-enhanced ultrasound (CEUS) is crucial to the assessment of plaque morphology and composition, which are linked to plaque vulnerability. Segmentation in BMUS is challenging because of noise, artifacts and echo-lucent plaques. CEUS allows better delineation of the lumen but contains artifacts and lacks tissue information. We describe a method that exploits the combined information from simultaneously acquired BMUS and CEUS images. Our method consists of non-rigid motion estimation, vessel detection, lumen-intima segmentation and media-adventitia segmentation. The evaluation was performed in training (n = 20 carotids) and test (n = 28) data sets by comparison with manually obtained ground truth. The average root-mean-square errors in the training and test data sets were comparable for media-adventitia (411 ± 224 and 393 ± 239 μm) and for lumen-intima (362 ± 192 and 388 ± 200 μm), and were comparable to inter-observer variability. To the best of our knowledge, this is the first method to perform fully automatic carotid plaque segmentation using combined BMUS and CEUS. PMID:25542485

  16. Fragmentation of calcified plaque after carotid artery stenting in heavily calcified circumferential stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Tsutsumi, Masanori; Kodama, Tomonobu; Aikawa, Hiroshi; Onizuka, Masanari; Iko, Minoru; Nii, Kouhei; Hamaguchi, Shuko; Etou, Housei; Sakamoto, Kimiya; Inoue, Ritsurou; Nakau, Hiroya [Fukuoka University Chikushi Hospital, Department of Neurosurgery and Neuroradiology, Fukuoka (Japan); Kazekawa, Kiyoshi [Fukuoka University Chikushi Hospital, Department of Neurosurgery and Neuroradiology, Fukuoka (Japan); Fukuoka University Chikushi Hospital, Department of Neurosurgery, Fukuoka (Japan)

    2010-09-15

    We assessed the morphological change of calcified plaque after carotid artery stenting (CAS) in vessels with heavily calcified circumferential lesions and discuss the possible mechanisms of stent expansion in these lesions. We performed 18 CAS procedures in 16 patients with severe carotid artery stenosis accompanied by plaque calcification involving more than 75% of the vessel circumference. All patients underwent multidetector-row computed tomography (MDCT) to evaluate lesion calcification before and within 3 months after intervention. The angiographic outcome immediately after CAS and follow-up angiographs obtained 6 months post-CAS were examined. The preoperative mean arc of the calcifications was 320.1 {+-} 24.5 (range 278-360 ). In all lesions, CAS procedures were successfully carried out; excellent dilation with residual stenosis {<=}30% was achieved in all lesions. Post-CAS MDCT demonstrated multiple fragmentations of the calcifications in 17 of 18 lesions (94.4%), but only cracks in the calcified plaque without fragmentation in one (5.6%). Angiographic study performed approximately 6 months post-CAS detected severe restenosis in one lesion (5.6%) without fragmentation of calcified plaque. Excellent stent expansion may be achieved and maintained in heavily calcified circumferential carotid lesions by disruption and fragmentation of the calcified plaques. (orig.)

  17. Fragmentation of calcified plaque after carotid artery stenting in heavily calcified circumferential stenosis

    International Nuclear Information System (INIS)

    We assessed the morphological change of calcified plaque after carotid artery stenting (CAS) in vessels with heavily calcified circumferential lesions and discuss the possible mechanisms of stent expansion in these lesions. We performed 18 CAS procedures in 16 patients with severe carotid artery stenosis accompanied by plaque calcification involving more than 75% of the vessel circumference. All patients underwent multidetector-row computed tomography (MDCT) to evaluate lesion calcification before and within 3 months after intervention. The angiographic outcome immediately after CAS and follow-up angiographs obtained 6 months post-CAS were examined. The preoperative mean arc of the calcifications was 320.1 ± 24.5 (range 278-360 ). In all lesions, CAS procedures were successfully carried out; excellent dilation with residual stenosis ≤30% was achieved in all lesions. Post-CAS MDCT demonstrated multiple fragmentations of the calcifications in 17 of 18 lesions (94.4%), but only cracks in the calcified plaque without fragmentation in one (5.6%). Angiographic study performed approximately 6 months post-CAS detected severe restenosis in one lesion (5.6%) without fragmentation of calcified plaque. Excellent stent expansion may be achieved and maintained in heavily calcified circumferential carotid lesions by disruption and fragmentation of the calcified plaques. (orig.)

  18. Multi-analyte profiling in human carotid atherosclerosis uncovers pro-inflammatory macrophage programming in plaques.

    Science.gov (United States)

    Shalhoub, Joseph; Viiri, Leena E; Cross, Amanda J; Gregan, Scott M; Allin, David M; Astola, Nagore; Franklin, Ian J; Davies, Alun H; Monaco, Claudia

    2016-05-01

    Molecular characterisation of vulnerable atherosclerosis is necessary for targeting functional imaging and plaque-stabilising therapeutics. Inflammation has been linked to atherogenesis and the development of high-risk plaques. We set to quantify cytokine, chemokine and matrix metalloproteinase (MMP) protein production in cells derived from carotid plaques to map the inflammatory milieu responsible for instability. Carotid endarterectomies from carefully characterised symptomatic (n=35) and asymptomatic (n=32) patients were enzymatically dissociated producing mixed cell type atheroma cell suspensions which were cultured for 24 hours. Supernatants were interrogated for 45 analytes using the Luminex 100 platform. Twenty-nine of the 45 analytes were reproducibly detectable in the majority of donors. The in vitro production of a specific network of mediators was found to be significantly higher in symptomatic than asymptomatic plaques, including: tumour necrosis factor α, interleukin (IL) 1β, IL-6, granulocyte-macrophage colony-stimulating factor (GM-CSF), macrophage colony-stimulating factor (M-CSF), CCL5, CCL20, CXCL9, matrix metalloproteinase (MMP)-3 and MMP-9. Ingenuity pathway analysis of differentially expressed analytes between symptomatic and asymptomatic patients identified a number of key biological pathways (p< 10(-25)). In conclusion, the carotid artery plaque culprit of ischaemic neurological symptoms is characterised by an inflammatory milieu favouring inflammatory cell recruitment and pro-inflammatory macrophage polarisation. PMID:26763091

  19. Study on Relationship Between Intima Medial Thickness and the Plaque in Stroke Patients on Carotid Artery Sonography

    International Nuclear Information System (INIS)

    The carotid intima-media thickness (IMT) is an early structural marker of the atherosclerotic process and is the only non-invasive test that is currently recommended by the American Heart Association for evaluation of the risk. However, use of this parameter has a limitation because it assumes uniform thickness throughout the blood vessel, whereas atherosclerosis is a focal phenomenon that is confined to intima. In fact, plaque can be found along the atherosclerotic blood vessels even though its value is unknown. The aim of this study is to analyze the carotid plaque and IMT in the stroke patients. We investigated the patients with ischemic stroke, who were admitted to the department of neurology at the Stroke Special Hospital from January to March 2008. After the carotid IMT and plaque were assessed by B-mode ultrasonography, IMT and carotid plaque to risk variables (age, sex) were analyzed. The distribution of CCA IMT was significantly different in terms of age (p = 0.004). Likewise, the distribution of carotid plaque was also significantly different in terms of age (p = 0.006). Carotid plaque was 69 and 92% in normal and abnormal CCA IMTs respectively. The results showed that the CCA IMT was closely associated with carotid plaque.

  20. Atherosclerotic plaque component segmentation in combined carotid MRI and CTA data incorporating class label uncertainty.

    Science.gov (United States)

    van Engelen, Arna; Niessen, Wiro J; Klein, Stefan; Groen, Harald C; Verhagen, Hence J M; Wentzel, Jolanda J; van der Lugt, Aad; de Bruijne, Marleen

    2014-01-01

    Atherosclerotic plaque composition can indicate plaque vulnerability. We segment atherosclerotic plaque components from the carotid artery on a combination of in vivo MRI and CT-angiography (CTA) data using supervised voxelwise classification. In contrast to previous studies the ground truth for training is directly obtained from 3D registration with histology for fibrous and lipid-rich necrotic tissue, and with μCT for calcification. This registration does, however, not provide accurate voxelwise correspondence. We therefore evaluate three approaches that incorporate uncertainty in the ground truth used for training: I) soft labels are created by Gaussian blurring of the original binary histology segmentations to reduce weights at the boundaries between components, and are weighted by the estimated registration accuracy of the histology and in vivo imaging data (measured by overlap), II) samples are weighted by the local contour distance of the lumen and outer wall between histology and in vivo data, and III) 10% of each class is rejected by Gaussian outlier rejection. Classification was evaluated on the relative volumes (% of tissue type in the vessel wall) for calcified, fibrous and lipid-rich necrotic tissue, using linear discriminant (LDC) and support vector machine (SVM) classification. In addition, the combination of MRI and CTA data was compared to using only one imaging modality. Best results were obtained by LDC and outlier rejection: the volume error per vessel was 0.9±1.0% for calcification, 12.7±7.6% for fibrous and 12.1±8.1% for necrotic tissue, with Spearman rank correlation coefficients of 0.91 (calcification), 0.80 (fibrous) and 0.81 (necrotic). While segmentation using only MRI features yielded low accuracy for calcification, and segmentation using only CTA features yielded low accuracy for necrotic tissue, the combination of features from MRI and CTA gave good results for all studied components. PMID:24762678

  1. MRI-derived measurements of fibrous-cap and lipid-core thickness: the potential for identifying vulnerable carotid plaques in vivo

    Energy Technology Data Exchange (ETDEWEB)

    Trivedi, Rikin A. [Addenbrooke' s Hospital, University Department of Radiology, Cambridge (United Kingdom); Addenbrooke' s Hospital, Academic Department of Neurosurgery, Cambridge (United Kingdom); U-King-Im, Jean-Marie; Graves, Martin J. [Addenbrooke' s Hospital, University Department of Radiology, Cambridge (United Kingdom); Horsley, Jo; Goddard, Martin [Papworth Hospital, Department of Histopathology, Papworth Everard (United Kingdom); Kirkpatrick, Peter J. [Addenbrooke' s Hospital, Academic Department of Neurosurgery, Cambridge (United Kingdom); Gillard, Jonathan H. [Addenbrooke' s Hospital, University Department of Radiology, Cambridge (United Kingdom); Addenbrooke' s Hospital, Hills Road, Box 219, Cambridge (United Kingdom)

    2004-09-01

    Vulnerable plaques have thin fibrous caps overlying large necrotic lipid cores. Recent studies have shown that high-resolution MR imaging can identify these components. We set out to determine whether in vivo high-resolution MRI could quantify this aspect of the vulnerable plaque. Forty consecutive patients scheduled for carotid endarterectomy underwent pre-operative in vivo multi-sequence MR imaging of the carotid artery. Individual plaque constituents were characterised on MR images. Fibrous-cap and lipid-core thickness was measured on MRI and histology images. Bland-Altman plots were generated to determine the level of agreement between the two methods. Multi-sequence MRI identified 133 corresponding MR and histology slices. Plaque calcification or haemorrhage was seen in 47 of these slices. MR and histology derived fibrous cap-lipid-core thickness ratios showed strong agreement with a mean difference between MR and histology ratios of 0.02 ({+-}0.04). The intra-class correlation coefficient between two readers for measurements was 0.87 (95% confidence interval, 0.73 and 0.93). Multi-sequence, high-resolution MR imaging accurately quantified the relative thickness of fibrous-cap and lipid-core components of carotid atheromatous plaques. This may prove to be a useful tool to characterise vulnerable plaques in vivo. (orig.)

  2. MRI-derived measurements of fibrous-cap and lipid-core thickness: the potential for identifying vulnerable carotid plaques in vivo

    International Nuclear Information System (INIS)

    Vulnerable plaques have thin fibrous caps overlying large necrotic lipid cores. Recent studies have shown that high-resolution MR imaging can identify these components. We set out to determine whether in vivo high-resolution MRI could quantify this aspect of the vulnerable plaque. Forty consecutive patients scheduled for carotid endarterectomy underwent pre-operative in vivo multi-sequence MR imaging of the carotid artery. Individual plaque constituents were characterised on MR images. Fibrous-cap and lipid-core thickness was measured on MRI and histology images. Bland-Altman plots were generated to determine the level of agreement between the two methods. Multi-sequence MRI identified 133 corresponding MR and histology slices. Plaque calcification or haemorrhage was seen in 47 of these slices. MR and histology derived fibrous cap-lipid-core thickness ratios showed strong agreement with a mean difference between MR and histology ratios of 0.02 (±0.04). The intra-class correlation coefficient between two readers for measurements was 0.87 (95% confidence interval, 0.73 and 0.93). Multi-sequence, high-resolution MR imaging accurately quantified the relative thickness of fibrous-cap and lipid-core components of carotid atheromatous plaques. This may prove to be a useful tool to characterise vulnerable plaques in vivo. (orig.)

  3. Carotid plaque characterization using CT and MRI scans for synergistic image analysis

    Science.gov (United States)

    Getzin, Matthew; Xu, Yiqin; Rao, Arhant; Madi, Saaussan; Bahadur, Ali; Lennartz, Michelle R.; Wang, Ge

    2014-09-01

    Noninvasive determination of plaque vulnerability has been a holy grail of medical imaging. Despite advances in tomographic technologies , there is currently no effective way to identify vulnerable atherosclerotic plaques with high sensitivity and specificity. Computed tomography (CT) and magnetic resonance imaging (MRI) are widely used, but neither provides sufficient information of plaque properties. Thus, we are motivated to combine CT and MRI imaging to determine if the composite information can better reflect the histological determination of plaque vulnerability. Two human endarterectomy specimens (1 symptomatic carotid and 1 stable femoral) were imaged using Scanco Medical Viva CT40 and Bruker Pharmascan 16cm 7T Horizontal MRI / MRS systems. μCT scans were done at 55 kVp and tube current of 70 mA. Samples underwent RARE-VTR and MSME pulse sequences to measure T1, T2 values, and proton density. The specimens were processed for histology and scored for vulnerability using the American Heart Association criteria. Single modality-based analyses were performed through segmentation of key imaging biomarkers (i.e. calcification and lumen), image registration, measurement of fibrous capsule, and multi-component T1 and T2 decay modeling. Feature differences were analyzed between the unstable and stable controls, symptomatic carotid and femoral plaque, respectively. By building on the techniques used in this study, synergistic CT+MRI analysis may provide a promising solution for plaque characterization in vivo.

  4. In vivo and in vitro evidence that 99mTc-HYNIC-interleukin-2 is able to detect T lymphocytes in vulnerable atherosclerotic plaques of the carotid artery

    International Nuclear Information System (INIS)

    Recent advances in basic science have established that inflammation plays a pivotal role in the pathogenesis of atherosclerosis. Inflammatory cells are thought to be responsible for the transformation of a stable plaque into a vulnerable one. Lymphocytes constitute at least 20 % of infiltrating cells in these vulnerable plaques. Therefore, the interleukin-2 (IL-2) receptor, being overexpressed on activated T lymphocytes, may represent an attractive biomarker for plaque vulnerability. The aim of this study was to evaluate the specificity of radiolabelled IL-2 [99mTc-hydrazinonicotinamide (HYNIC)-IL-2] for imaging the lymphocytic infiltration in carotid plaques in vivo by planar and single photon emission computed tomography (SPECT)/CT imaging and ex vivo by microSPECT and autoradiography. For the in vivo study, ten symptomatic patients with advanced plaques at ultrasound who were scheduled for carotid endarterectomy underwent 99mTc-HYNIC-IL-2 scintigraphy. The images were analysed visually on planar and SPECT images and semi-quantitatively on SPECT images by calculating target to background (T/B) ratios. After endarterectomy, immunomorphological evaluation and immunophenotyping were performed on plaque slices. For the ex vivo studies, four additional patients were included and, after in vitro incubation of removed plaques with 99mTc-HYNIC-IL-2, autoradiography was performed and microSPECT images were acquired. Visual analysis defined clear 99mTc-HYNIC-IL-2 uptake in seven of the ten symptomatic plaques. SPECT/CT allowed visualization in eight of ten. A significant correlation was found between the number of CD25+ lymphocytes and the total number of CD25+ cells in the plaque and the T/B ratio with adjacent carotid artery as background (Pearson's r = 0.89, p = 0.003 and r = 0.87, p = 0.005, respectively). MicroSPECT imaging showed clear 99mTc-HYNIC-IL-2 uptake within the plaque wall and not in the lipidic core. With autoradiography, only CD3+ lymphocytes were found to

  5. Significance of ultrasound evaluation of carotid atherosclerotic plaque for diagnosing ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Carotid artery is the main source for craniocerebral blood supply. Its intimal plaque formation and arterial stenosis degree both are the risk factors for ischemic cerebrovascular disease.Therefore, the close relationship of carotid atherosclerotic plaque and ischemic cerebrovascular disease, and ultrasound evaluation of carotid atherosclerotic plaque have become the hot spot in studying ischemic cerebrovascular disease.OBJECTIVE: This study was to detect the degree of carotid atherosclerosis of ischemic cerebrovascular disease patients by ultrasonography, and to analyze the situation of carotid atherosclerosis and its relationship with clinic.DESIGN: Clinical randomized concurrent control experiment.SETTING: Lintong Convalescent Hospital of Lanzhou Military Area Command of Chinese PLA.PARTICIPANTS: Totally 60 outpatients and inpatients with ischemic cerebrovascular disease, 42 males and 18 females, admitted to Lintong Convalescent Hospital of Lanzhou Military Area Command of Chinese PLA between January 2006 and December 2006 were involved in the patient group. They met the diagnosis criteria of ischemic cerebrovascular disease constituted by the 4th Cerebrovascular Disease Conference in 1996, and were confirmed to suffer from ischemic cerebrovascular disease by skull CT and MRI. Another 20 subjects who received healthy examination concurrently in the same hospital, 12 males and 8 females, were involved in the control group. Informed consents of detected items were obtained from involved subjects.METHODS: The plaque thickness of mid portion, distal end and crotch of common carotid artery (CCA),internal carotid artery (ICA), external carotid artery (ECA) and vertebral artery (VA) of involved subjects,who received health examination was separately detected with color Doppler ultrasonograph (HDI-5000).Then, total integral of plaque was calculated. The intima-media thickness (IMT) was measured with two-dimensional ultrasonography. The inner diameter

  6. Alternation of histone and DNA methylation in human atherosclerotic carotid plaques.

    Science.gov (United States)

    Greißel, A; Culmes, M; Napieralski, R; Wagner, E; Gebhard, H; Schmitt, M; Zimmermann, A; Eckstein, H-H; Zernecke, A; Pelisek, J

    2015-08-01

    Little is known about epigenetics and its possible role in atherosclerosis. We here analysed histone and DNA methylation and the expression of corresponding methyltransferases in early and advanced human atherosclerotic carotid lesions in comparison to healthy carotid arteries. Western Blotting was performed on carotid plaques from our biobank with early (n=60) or advanced (n=60) stages of atherosclerosis and healthy carotid arteries (n=12) to analyse di-methylation patterns of histone H3 at positions K4, K9 and K27. In atherosclerotic lesions, di-methylation of H3K4 was unaltered and that of H3K9 and H3K27 significantly decreased compared to control arteries. Immunohistochemistry revealed an increased appearance of di-methylated H3K4 in smooth muscle cells (SMCs), a decreased expression of di-methylated H3K9 in SMCs and inflammatory cells, and reduced di-methylated H3K27 in inflammatory cells in advanced versus early atherosclerosis. Expression of corresponding histone methyltransferases MLL2 and G9a was increased in advanced versus early atherosclerosis. Genomic DNA hypomethylation, as determined by PCR for methylated LINE1 and SAT-alpha, was observed in early and advanced plaques compared to control arteries and in cell-free serum of patients with high-grade carotid stenosis compared to healthy volunteers. In contrast, no differences in DNA methylation were observed in blood cells. Expression of DNA-methyltransferase DNMT1 was reduced in atherosclerotic plaques versus controls, DNMT3A was undetectable, and DNMT3B not altered. DNA-demethylase TET1 was increased in atherosclerosisc plaques. The extent of histone and DNA methylation and expression of some corresponding methyltransferases are significantly altered in atherosclerosis, suggesting a possible contribution of epigenetics in disease development. PMID:25993995

  7. Novel methodology for 3D reconstruction of carotid arteries and plaque characterization based upon magnetic resonance imaging carotid angiography data.

    Science.gov (United States)

    Sakellarios, Antonis I; Stefanou, Kostas; Siogkas, Panagiotis; Tsakanikas, Vasilis D; Bourantas, Christos V; Athanasiou, Lambros; Exarchos, Themis P; Fotiou, Evangelos; Naka, Katerina K; Papafaklis, Michail I; Patterson, Andrew J; Young, Victoria E L; Gillard, Jonathan H; Michalis, Lampros K; Fotiadis, Dimitrios I

    2012-10-01

    In this study, we present a novel methodology that allows reliable segmentation of the magnetic resonance images (MRIs) for accurate fully automated three-dimensional (3D) reconstruction of the carotid arteries and semiautomated characterization of plaque type. Our approach uses active contours to detect the luminal borders in the time-of-flight images and the outer vessel wall borders in the T(1)-weighted images. The methodology incorporates the connecting components theory for the automated identification of the bifurcation region and a knowledge-based algorithm for the accurate characterization of the plaque components. The proposed segmentation method was validated in randomly selected MRI frames analyzed offline by two expert observers. The interobserver variability of the method for the lumen and outer vessel wall was -1.60%±6.70% and 0.56%±6.28%, respectively, while the Williams Index for all metrics was close to unity. The methodology implemented to identify the composition of the plaque was also validated in 591 images acquired from 24 patients. The obtained Cohen's k was 0.68 (0.60-0.76) for lipid plaques, while the time needed to process an MRI sequence for 3D reconstruction was only 30 s. The obtained results indicate that the proposed methodology allows reliable and automated detection of the luminal and vessel wall borders and fast and accurate characterization of plaque type in carotid MRI sequences. These features render the currently presented methodology a useful tool in the clinical and research arena. PMID:22617149

  8. Analysis of carotid artery plaque and wall boundaries on CT images by using a semi-automatic method based on level set model

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the potentialities of a semi-automated technique in the detection and measurement of the carotid artery plaque. Twenty-two consecutive patients (18 males, 4 females; mean age 62 years) examined with MDCTA from January 2011 to March 2011 were included in this retrospective study. Carotid arteries are examined with a 16-multi-detector-row CT system, and for each patient, the most diseased carotid was selected. In the first phase, the carotid plaque was identified and one experienced radiologist manually traced the inner and outer boundaries by using polyline and radial distance method (PDM and RDM, respectively). In the second phase, the carotid inner and outer boundaries were traced with an automated algorithm: level-set-method (LSM). Data were compared by using Pearson rho correlation, Bland-Altman, and regression. A total of 715 slices were analyzed. The mean thickness of the plaque using the reference PDM was 1.86 mm whereas using the LSM-PDM was 1.96 mm; using the reference RDM was 2.06 mm whereas using the LSM-RDM was 2.03 mm. The correlation values between the references, the LSM, the PDM and the RDM were 0.8428, 0.9921, 0.745 and 0.6425. Bland-Altman demonstrated a very good agreement in particular with the RDM method. Results of our study indicate that LSM method can automatically measure the thickness of the plaque and that the best results are obtained with the RDM. Our results suggest that advanced computer-based algorithms can identify and trace the plaque boundaries like an experienced human reader. (orig.)

  9. The analysis of the connection between plaque morphology of the asymptomatic carotid stenosis and ischemic brain lesions

    Directory of Open Access Journals (Sweden)

    Milošević Đorđe

    2013-01-01

    Full Text Available Background/Aim. A certain percentage of patients with asymptomatic carotid stenosis have an unstable carotid plaque. For these patients it is possible to register by modern imaging methods the existence of lesions of the brain parenchyma - the silent brain infarction. These patients have a greater risk of ischemic stroke. The aim of this study was to analyze the connection between the morphology of atherosclerotic carotid plaque in patients with asymptomatic carotid stenosis and the manifestation of silent brain infarction, and to analyze the influence of risk factors for cardiovascular diseases on the occurrence of silent brain infarction and the morphology of carotid plaque. Methods. This retrospective study included patients who had been operated for high grade (> 70% extracranial atherosclerotic carotid stenosis at the Clinic for Vascular and Transplantation Surgery of the Clinical Center of Vojvodina over a period of 5 years. The patients analyzed had no clinical manifestation of cerebrovascular insufficiency of the carotid artery territory up to the time of operation. The classification of carotid plaque morphology was carried out according to the Gray-Weale classification, after which all the types were subcategorized into two groups: stable and unstable. Brain lesions were verified using preoperative imaging of the brain parenchyma by magnetic resonance. We analyzed ipsilateral lesions of the size > or = 3 mm. Results. Out of a 201 patients 78% had stable plaque and 22% unstable one. Unstable plaque was prevalent in the male patients (male/female ratio = 24.8% : 17.8%, but without a statistically significant difference (p > 0.05. The risk factors (hypertension, nicotinism, hyperlipoproteinemia, and diabetes mellitus showed no statistically significant impact on carotid plaque morphology and the occurrence of silent brain infarction. Silent brain infarction was detected in 30.8% of the patients. Unstable carotid plaque was found in a

  10. Associations of Biomarkers of Atherosclerotic Plaques Instability (MMP-9, TIMP-1 and Zinc Levels in Carotid Atherosclerosis

    Directory of Open Access Journals (Sweden)

    Gulnora A. Rozikhodjaeva

    2015-03-01

    Full Text Available The levels of matrix metalloproteinase-9 (MMP-9 and its tissue inhibitor (TIMP-1 in serum, and the concentration of Zn in the serum, hair and carotid atherosclerotic plaques were examined. The relationships zinc-dependent endopeptidases as biomarkers instability of atherosclerotic plaques and zinc in patients with carotid atherosclerosis were studied. The results contribute to the selection of patients at high risk for cardiovascular events.

  11. Imaging characteristics of two-dimensional spin echo T1-weighted image in carotid artery plaque

    International Nuclear Information System (INIS)

    Recently, T1 weighted image (T1WI) has proven to be useful for diagnosing carotid plaque. This time, the image parameter of two-dimensional spin echo (2D SE) T1WI was examined. Phantoms that imitated muscle and carotid plaque were made. Signal noise ratio (SNR) and the contrast of phantoms were examined when the flip angle (FA) of radio frequency (RF) pulse, repetition time (TR), and echo train length (ETL) was changed. A visual evaluation was done in a clinical case. Both SE and fast spin echo (FSE) SNR improved according to the extension of TR, and the contrast decreased. Moreover, the contrast improved when there was a lot of ETL and the FA of RF pulse. It is thought that this is because SNR and the contrast depend on the interrelation of TR, T1 value, and the FA of RF pulse. When the FA of RF pulse was set to 70 degrees and the TR was set to 400 ms resulting from the phantom experiment, clinical cases obtained great results. This examination confirmed the utility of 2D SE in carotid plaque inspection. (author)

  12. Magnetic resonance plaque imaging to predict the occurrence of the slow-flow phenomenon in carotid artery stenting procedures

    International Nuclear Information System (INIS)

    The purpose is to investigate the feasibility of magnetic resonance (MR) plaque imaging in predicting the arterial flow impairment (slow-flow phenomenon) during carotid artery stenting (CAS) using a filter-type protection device. Thirty-one carotid artery stenotic lesions in 30 patients (28 men and two women; mean age, 71.8 years) were evaluated by MR plaque imaging with black blood T1- and T2-weighted and time-of-flight sequences before CAS. Main plaque components were classified as vulnerable (intraplaque hemorrhage and lipid-rich/necrotic core) or stable (fibrous tissue and dense calcification) from the signal pattern. The plaque classification was statistically compared with the occurrence of slow-flow phenomenon. The slow-flow phenomenon was observed in ten CAS procedures (five flow arrests and five flow reductions). Flow arrests consisted of four vulnerable and one stable plaque, and flow reductions consisted of four vulnerable and one stable plaque. The slow-flow phenomenon occurred significantly (P < 0.01) more frequently in patients with vulnerable plaque. Vulnerable carotid plaques have a significantly higher risk of slow-flow phenomenon than stable plaques. The occurrence of the slow-flow phenomenon can be predicted by MR plaque imaging before CAS. (orig.)

  13. Magnetic resonance plaque imaging to predict the occurrence of the slow-flow phenomenon in carotid artery stenting procedures

    Energy Technology Data Exchange (ETDEWEB)

    Sakamoto, Masahiko; Taoka, Toshiaki; Nakagawa, Hiroyuki; Wada, Takeshi; Akashi, Toshiaki; Kichikawa, Kimihiko [Nara Medical University, Department of Radiology, Nara (Japan); Takayama, Katsutoshi; Myouchin, Kaoru [Ishinkai Yao General Hospital, Department of Interventional Neuroradiology, Osaka (Japan); Miyasaka, Toshiteru [Nara Prefectural Nara Hospital, Department of Radiology, Nara (Japan); Fukusumi, Akio [Takanohara Central Hospital, Department of Radiology, Nara (Japan); Iwasaki, Satoru [Higashiosaka General Hospital, Department of Radiology, Osaka (Japan)

    2010-04-15

    The purpose is to investigate the feasibility of magnetic resonance (MR) plaque imaging in predicting the arterial flow impairment (slow-flow phenomenon) during carotid artery stenting (CAS) using a filter-type protection device. Thirty-one carotid artery stenotic lesions in 30 patients (28 men and two women; mean age, 71.8 years) were evaluated by MR plaque imaging with black blood T1- and T2-weighted and time-of-flight sequences before CAS. Main plaque components were classified as vulnerable (intraplaque hemorrhage and lipid-rich/necrotic core) or stable (fibrous tissue and dense calcification) from the signal pattern. The plaque classification was statistically compared with the occurrence of slow-flow phenomenon. The slow-flow phenomenon was observed in ten CAS procedures (five flow arrests and five flow reductions). Flow arrests consisted of four vulnerable and one stable plaque, and flow reductions consisted of four vulnerable and one stable plaque. The slow-flow phenomenon occurred significantly (P < 0.01) more frequently in patients with vulnerable plaque. Vulnerable carotid plaques have a significantly higher risk of slow-flow phenomenon than stable plaques. The occurrence of the slow-flow phenomenon can be predicted by MR plaque imaging before CAS. (orig.)

  14. Coincidence of calcified carotid atheromatous plaque, osteoporosis, and periodontal bone loss in dental panoramic radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Ramesh, Aruna; Ganguly, Rumpa [Dept. of Diagnosis and Health Promotion, Division of Oral and Maxillofacial Radiology, Tufts University School of Dental Medicine, Boston (United States); Soroushian, Sheila [Dept. of Orthodontics, Howard University College of Dentistry, Washington, DC(United States)

    2013-12-15

    This study was performed to assess the correlation of calcified carotid atheromatous plaque (CCAP), the mandibular cortical index, and periodontal bone loss in panoramic radiographs. One hundred eighty-five panoramic radiographs with CCAP and 234 without this finding were evaluated by 3 observers for the presence of osseous changes related to osteoporosis and periodontal bone loss. Chi-squared and Mann-Whitney U tests were used to compare the two groups for an association of CCAP with the mandibular cortical index and periodontal bone loss, respectively. There was a statistically significant coincidence of CCAP and osseous changes related to osteopenia/osteoporosis, with a p-value <0.001. There was no statistically significant coincidence of CCAP and periodontal bone loss. When comparing the 2 groups, 'With CCAP' and 'Without CCAP', there was a statistically significant association with the mean body mass index (BMI), number of remaining teeth, positive history of diabetes mellitus, and vascular accidents. There was no statistically significant association with gender or a history of smoking. This study identified a possible concurrence of CCAP and mandibular cortical changes secondary to osteopenia/osteoporosis in panoramic radiographs. This could demonstrate the important role of dental professionals in screening for these systemic conditions, leading to timely and appropriate referrals resulting in early interventions and thus improving overall health.

  15. Coincidence of calcified carotid atheromatous plaque, osteoporosis, and periodontal bone loss in dental panoramic radiographs

    International Nuclear Information System (INIS)

    This study was performed to assess the correlation of calcified carotid atheromatous plaque (CCAP), the mandibular cortical index, and periodontal bone loss in panoramic radiographs. One hundred eighty-five panoramic radiographs with CCAP and 234 without this finding were evaluated by 3 observers for the presence of osseous changes related to osteoporosis and periodontal bone loss. Chi-squared and Mann-Whitney U tests were used to compare the two groups for an association of CCAP with the mandibular cortical index and periodontal bone loss, respectively. There was a statistically significant coincidence of CCAP and osseous changes related to osteopenia/osteoporosis, with a p-value <0.001. There was no statistically significant coincidence of CCAP and periodontal bone loss. When comparing the 2 groups, 'With CCAP' and 'Without CCAP', there was a statistically significant association with the mean body mass index (BMI), number of remaining teeth, positive history of diabetes mellitus, and vascular accidents. There was no statistically significant association with gender or a history of smoking. This study identified a possible concurrence of CCAP and mandibular cortical changes secondary to osteopenia/osteoporosis in panoramic radiographs. This could demonstrate the important role of dental professionals in screening for these systemic conditions, leading to timely and appropriate referrals resulting in early interventions and thus improving overall health.

  16. The development and potential of acoustic radiation force impulse (ARFI) imaging for carotid artery plaque characterization.

    Science.gov (United States)

    Allen, Jason D; Ham, Katherine L; Dumont, Douglas M; Sileshi, Bantayehu; Trahey, Gregg E; Dahl, Jeremy J

    2011-08-01

    Stroke is the third leading cause of death and long-term disability in the USA. Currently, surgical intervention decisions in asymptomatic patients are based upon the degree of carotid artery stenosis. While there is a clear benefit of endarterectomy for patients with severe (> 70%) stenosis, in those with high/moderate (50-69%) stenosis the evidence is less clear. Evidence suggests ischemic stroke is associated less with calcified and fibrous plaques than with those containing softer tissue, especially when accompanied by a thin fibrous cap. A reliable mechanism for the identification of individuals with atherosclerotic plaques which confer the highest risk for stroke is fundamental to the selection of patients for vascular interventions. Acoustic radiation force impulse (ARFI) imaging is a new ultrasonic-based imaging method that characterizes the mechanical properties of tissue by measuring displacement resulting from the application of acoustic radiation force. These displacements provide information about the local stiffness of tissue and can differentiate between soft and hard areas. Because arterial walls, soft tissue, atheromas, and calcifications have a wide range in their stiffness properties, they represent excellent candidates for ARFI imaging. We present information from early phantom experiments and excised human limb studies to in vivo carotid artery scans and provide evidence for the ability of ARFI to provide high-quality images which highlight mechanical differences in tissue stiffness not readily apparent in matched B-mode images. This allows ARFI to identify soft from hard plaques and differentiate characteristics associated with plaque vulnerability or stability. PMID:21447606

  17. Multi-center MRI carotid plaque component segmentation using feature normalization and transfer learning

    DEFF Research Database (Denmark)

    van Engelen, Arna; van Dijk, Anouk C; Truijman, Martine T.B.;

    2015-01-01

    Automated segmentation of plaque components in carotid artery MRI is important to enable large studies on plaque vulnerability, and for incorporating plaque composition as an imaging biomarker in clinical practice. Especially supervised classification techniques, which learn from labeled examples......, have shown good performance. However, a disadvantage of supervised methods is their reduced performance on data different from the training data, for example on images acquired with different scanners. Reducing the amount of manual annotations required for each new dataset will facilitate widespread...... with two approaches that use little or no annotated same-center data. These approaches additionally use an annotated set of differentcenter data. We evaluate 1) a non-linear feature normalization approach, and 2) two transfer-learning algorithms that use same and different-center data with different...

  18. An integrated system for the segmentation of atherosclerotic carotid plaque ultrasound video.

    Science.gov (United States)

    Loizou, Christos; Petroudi, Styliani; Pantziaris, Marios; Nicolaides, Andrew; Pattichis, Constantinos

    2014-01-01

    The robust border identification of atherosclerotic carotid plaque, the corresponding degree of stenosis of the common carotid artery (CCA), and also the characteristics of the arterial wall, including plaque size, composition, and elasticity, have significant clinical relevance for the assessment of future cardiovascular events. To facilitate the follow-up and analysis of the carotid stenosis in serial clinical investigations, we propose and evaluate an integrated system for the segmentation of atherosclerotic carotid plaque in ultrasound videos of the CCA based on video frame normalization, speckle reduction filtering, M-mode state-based identification, parametric active contours, and snake segmentation. Initially, the cardiac cycle in each video is identified and the video M-mode is generated, thus identifying systolic and diastolic states. The video is then segmented for a time period of at least one full cardiac cycle. The algorithm is initialized in the first video frame of the cardiac cycle, with human assistance if needed, and the moving atherosclerotic plaque borders are tracked and segmented in the subsequent frames. Two different initialization methods are investigated in which initial contours are estimated every 20 video frames. In the first initialization method, the initial snake contour is estimated using morphology operators; in the second initialization method, the Chan-Vese active contour model is used. The performance of the algorithm is evaluated on 43 real CCA digitized videos from B-mode longitudinal ultrasound segments and is compared with the manual segmentations of an expert, available every 20 frames in a time span of 3 to 5 s, covering, in general, 2 cardiac cycles. The segmentation results were very satisfactory, according to the expert objective evaluation, for the two different methods investigated, with true-negative fractions (TNF-specificity) of 83.7 ± 7.6% and 84.3 ± 7.5%; true-positive fractions (TPF-sensitivity) of 85.42 ± 8

  19. 3T imaging of cervical carotid plaque using a 3D T1-weighted sequence. Experience of 130 consecutive cases

    International Nuclear Information System (INIS)

    Three-dimensional (3D) T1-weighted imaging is reported to depict hemorrhagic plaque of the carotid artery with high signal intensity. Using a 3-tesla MR imaging unit, we prospectively evaluated how often 3D T1-weighted imaging can detect such plaque in 130 consecutive patients with (Group A, 80 patients) and without (Group B, 50 patients) ischemic brain disease. We evaluated the presence or absence of carotid plaque (s) in each patient, compared the signal intensity of plaque to that of the sternocleidomastoid muscle, and calculated the signal ratio of plaque to muscle (plaque/muscle). High intensity was defined as a signal ratio of 2 or greater. The degree of intravascular nullity was visually rated as good or poor and evaluated quantitatively. We investigated factors including diabetes, hypertension, and hyperlipidemia to determine whether those factors affect the presence of high-signal plaques. The degree of intravascular nullity was poor in 30.8% of all patients. High-signal plaque was observed more frequently in Group A than Group B (p=0.003). No risk factor was significantly associated with the presence of high-signal plaques. The use of 3D T1-weighted plaque imaging with a 3T unit contributes to the screening of unstable plaque that might otherwise be missed in a clinical setting. (author)

  20. Endothelial dysfunction, carotid artery plaque burden, and conventional exercise-induced myocardial ischemia as predictors of coronary artery disease prognosis

    Directory of Open Access Journals (Sweden)

    Ishihara Masayuki

    2008-12-01

    Full Text Available Abstract Background While both flow-mediated vasodilation (FMD in the brachial artery (BA, which measures endothelium-dependent vasodilatation, and intima-media thickness (IMT in the carotid artery are correlated with the prognosis of coronary artery disease (CAD, it is not clear which modality is a better predictor of CAD. Furthermore, it has not been fully determined whether either of these modalities is superior to conventional ST-segment depression on exercise stress electrocardiogram (ECG as a predictor. Thus, the goal of the present study was to compare the predictive value of FMD, IMT, and stress ECG for CAD prognosis. Methods and Results A total of 103 consecutive patients (62 ± 9 years old, 79 men with clinically suspected CAD had FMD and nitroglycerin-induced dilation (NTG-D in the BA, carotid artery IMT measurement using high-resolution ultrasound, and exercise treadmill testing. The 73 CAD patients and 30 normal coronary patients were followed for 50 ± 15 months. Fifteen patients had coronary events during this period (1 cardiac death, 2 non-fatal myocardial infarctions, 3 acute heart failures, and 9 unstable anginas. On Kaplan-Meier analysis, only FMD and stress ECG were significant predictors for cardiac events. Conclusion Brachial endothelial function as reflected by FMD and conventional exercise stress testing has comparable prognostic value, whereas carotid artery plaque burden appears to be less powerful for predicting future cardiac events.

  1. Serum Osteoprotegerin Is Associated With Calcified Carotid Plaque: A Strobe-Compliant Observational Study.

    Science.gov (United States)

    Kwon, Ami; Choi, Yun-Seok; Choi, Yong-Won; Chung, Woo-Baek; Park, Chul-Soo; Chung, Wook-Sung; Lee, Man-Young; Youn, Ho-Joong

    2016-04-01

    Osteoprotegerin (OPG) is a kind of tumor necrosis factor, which is related to bone metabolism and vascular calcification. The increase of Osteoprotegerin concentration in serum is related to cardiovascular diseases in humans. The purpose of this study was to figure out the relevance between osteoprotegerin in serum and carotid calcification.Serum OPG concentrations were compared in 145 patients who underwent carotid sonography (average age: 68 ± 9 years old, male: female = 81:64). A calcified plaque (CP) (37 people [27%]), a noncalcified plaque (NCP) (54 people [37%]), and a nonplaque (NP) (54 people [37%]) were classified for this study.No significant differences among 3 groups were demonstrated in the distribution of age, diabetes, high blood pressure, and hyperlipidemia. Serum osteoprotegerin concentrations were significantly increased in CP group rather than NCP group or NP group; (median [interquartile range], 4016 [1410] vs 3210 [1802] pg/mL, P calcification in carotid artery disease had an increased serum OPG concentration, so it could consider that OPG plays an important function on calcification related to arteriosclerosis. PMID:27082605

  2. Classification of Symptomatic and Asymptomatic Patients with and without Cognitive Decline Using Non-invasive Carotid Plaque Strain Indices as Biomarkers.

    Science.gov (United States)

    Wang, Xiao; Jackson, Daren C; Mitchell, Carol C; Varghese, Tomy; Wilbrand, Stephanie M; Rocque, Brandon G; Hermann, Bruce P; Dempsey, Robert J

    2016-04-01

    Vascular cognitive decline may be caused by micro-emboli generated by carotid plaque instability. We previously found that maximum strain indices in carotid plaque were significantly correlated with cognitive function. In the work described here, we examined these associations with a larger sample size, as well as evaluated the performance of these maximum strain indices in predicting cognitive impairment. Ultrasound-based strain imaging and cognition assessment were conducted on 75 human patients. Patients underwent one of two standardized cognitive test batteries, either the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) or the National Institute of Neurologic Disorder and Stroke-Canadian Stroke Network (NINDS-CSN) Vascular Cognitive Impairment Harmonization Standards (60 min). Scores were standardized within each battery to allow these data to be combined across all participants. Radiofrequency signals for ultrasound strain imaging were acquired on the carotid arteries using either a Siemens Antares with a VFX 13-5 linear array transducer or a Siemens S2000 with an 18 L6 linear array transducer. The same hierarchical block-matching motion tracking algorithm developed in our laboratory was used to estimate accumulated axial, lateral, and shear strain indices in carotid plaque, with inclusion of adventitia regardless of the ultrasound system and transducer used. Associations between cognitive z-scores and maximum strain indices were examined using Pearson's correlation coefficients. Maximum strain indices were also employed to predict cognitive impairment using receiver operating characteristic analysis. All correlations between maximum strain indices and total cognition were statistically significant (p segmentation of plaque. PMID:26778288

  3. Multi-Center MRI Carotid Plaque Component Segmentation Using Feature Normalization and Transfer Learning.

    Science.gov (United States)

    van Engelen, Arna; van Dijk, Anouk C; Truijman, Martine T B; Van't Klooster, Ronald; van Opbroek, Annegreet; van der Lugt, Aad; Niessen, Wiro J; Kooi, M Eline; de Bruijne, Marleen

    2015-06-01

    Automated segmentation of plaque components in carotid artery magnetic resonance imaging (MRI) is important to enable large studies on plaque vulnerability, and for incorporating plaque composition as an imaging biomarker in clinical practice. Especially supervised classification techniques, which learn from labeled examples, have shown good performance. However, a disadvantage of supervised methods is their reduced performance on data different from the training data, for example on images acquired with different scanners. Reducing the amount of manual annotations required for each new dataset will facilitate widespread implementation of supervised methods. In this paper we segment carotid plaque components of clinical interest (fibrous tissue, lipid tissue, calcification and intraplaque hemorrhage) in a multi-center MRI study. We perform voxelwise tissue classification by traditional same-center training, and compare results with two approaches that use little or no annotated same-center data. These approaches additionally use an annotated set of different-center data. We evaluate 1) a nonlinear feature normalization approach, and 2) two transfer-learning algorithms that use same and different-center data with different weights. Results showed that the best results were obtained for a combination of feature normalization and transfer learning. While for the other approaches significant differences in voxelwise or mean volume errors were found compared with the reference same-center training, the proposed approach did not yield significant differences from that reference. We conclude that both extensive feature normalization and transfer learning can be valuable for the development of supervised methods that perform well on different types of datasets. PMID:25532205

  4. Wall shear stress as a stimulus for carotid atherosclerotic plaque progression: An MRI-based CFD pilot study

    Science.gov (United States)

    Canton, Gador; Chiu, Bernard; Hatsukami, Tom; Kerwin, William; Yuan, Chun

    2010-11-01

    The aim of this study was to explore the hypothesis that intra-plaque hemorrhage, a feature associated with adverse outcomes and atherosclerotic plaque progression and destabilization, is more likely to occur in plaques with elevated levels of wall shear stress (WSS). We used multi-sequence in-vivo magnetic resonance imaging (MRI) to characterize ten human carotid atherosclerotic plaques and an MRI-based computational fluid dynamics (CFD) model to solve the equations governing the blood flow. Hemorrhage was detected within the necrotic core (intra-plaque hemorrhage) in five of these ten cases. WSS data were extracted from the results of the CFD simulations to compare patterns between the cases with and without hemorrhage. We computed the mean value of the WSS (for each time point of the cardiac cycle) at the region where a necrotic core was detected. The results from this pilot study indicate a possible link between the presence of hemorrhage within a lipid-rich necrotic core in human carotid atherosclerotic plaques and elevated levels of shear stress force acting on the luminal surface. Thus, elevated wall shear stress may be used as a high risk feature in advanced carotid atherosclerotic plaques.

  5. Carotid ultrasound symptomatology using atherosclerotic plaque characterization: a class of Atheromatic systems.

    Science.gov (United States)

    Acharya, U Rajendra; S, Vinitha Sree; Molinari, Filippo; Saba, Luca; Nicolaides, Andrew; Shafique, Shoaib; Suri, Jasjit S

    2012-01-01

    In this paper, we present a Computer Aided Diagnosis (CAD) based technique (Atheromatic system) for classification of carotid plaques in B-mode ultrasound images into symptomatic or asymptomatic classes. This system, called Atheromatic, has two steps: (i) feature extraction using a combination of Discrete Wavelet Transform (DWT) and averaging algorithms and (ii) classification using Support Vector Machine (SVM) classifier for automated decision making. The CAD system was built and tested using a database consisting of 150 asymptomatic and 196 symptomatic plaque regions of interests which were manually segmented. The ground truth of each plaque was determined based on the presence or absence of symptoms. Three-fold cross-validation protocol was adapted for developing and testing the classifiers. The SVM classifier with a polynomial kernel of order 2 recorded the highest classification accuracy of 83.7%. In the clinical scenario, such a technique, after much more validation, can be used as an adjunct tool to aid physicians by giving a second opinion on the nature of the plaque (symptomatic/asymptomatic) which would help in the more confident determination of the subsequent treatment regime for the patient. PMID:23366606

  6. Endothelial dysfunction is associated with carotid plaque: a cross-sectional study from the population based Northern Manhattan Study

    Directory of Open Access Journals (Sweden)

    Boden-Albala Bernadette

    2006-08-01

    Full Text Available Abstract Background Impaired vascular function occurs early in atherogenesis. Brachial flow mediated dilatation (FMD is a non-invasive measure of vascular function and may be an important marker of preclinical atherosclerosis. Data on the association between FMD and carotid plaque in multi-ethnic populations are limited. The objective of this study was to determine whether endothelial dysfunction is independently associated with carotid plaque in a community of northern Manhattan. Methods In the population-based Northern Manhattan Study (NOMAS, high-resolution B-mode ultrasound images of the brachial and carotid arteries were obtained in 643 stroke-free subjects (mean age 66 years; 55% women; 65% Caribbean-Hispanic, 17% African-American, 16% Caucasian. Brachial FMD was measured during reactive hyperemia. Maximum carotid plaque thickness (MCPT was measured at the peak plaque prominence. Results The mean brachial FMD was 5.78 ± 3.83 %. Carotid plaque was present in 339 (53% subjects. The mean MCPT was 1.68 ± 0.82 mm, and the 75th percentile was 2.0 mm. Reduced FMD was significantly associated with increased MCPT. After adjusting for demographics, vascular risk factors, and education, each percent of FMD decrease was associated with a significant 0.02 mm increase in MCPT (p = 0.028. In a dichotomous adjusted model, blunted FMD was associated with an increased risk of MCPT ≥ 2.0 mm (OR, 1.11 for every 1% decrease in FMD; 95% CI, 1.03–1.19. Conclusion Decreased brachial FMD is independently associated with carotid plaque. Non-invasive evaluation of endothelial dysfunction may be a useful marker of preclinical atherosclerosis and help to individualize cardiovascular risk assessment beyond traditional risk factors.

  7. Prevalence of Foam Cells and Helper-T cells in Atherosclerotic Plaques of Korean Patients with Carotid Atheroma

    OpenAIRE

    Lee, Won-Ha; Ko, Young-Hyeh; Kim, Dong-Ik; Lee, Byung-Boong; Park, Jeong-Euy

    2000-01-01

    Background Inflammation and activation of immune cells have important roles in the pathogenesis of atherosclerosis. We analyzed the involvement of various immune cells in the pathogenesis of atherosclerosis. Methods We investigated the presence of foam cells, lymphocytes and killer cells in 11 atherosclerotic plaque specimens removed from Korean patients who underwent carotid endoarterectomy. Atherosclerotic plaques were analyzed by immunohistochemistry using monoclonal antibody specific to f...

  8. Ultrasound and Biochemical Diagnostic Tools for the Characterization of Vulnerable Carotid Atherosclerotic Plaque.

    Science.gov (United States)

    Lechareas, Simeon; Yanni, Amalia E; Golemati, Spyretta; Chatziioannou, Achilles; Perrea, Despoina

    2016-01-01

    Stroke is a leading cause of morbidity and mortality worldwide, and characterization of vulnerable carotid plaque remains the spearhead of scientific research. Plaque destabilization, the key factor that induces the series of events leading to the clinical symptoms of carotid artery disease, is a consequence of complex mechanical, structural and biochemical processes. Novel imaging and molecular markers have been studied as predictors of disease outcome with promising results. The aim of this review is to present the current state of research on the association between ultrasound-derived echogenicity indices and blood parameters indicative of carotid plaque stability and activity. Bibliographic research revealed that there are limited available data. Among the biomarkers studied, those related to oxidative stress, lipoproteins and diabetes/insulin resistance are associated with echolucent plaques, whereas adipokines are associated with echogenic plaques. Biomarkers of inflammation and coagulation have not exhibited any conclusive relationship with plaque echogenicity, and it is not possible to come to any conclusion regarding calcification-, apoptosis- and neo-angiogenesis-related parameters because of the extremely limited bibliographic data. PMID:26493239

  9. Automatic plaque characterization and vessel wall segmentation in magnetic resonance images of atherosclerotic carotid arteries

    Science.gov (United States)

    Adame, Isabel M.; van der Geest, Rob J.; Wasserman, Bruce A.; Mohamed, Mona; Reiber, Johan H. C.; Lelieveldt, Boudewijn P. F.

    2004-05-01

    Composition and structure of atherosclerotic plaque is a primary focus of cardiovascular research. In vivo MRI provides a meanse to non-invasively image and assess the morphological features of athersclerotic and normal human carotid arteries. To quantitatively assess the vulnerability and the type of plaque, the contours of the lumen, outer boundary of the vessel wall and plaque components, need to be traced. To achieve this goal, we have developed an automated contou detection technique, which consists of three consecutive steps: firstly, the outer boundary of the vessel wall is detected by means of an ellipse-fitting procedure in order to obtain smoothed shapes; secondly, the lumen is segnented using fuzzy clustering. Thre region to be classified is that within the outer vessel wall boundary obtained from the previous step; finally, for plaque detection we follow the same approach as for lumen segmentation: fuzzy clustering. However, plaque is more difficult to segment, as the pixel gray value can differ considerably from one region to another, even when it corresponds to the same type of tissue. That makes further processing necessary. All these three steps might be carried out combining information from different sequences (PD-, T2-, T1-weighted images, pre- and post-contrast), to improve the contour detection. The algorithm has been validated in vivo on 58 high-resolution PD and T1 weighted MR images (19 patients). The results demonstrate excellent correspondence between automatic and manual area measurements: lumen (r=0.94), outer (r=0.92), and acceptable for fibrous cap thickness (r=0.76).

  10. Characteristics of carotid atherosclerotic plaques of chronic lipid apheresis patients as assessed by In Vivo High-Resolution CMR - a comparative analysis

    Directory of Open Access Journals (Sweden)

    Grimm Jochen M

    2012-11-01

    Full Text Available Abstract Background Components of carotid atherosclerotic plaques can reliably be identified and quantified using high resolution in vivo 3-Tesla CMR. It is suspected that lipid apheresis therapy in addition to lowering serum lipid levels also has an influence on development and progression of atherosclerotic plaques. The purpose of this study was to evaluate the influence of chronic lipid apheresis (LA on the composition of atherosclerotic carotid plaques. Methods 32 arteries of 16 patients during chronic LA-therapy with carotid plaques and stenosis of 1–80% were matched according to degree of stenosis with 32 patients, who had recently suffered an ischemic stroke. Of these patients only the asymptomatic carotid artery was analyzed. All patients underwent black-blood 3 T CMR of the carotids using parallel imaging and dedicated surface coils. Cardiovascular risk factors were recorded. Morphology and composition of carotid plaques were evaluated. For statistical evaluation Fisher’s Exact and unpaired t-test were used. A p-value Results Patients in the LA-group were younger (63.5 vs. 73.9. years, p2, p Conclusion Results of this study suggest that, despite a severer risk profile for cardiovascular complications in LA-patients, chronic LA is associated with significantly lower lipid content in carotid plaques compared to plaques of patients without LA with similar degrees of stenosis, which is characteristic of clinically stable plaques.

  11. Correlation Analysis of Carotid Artery Plaque in Shanghai Community Elderly Patients with Serum Homocysteine, Hyperlipidemia%上海社区老年患者颈动脉斑块与血清同型半胱氨酸、高脂血症的相关分析

    Institute of Scientific and Technical Information of China (English)

    滕斌; 王泰蓉; 阮秀兰; 杨涛

    2015-01-01

    目的:通过分析中心城区老年患者颈动脉斑块与血清同型半胱氨酸、高脂血症的关系,为防治心脑血管疾病提供参考。方法:选择2014年1月至2014年6月在五里桥街道社区卫生服务中心就诊的社区老年患者共226例,进行血清HCY、血脂和颈动脉超声检测,比较颈动脉斑块与血清HCY、血脂关系。结果:大于70岁组老年患者颈动脉斑块检出率显著增高;不同年龄层次男性高HCY检出率大于女性(P<0.05);年龄大于等于60岁的颈动脉斑块患者中,男性高HCY检出率大于女性(P<0.05);男性患者颈动脉斑块检出与高血脂无统计学意义;高HCY患者及高HCY+高TG患者颈动脉斑块检出率高,有统计学意义(P<0.05)。结论:老年患者中应关注颈动脉斑块发生以及血清HCY、血脂水平,应对多种危险因素进行控制,及早给予干预治疗。%Objective: By analyzing urban elderly patients with carotid plaques and serum homocysteine,hyperlipidemia,provide reference for prevention and treatment of cardiovascular and cerebrovascular diseases.Methods:Choose between January 2014 and June 2014 in Wuliqiao street community health service center elderly patients,serum HCY and lipid and carotid ultrasound examination, a total of 226 cases,By gender,age,layered,Compare different gender and age level relationship between carotid plaques and serum HCY and lipid.Results:More than 70 years groups of elderly patients with carotid artery plaque detection rate increased significantly. Different age levels of male high HCY detection rate is more than women(P<0.05). Age greater than equal to 60 in patients with carotid plaques,Male high HCY detection rate is more than women(P<0.05).Male patients with carotid plaques detection with high cholesterol has no statistical significance; Patients with high HCY and high HCY + high TG in patients with carotid artery plaque detection rate is high,There are

  12. Correlation between carotid atherosclerosis and serum high-sensitivity C-reactive protein in patients with cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Yan Du; Yan Ren; Bo Chen; Chun Li

    2007-01-01

    artery atherosclerostic plaques. If artery atherosclerostic plaques were formed, their properties and amounts were determined based on the characteristics of light-echo signals. Evaluating criteria: Intima media thickness of artery was the vertical dimension from crossed face between lumen and tunica intima to crossed face between tunica media and tunica adventitia. Intima media thickness ≤ 0.9 mm was regarded as normal; 0.9 mm < intima media thickness ≤ 1.2 mm was regarded as thickening; when local eminence thickening was processed towards to lumen, the intima media thickness was more than 1.2 mm and plaque of tunica intima was formed at the same time. Properties of plaque were classified into 4 types: steady low-echo lipid malacoplakia, equal-echo fiber plaque, strong-echo or sound imaging calcification hard plaque and unsteady-echo ulcer mixed plaque. Fiber plaque and calcification hard plaque were steady but malacoplakia and mixed plaque were unsteady.MAIN OUTCOME MEASURES: Thickness of tunica media, characteristics of plaque and level of serum high-sensitivity C-reactive protein in carotid artery in two groups.RESULTS: All 102 patients with cerebral infarction and 96 healthy subjects were involved in the final analysis. ① Comparisons of level of high-sensitivity C-reactive protein: Level of high-sensitivity C-reactive protein in normal tunica media was higher in the cerebral infarction group [(4.66±1.55) mg/L]than the control group [(3.49±1.24) mg/L, t =2.541, P <0.05]. In addition, level of high-sensitivity C-reactive protein in patients with thickening tunica media and plaque was not significantly different between the cerebral infarction group and the control group (P > 0.05). ② Correlation between various degrees of vascular lesion and level of high-sensitivity C-reactive protein in the cerebral infarction group:Level of high-sensitivity C-reactive protein was statistically significantly higher in patients with thickening tunica media [(8.16±2

  13. The effect of simvastatin on inflammation level and carotid artery plaque in patients with diabetes and hyperlipidaemia

    International Nuclear Information System (INIS)

    Objective: To investigate the effect of simvastatin on inflammation level and carotid artery plaque in those patients with diabetes and hyperlipidaemia. Methods: A total of 120 patients with type 2 diabetes, accompanying with hyperlipidaemia were orally administered with 20 mg simvastatin each night for 12 weeks to control blood glucose. The changes of their blood lipid, hs-CRP, TNF-α and carotid artery plaque were observed. Results: After simvastatin administration,the serum total cholesterol (TC), triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) decreased significantly compared to that before treatment (P0.05). The level of high sensitivity C-reactive protein(hs-CRP), tumor necrosis factor-α (TNF-α) descended markedly in patients after treatment versus before treatment (P<0.05 or P<0.01). The carotid artery plaque area, thickness and amounts all improved significantly after treatment (P<0.05 or P<0.01). Conclusion: Simvastatin can reduce the level of serum TC, TG and LDL-C in those patients with diabetes and hyperlipidaemia uniquely, but also diminish the inflammation level by regulating the levels of hs-CRP, TNF-α, thus reversing the occurrence, development of carotid artery plaque, lowering the long-term cerebrocardiovascular complications, and improving patients' prognosis. (authors)

  14. Enhancement patterns in the fibro cellular tissue in different kinds of plaques of the internal carotid artery

    International Nuclear Information System (INIS)

    Background: The differentiation between stable and vulnerable plaques in the internal carotid artery (ICA) remains a matter of interest. With the implementation of contrast agent in magnetic resonance imaging (MRI) a more detailed plaque characterization is possible. The study at hand focuses on enhancement patterns of fibro cellular tissue in different kinds of plaques in the ICA. Methods: Between May 2011 and December 2012, 49 patients (39 male) with >50% stenosis of the ICA were consecutively enrolled. In 10 patients with bilateral ICA stenosis, both plaques were included for analysis. We performed a classification of plaques according to Cai and observed 11 type 4–5 plaques, 15 type 6 plaques and 33 type 8 plaques. MRI was performed on a 3 T whole body MR system. The standard 12 channel head coil was combined with the neck extension coil and two bilateral 7 cm loop coils. Post-contrast T1w images were subtracted from pre contrast images to identify late enhancement in fibro cellular tissue. Enhancement patterns were allocated as intraluminal, intraplaque and vasa vasorum enhancement in different types of plaques. Results: Fibro cellular tissue always exhibited a higher contrast enhancement compared to the sternocleidomastoid muscle. This reflects a higher grade of vascularization of the fibrocellular tissue. Contrast enhancement was present irrespective of the plaque type. In detail, intraluminal, intraplaque and vasa vasorum enhancement were observed in all types of plaques. Even type 8 plaques, according to the classification of Cai, had a significant contrast enhancement, though supposed to be with low inflammatory activity. Conclusion: Type 8 plaques might not be as stable as postulated. Whether the relevant uptake of contrast agent is due to the fibrous tissue or reflects the inflammatory activity of the plaque should be matter of further investigations

  15. Proteomic Profile of Unstable Atheroma Plaque: Increased Neutrophil Defensin 1, Clusterin, and Apolipoprotein E Levels in Carotid Secretome.

    Science.gov (United States)

    Aragonès, Gemma; Auguet, Teresa; Guiu-Jurado, Esther; Berlanga, Alba; Curriu, Marta; Martinez, Salomé; Alibalic, Ajla; Aguilar, Carmen; Hernández, Esteban; Camara, María-Luisa; Canela, Núria; Herrero, Pol; Ruyra, Xavier; Martín-Paredero, Vicente; Richart, Cristóbal

    2016-03-01

    Because of the clinical significance of carotid atherosclerosis, the search for novel biomarkers has become a priority. The aim of the present study was to compare the protein secretion profile of the carotid atherosclerotic plaque (CAP, n = 12) and nonatherosclerotic mammary artery (MA, n = 10) secretomes. We used a nontargeted proteomic approach that incorporated tandem immunoaffinity depletion, iTRAQ labeling, and nanoflow liquid chromatography coupled to high-resolution mass spectrometry. In total, 162 proteins were quantified, of which 25 showed statistically significant differences in secretome levels between carotid atherosclerotic plaque and nondiseased mammary artery. We found increased levels of neutrophil defensin 1, apolipoprotein E, clusterin, and zinc-alpha-2-glycoprotein in CAP secretomes. Results were validated by ELISA assays. Also, differentially secreted proteins are involved in pathways such as focal adhesion and leukocyte transendothelial migration. In conclusion, this study provides a subset of identified proteins that are differently expressed in secretomes of clinical significance. PMID:26795031

  16. Identification of two genes potentially associated in iron-heme homeostasis in human carotid plaque using microarray analysis

    Indian Academy of Sciences (India)

    Hanène Ayari; Giampiero Bricca

    2013-06-01

    Classic characteristics are poor predictors of the risk of thromboembolism. Thus, better markers for the carotid atheroma plaque formation and symptom causing are needed. Our objective was to study by microarray analysis gene expression of genes involved in homeostasis of iron and heme in carotid atheroma plaque from the same patient. mRNA gene expression was measured by an Affymetrix GeneChip Human Gene 1.0 ST arrays (Affymetrix, Santa Clara, CA, USA) using RNA prepared from 68 specimens of endarteriectomy from 34 patients. Two genes involved in iron-heme homeostasis, CD163 and heme oxygenase (HO-1), were analysed in 34 plaques. CD163 (2.18, =1.45E−08) and HO-1 (fold-change 2.67, =2.07E−09) mRNAs were induced. We suggest that atheroma plaques show a more pronounced induction of CD163 and HO-1. Although further evidence is needed, our results support previous data. To our knowledge, this is the first report comparing gene expression between intact arterial tissue and carotid plaque using microarray analysis.

  17. The effect of interleukin and matrix metalloproteinase on the vulnerability of carotid atherosclerotic plaque and cerebral infarction

    Directory of Open Access Journals (Sweden)

    HUANG Yan

    2012-06-01

    Full Text Available Objective To investigate the relationship of IL-17, IL-10 and MMP-12 with the vulnerability of carotid atherosclerotic plaque and cerebral infarction. Methods According to clinical stroke event 70 carotid atherosclersis patients were divided into asymptomatic carotid atherosclerosis (ACAS group (n = 35 and acute atherosclerotic cerebral infarction (AACI group (n = 35. The patients were also divided into vulnerable plague (VP group (n = 38 and unvulnerable plague (UVP group (n = 32 by color ultrasonic technique. Normal control group (n = 35 was established. The plasma levels of cytokines were tested by enzyme-linked immunosorbent assay (ELISA. Results Compared with the control group, the concentrations of IL-17, IL-10 and MMP-12 in ACAS group and AACI group were significantly elevated (P = 0.000; P = 0.000, moreover, the concentrations of IL-17 and MMP-12 in AACI group were higher than those in ACAS group (P = 0.000; P = 0.002, respectively. In AACI group, the level of IL-10 was lower than the ACAS group and control group (P = 0.000, for all, whereas, no significant difference of IL-10 level was seen between ACAS group and control group (P = 0.275. In VP group, the concentrations of IL-17 and MMP-12 were higher than those in UVP group (P = 0.000 and 0.014, respectively. In VP group, the level of IL-10 was lower than that in UVP group and control group (P = 0.000, for all, but no significant difference of IL-10 level was seen between UVP group and control group (P = 0.742. Correlation analysis showed, the level of IL-17 was positively correlated with the level of MMP-12 (r = 0.640, P = 0.000, and was negatively correlated with the level of IL-10 (r =-0.430, P = 0.000. The level of MMP-12 was weakly negatively correlated with the level of IL-10 (r =-0.242, P = 0.013. Conclusion IL-17, IL-10 and MMP-12 all participate the pathological process of atherosclerosis and cerebral infarction. The elevated IL-17 and MMP-12 levels and decreased IL-10 level

  18. Correlation of arterial stiffness index with carotid atherosclerosis in patients with primary hypertension

    Institute of Scientific and Technical Information of China (English)

    Wen-Hua Cai; Li-Min Li; Xue-Min Wang; Cui-Qing Sun; Hai-Wei Zhao; Hui Wang; Rui-Chao Liu

    2016-01-01

    Objective:To explore the correlation of arterial stiffness index with carotid atherosclerosis in patients with primary hypertension.Methods:A total of 86 patients with primary hypertension who were admitted in our hospital from January, 2013 to September, 2015 were included in the study, and divided into the carotid atherosclerosis group (IMT≥0.9 mm, with plaque being detected) and the pure hypertension group (normal IMT) according to the carotid artery color Doppler ultrasound results. According to the ambulatory blood pressure monitoring results, the carotid atherosclerosis group was divided into the low BPV (7.02-9.57) group and the high BPV (>9.57-14.29) group. The non-invasive ambulatory blood pressure monitoring apparatus was used for 24 h blood pressure monitoring, measuring time in the daytime: 6:00-21:59, measuring one time every 30 min; measuring time in the nighttime: 22:00-5:59, measuring one time every 60 min. The dSBP, dDBP, nSBP, nDBP, 24 h SBP, and 24 h DBP were recorded. BPV was expressed as 24 h SCV and 24 h DCV.Results:The dSBP, nSBP, 24 h SBP, 24 h DBP, and 24 h SCV in the carotid atherosclerosis group were significantly higher than those in the pure hypertension group, while the comparison of dDBP, nDBP, and 24 h DCV between the two groups was not statistically significant. The common carotid artery and external carotid artery IMT, and the mean IMT in the high BPV group were significantly higher than those in the low BPV group, and the number of carotid plaques being detected was significantly greater than that in the low BPV group.Conclusions:BPV is involved in the arterial functional and structural changes, resulting in the target organ damage. Detection of carotid IMT is of great significance in evaluating the early vascular damage and predicting the cardiovascular events; therefore, BPV monitoring should be strengthened during the diagnosis and treatment of hypertension.

  19. Advantage in Bright-blood and Black-blood Magnetic Resonance Imaging with High-resolution for Analysis of Carotid Atherosclerotic Plaques

    Directory of Open Access Journals (Sweden)

    Mei Li

    2015-01-01

    Full Text Available Background: About 50% of the cerebral ischemia events are induced by intracranial and extracranial atherosclerosis. This study aimed to evaluate the feasibility and accuracy for displaying atherosclerotic plaques in carotid arteries and analyzing their ingredients by using high-resolution new magnetic resonance imaging (MRI techniques. Methods: Totally, 49 patients suspected of extracranial carotid artery stenosis were subjected to cranial MRI scan and magnetic resonance angiography (MRA examination on carotid arteries, and high-resolution bright-blood and black-blood MRI analysis was carried out within 1 week. Digital subtraction angiography (DSA examination was carried out for 16 patients within 1 month. Results: Totally, 103 plaques were detected in the 49 patients, which were characterized by localized or diffusive thickening of the vessel wall, with the intrusion of crescent-shaped abnormal signal into lumens. Fibrous cap was displayed as isointensity in T1-weighted image (T1WI and hyperintensities in proton density weighted image (PDWI and T2-weighted image (T2WI, lipid core was displayed as isointensity or slight hyperintensities in T1WI, isointensity, hyperintensities or hypointensity in PDWI, and hypointensity in T2WI. Calcification in plaques was detected in 11 patients. Eight patients were detected with irregular plaque surface or ulcerative plaques, which were characterized by irregular intravascular space surface in the black-blood sequences, black hypointensity band was not detected in three-dimensional time-of-flight, or the hypointensity band was not continuous, and intrusion of hyperintensities into plaques can be detected. Bright-blood and black-blood techniques were highly correlated with the diagnosis of contrast-enhanced MRA in angiostenosis degree, Rs = 0.97, P < 0.001. In comparison to DSA, the sensitivity, specificity, and accuracy of MRI diagnosis of stenosis for ≥50% were 88.9%, 100%, and 97.9%, respectively

  20. Effective computer-aided diagnosis analysis for the plaque measurement on the ultrasound image of the carotid artery

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Hyun Joo; Kim, Myoung Hee [Ewha Womans University, Seoul (Korea, Republic of); Choe, Yeon Hyeon [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2004-06-15

    To evaluate the accuracy and utility of using Computer Vision techniques such as image filtering and image segmentation instead of using manual method for measuring plaque of the carotid artery on ultrasound examination. The image filtering called Speckle Reducing Anisotropic Diffusion (SRAD) was used for ultrasound images of three patients with plaques on their carotid arteries. After filtering, segmentation was executed using the expanding plaque region, which based on the computer operator inputting the seed point. Finally, the post-processing was performed to complement the measured result. These experiments were processed using the Visual C++ program on a personal computer (Pentium 2.4, 512 ram, NVIDIA GeForce4MX440). The numbers of SRAD processing, the threshold values for the expanding plaque region, and the numbers of interaction for segmentation were examined. The computer-aided diagnosis measures real shape of the plaque more correctly than the manual method. In this research, SRAD was repeatedly done over 100 times for efficient image filtering, and the appropriate results came out in the case of 0.25 or 0.3 being inputted as the initial value, on the average, although the initial values were different according to the images. The threshold value for region segmentation was 70. Although the area of extracted plaque was different according to the character of the image, the appropriate results were derived when the user did 4 interactions. This research has shown that the more objective and accurate measurement of plaque was possible using image filtering and segmentation on a computer than by the manual method by clinicians. The current plaque measuring method allows the clinician to get the slick shape of ellipsoid but this new method enables the physical to characterize the plaque according to shape. Therefore it could be efficiently used in the test and diagnosis.

  1. Effective computer-aided diagnosis analysis for the plaque measurement on the ultrasound image of the carotid artery

    International Nuclear Information System (INIS)

    To evaluate the accuracy and utility of using Computer Vision techniques such as image filtering and image segmentation instead of using manual method for measuring plaque of the carotid artery on ultrasound examination. The image filtering called Speckle Reducing Anisotropic Diffusion (SRAD) was used for ultrasound images of three patients with plaques on their carotid arteries. After filtering, segmentation was executed using the expanding plaque region, which based on the computer operator inputting the seed point. Finally, the post-processing was performed to complement the measured result. These experiments were processed using the Visual C++ program on a personal computer (Pentium 2.4, 512 ram, NVIDIA GeForce4MX440). The numbers of SRAD processing, the threshold values for the expanding plaque region, and the numbers of interaction for segmentation were examined. The computer-aided diagnosis measures real shape of the plaque more correctly than the manual method. In this research, SRAD was repeatedly done over 100 times for efficient image filtering, and the appropriate results came out in the case of 0.25 or 0.3 being inputted as the initial value, on the average, although the initial values were different according to the images. The threshold value for region segmentation was 70. Although the area of extracted plaque was different according to the character of the image, the appropriate results were derived when the user did 4 interactions. This research has shown that the more objective and accurate measurement of plaque was possible using image filtering and segmentation on a computer than by the manual method by clinicians. The current plaque measuring method allows the clinician to get the slick shape of ellipsoid but this new method enables the physical to characterize the plaque according to shape. Therefore it could be efficiently used in the test and diagnosis.

  2. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors

    OpenAIRE

    Rozie, S.; de Weert, T. T.; de Monyé, C.; Homburg, P. J.; Tanghe, H L J; Dippel, D W J; van der Lugt, A.

    2009-01-01

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk factors. One hundred patients with cerebrovascular symptoms underwent CT angiography. We measured plaque volume (PV) and the relative contribution of plaque components (calcifications, fibrous tissue, and lipid) in the symptomatic a...

  3. Meshless Generalized Finite Difference Method and Human Carotid Atherosclerotic Plaque Progression Simulation Using Multi-Year MRI Patient-Tracking Data

    OpenAIRE

    Yang, Chun; Tang, Dalin; Yuan, Chun; Kerwin, William; Liu, Fei; Canton, Gador; Hatsukami, Thomas S.; Atluri, Satya

    2008-01-01

    Atherosclerotic plaque rupture and progression have been the focus of intensive investigations in recent years. Plaque rupture is closely related to most severe cardiovascular syndromes such as heart attack and stroke. A computational procedure based on meshless generalized finite difference (MGFD) method and serial magnetic resonance imaging (MRI) data was introduced to quantify patient-specific carotid atherosclerotic plaque growth functions and simulate plaque progression. Participating pa...

  4. Stresses in Carotid Plaques using MRI-based Fluid Structure Interaction Models

    DEFF Research Database (Denmark)

    Samuel, Samuel Alberg; Fründ, Torben; Kim, Won Yong;

    2006-01-01

    ’s modulus set to 1/100 of that of the equivalent Young’s modulus of the vessel wall (E=1e5, ν=0.45, ρ=900). To facilitate convergence, the fluid was simulated using artificial high viscosity and low velocity which were gradually changed to the correct values. An initial simulation employing the stationary......Stresses in Carotid Plaques using MRI-based Fluid Structure Interaction models Samuel A. Kock1, Ernst-Torben Fründ2, Won Y. Kim1,3 and Jens V. Nygaard4 1MR-Center, Aarhus University Hospital, Denmark, 2Dept. of Biomechanical Engineering, Aarhus University Hospital, Denmark, 3Dept. of Cardiology...... occur when static stresses exceed 300 kPa. The ability to estimate stress magnitudes in the fibrous cap is thus expected to improve risk assessment. Methods A patient with severe atherosclerosis was scanned using magnetic resonance imaging (MRI). The plaque was segmented into lipid core, fibrous cap...

  5. In vivo and in vitro evidence that {sup 99m}Tc-HYNIC-interleukin-2 is able to detect T lymphocytes in vulnerable atherosclerotic plaques of the carotid artery

    Energy Technology Data Exchange (ETDEWEB)

    Glaudemans, Andor W.J.M.; Vries, Erik F.J. de; Koole, Michel; Luurtsema, Gert; Slart, Riemer H.J.A. [University Medical Center Groningen (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging; Bonanno, Elena [Univ. of Rome Tor Vergata (Italy). Dept. of Anatomic Pathology; Galli, Filippo [Sapienza Univ, Rome (Italy). Nuclear Medicine Unit; Zeebregts, Clark J. [University Medical Center Groningen (Netherlands). Surgery (Div. Vascular Surgery); Boersma, Hendrikus H. [University Medical Center Groningen (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging; University Medical Center Groningen (Netherlands). Clinical and Hospital Pharmacy; Taurino, Maurizio [Sapienza Univ., Rome (Italy). Vascular Surgery Unit; Signore, Alberto [University Medical Center Groningen (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging; Sapienza Univ, Rome (Italy). Nuclear Medicine Unit

    2014-09-15

    Recent advances in basic science have established that inflammation plays a pivotal role in the pathogenesis of atherosclerosis. Inflammatory cells are thought to be responsible for the transformation of a stable plaque into a vulnerable one. Lymphocytes constitute at least 20 % of infiltrating cells in these vulnerable plaques. Therefore, the interleukin-2 (IL-2) receptor, being overexpressed on activated T lymphocytes, may represent an attractive biomarker for plaque vulnerability. The aim of this study was to evaluate the specificity of radiolabelled IL-2 [{sup 99m}Tc-hydrazinonicotinamide (HYNIC)-IL-2] for imaging the lymphocytic infiltration in carotid plaques in vivo by planar and single photon emission computed tomography (SPECT)/CT imaging and ex vivo by microSPECT and autoradiography. For the in vivo study, ten symptomatic patients with advanced plaques at ultrasound who were scheduled for carotid endarterectomy underwent {sup 99m}Tc-HYNIC-IL-2 scintigraphy. The images were analysed visually on planar and SPECT images and semi-quantitatively on SPECT images by calculating target to background (T/B) ratios. After endarterectomy, immunomorphological evaluation and immunophenotyping were performed on plaque slices. For the ex vivo studies, four additional patients were included and, after in vitro incubation of removed plaques with {sup 99m}Tc-HYNIC-IL-2, autoradiography was performed and microSPECT images were acquired. Visual analysis defined clear {sup 99m}Tc-HYNIC-IL-2 uptake in seven of the ten symptomatic plaques. SPECT/CT allowed visualization in eight of ten. A significant correlation was found between the number of CD25+ lymphocytes and the total number of CD25+ cells in the plaque and the T/B ratio with adjacent carotid artery as background (Pearson's r = 0.89, p = 0.003 and r = 0.87, p = 0.005, respectively). MicroSPECT imaging showed clear {sup 99m}Tc-HYNIC-IL-2 uptake within the plaque wall and not in the lipidic core. With autoradiography

  6. Surface expression of CXCR4 on circulating CD133+ progenitor cells is associated with plaque instability in subjects with carotid artery stenosis

    Directory of Open Access Journals (Sweden)

    Sadikovic Suwad

    2009-12-01

    Full Text Available Abstract Background Circulating progenitor cells (PCs are considered to contribute to the remodeling of atherosclerotic plaques. Their surface receptor CXCR4 plays an important role in the recruitment of PCs to their target. This study compares the mobilization of PCs and their functional characteristics in asymptomatic subjects with stable and with unstable carotid plaques. This could provide insight into plaque remodeling and help to develop biomarkers for plaque stability. Methods In 31 subjects with asymptomatic carotid artery stenosis we analyzed the number of CD133+ PCs, VEGFR2+CD34+ PCs and the surface expression of CXCR4 on CD133+ PCs by flow cytometry. Subjects underwent bilateral carotid MRI in a 1.5-T scanner in order to allow the categorization of plaques, following the modified criteria of the American Heart Association. Results The number of CD133+ PCs and VEGFR2+CD34+ PCs showed no significant difference between subjects with stable and unstable carotid plaques. The expression of CXCR4 on CD133+ PCs was higher in subjects with unstable plaques than in subjects with stable plaques (p = 0.009. Conclusions This study demonstrates an association between functional characteristics of circulating CD133+ PCs and plaque stability in subjects with asymptomatic carotid artery stenosis. The higher expression of CXCR4 on CD133+ PCs suggests a difference in the recruitment of PCs to the injured tissue in subjects with unstable plaques and subjects with stable plaques. As surface expression of CXCR4 on CD133+ PCs differs in subjects with unstable and with stable plaques, CXCR4 is a promising candidate for a serological biomarker for plaque stability.

  7. A Case of In-Stent Neoatherosclerosis 10 Years after Carotid Artery Stent Implantation: Observation with Optical Coherence Tomography and Plaque Histological Findings

    OpenAIRE

    Matsumoto, Hiroyuki; YAKO, Rie; Masuo, Osamu; HIRAYAMA, Katsuhisa; Uematsu, Yuji; Nakao, Naoyuki

    2013-01-01

    We report a patient's case of slow progressive in-stent restenosis 10 years after bare-metal stent implantation to his carotid artery. We treated the patient with an additional stent placement under a distal filter protection device. Optical coherence tomographic assessment and plaque histology during the carotid artery stenting (CAS) revealed atheromatous change at in-stent neointima, which contained lipid-rich plaque and calcification deposits. These findings suggest that in-stent neoathero...

  8. Cadmium exposure and atherosclerotic carotid plaques –Results from the Malmö diet and Cancer study

    Energy Technology Data Exchange (ETDEWEB)

    Fagerberg, Björn, E-mail: bjorn.fagerberg@wlab.gu.se [Department of Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, University of Gothenburg, Sahlgrenska University Hospital, SE-413 45 Gothenburg (Sweden); Barregard, Lars, E-mail: lars.barregard@amm.gu.se [Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, SE 413 45 Gothenburg (Sweden); Sallsten, Gerd, E-mail: gerd.sallsten@amm.gu.se [Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, SE 413 45 Gothenburg (Sweden); Forsgard, Niklas, E-mail: niklas.forsgard@vgregion.se [Department of Clinical Chemistry, Sahlgrenska University Hospital, SE-413 45 Gothenburg (Sweden); Östling, Gerd, E-mail: gerd.ostling@med.lu.se [Cardiovascular Epidemiology, Department of Clinical Sciences in Malmö, CRC, Jan Waldenströms gata 35, Skane University Hospital, Malmö, 205 02 Malmö (Sweden); Persson, Margaretha, E-mail: margaretha.persson@med.lu.se [Cardiovascular Epidemiology, Department of Clinical Sciences in Malmö, CRC, Jan Waldenströms gata 35, Skane University Hospital, Malmö, 205 02 Malmö (Sweden); Borné, Yan, E-mail: yan.borne@med.lu.se [Cardiovascular Epidemiology, Department of Clinical Sciences in Malmö, CRC, Jan Waldenströms gata 35, Skane University Hospital, Malmö, 205 02 Malmö (Sweden); and others

    2015-01-15

    Background: Epidemiological studies indicate that cadmium exposure through diet and smoking is associated with increased risk of cardiovascular disease. There are few data on the relationship between cadmium and plaques, the hallmark of underlying atherosclerotic disease. Objectives: To examine the association between exposure to cadmium and the prevalence and size of atherosclerotic plaques in the carotid artery. Methods: A population sample of 4639 Swedish middle-aged women and men was examined in 1991–1994. Carotid plaque was determined by B-mode ultrasound. Cadmium in blood was analyzed by inductively coupled plasma mass spectrometry. Results: Comparing quartile 4 with quartile 1 of blood cadmium, the odds ratio (OR) for prevalence of any plaque was 1.9 (95% confidence interval 1.6–2.2) after adjustment for sex and, age; 1.4 (1.1–1.8) after additional adjustment for smoking status; 1.4 (1.1–1.7) after the addition of education level and life style factors; 1.3 (1.03–1.8) after additional adjustment for risk factors and predictors of cardiovascular disease. No effect modification by sex was found in the cadmium-related prevalence of plaques. Similarly, ORs for the prevalence of small and large plaques were after full adjustment 1.4 (1.0–2.1) and 1.4 (0.9–2.0), respectively. The subgroup of never smokers showed no association between cadmium and atherosclerotic plaques. Conclusions: These results extend previous studies on cadmium exposure and clinical cardiovascular events by adding data on the association between cadmium and underlying atherosclerosis in humans. The role of smoking remains unclear. It may both cause residual confounding and be a source of pro-atherogenic cadmium exposure. - Highlights: • Blood cadmium level is associated with atherosclerotic plaques in the carotid artery. • The results extend previous knowledge of cadmium exposure and clinical events. • The role of smoking remains unclear.

  9. Cadmium exposure and atherosclerotic carotid plaques –Results from the Malmö diet and Cancer study

    International Nuclear Information System (INIS)

    Background: Epidemiological studies indicate that cadmium exposure through diet and smoking is associated with increased risk of cardiovascular disease. There are few data on the relationship between cadmium and plaques, the hallmark of underlying atherosclerotic disease. Objectives: To examine the association between exposure to cadmium and the prevalence and size of atherosclerotic plaques in the carotid artery. Methods: A population sample of 4639 Swedish middle-aged women and men was examined in 1991–1994. Carotid plaque was determined by B-mode ultrasound. Cadmium in blood was analyzed by inductively coupled plasma mass spectrometry. Results: Comparing quartile 4 with quartile 1 of blood cadmium, the odds ratio (OR) for prevalence of any plaque was 1.9 (95% confidence interval 1.6–2.2) after adjustment for sex and, age; 1.4 (1.1–1.8) after additional adjustment for smoking status; 1.4 (1.1–1.7) after the addition of education level and life style factors; 1.3 (1.03–1.8) after additional adjustment for risk factors and predictors of cardiovascular disease. No effect modification by sex was found in the cadmium-related prevalence of plaques. Similarly, ORs for the prevalence of small and large plaques were after full adjustment 1.4 (1.0–2.1) and 1.4 (0.9–2.0), respectively. The subgroup of never smokers showed no association between cadmium and atherosclerotic plaques. Conclusions: These results extend previous studies on cadmium exposure and clinical cardiovascular events by adding data on the association between cadmium and underlying atherosclerosis in humans. The role of smoking remains unclear. It may both cause residual confounding and be a source of pro-atherogenic cadmium exposure. - Highlights: • Blood cadmium level is associated with atherosclerotic plaques in the carotid artery. • The results extend previous knowledge of cadmium exposure and clinical events. • The role of smoking remains unclear

  10. Agreement between multi-detector-row CT angiography and US-ECD in quantification of carotid artery stenosis and plaque characterization

    Directory of Open Access Journals (Sweden)

    Sameh Abd El Raouf

    2014-03-01

    Conclusion: We observed a good agreement between US-ECD and MDCTA in the quantification of carotid artery stenosis and the assessment of plaque type. There was, however, a poor agreement in the evaluation of plaque ulceration. The use of US-ECD and MDCTA provides different results in the evaluation of plaque. Our results suggest that information derived from US-ECD should be always critically compared with other diagnostic techniques.

  11. Relationship between Levels of Serum C-Reactive Protein,Leucocyte Count and Carotid Plaque in Patients with Ischemic Stroke

    Institute of Scientific and Technical Information of China (English)

    郭毅; 姜昕; 周志斌; 陈实; 赵宏文; 李富康

    2003-01-01

    In order to study the relationship between serum C-reactive protein (CRP) levels, leuko-cyte count and carotid plaque in patients with ischemic stroke, carotid duplex examination was per-formed by high-definition imaging (HDI) 5000 triplex system. Serum CRP was measured by nephe-lometry within 72 h after index ischemic stroke. A lesion was considered a plaque in the presence ofa maximum intimal-medial wall thickness (IMT) 1.2 mm. Results of carotid ultrasonography weredivided into two groups: M1, normal (IMT <l. 2 mm) and M2, abnormal (IMT ≥1.2 mm). Theresults showed that the mean age of M2 was significantly older than that of M1 (69.7± 10.4 versus62.5±9.6, P=0. 001). The patients with hypertension and diabetes mellitus (78 %, 35 % re-spectively)in M2 were significantly more than those (52 %, 18 % respectively) in M1 (P<0.0l,P<0.05). There were 32 (65 % ) patients with elevated CRP levels in M2, but 33 (46 %) pa-tients with elevated CRP levels in M1, with the difference being significant between the two groups(P<0.05). The levels of serum glucose and leukocyte count (8. 1±5.5, 10.3±4.0, respectively)in abnormal CRP group were significantly higher than that of normal CRP group (6.4 ± 2.8, 8.7 ±3.4) (P<0.05, P<0.05); elevated CRP levels was found in 42 (62 %) patients with territory in-farction and 23 (43 %) patients with lacunar infarction respectively, with the difference being sig-nificant between these two groups (P<0.05). It was concluded that the elevation of CRP levelswas an significant clinical index for carotid plaque in patients with acute cerebral infarction.

  12. Non-invasive in vivo characterization of human carotid plaques with acoustic radiation force impulse ultrasound: comparison with histology after endarterectomy.

    Science.gov (United States)

    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

    2015-03-01

    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 non-invasive 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 non-invasively 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 for four patients undergoing clinically indicated carotid endarterectomy and compared with 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 were 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 illustrates 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. PMID:25619778

  13. Increased Levels of Human Carotid Lesion Linoleic Acid Hydroperoxide in Symptomatic and Asymptomatic Patients Is Inversely Correlated with Serum HDL and Paraoxonase 1 Activity

    Directory of Open Access Journals (Sweden)

    Elad Cohen

    2012-01-01

    Full Text Available Human carotid plaque components interact directly with circulating blood elements and thus they might affect each other. We determined plaque paraoxonase1 (PON1 hydrolytic-catalytic activity and compared plaque and blood levels of lipids, HDL, PON1, and HbA1c, as well as plaque-oxidized lipids in symptomatic and asymptomatic patients. Human carotid plaques were obtained from symptomatic and asymptomatic patients undergoing routine endarterectomy, and the lesions were ground and extracted for PON activity and lipid content determinations. Plaque PONs preserved paraoxonase, arylesterase, and lactonase activities. The PON1-specific inhibitor 2-hydroxyquinoline almost completely inhibited paraoxonase and lactonase activities, while only moderately inhibiting arylesterase activity. Oxysterol and triglyceride levels in plaques from symptomatic and asymptomatic patients did not differ significantly, but plaques from symptomatic patients had significantly higher (135% linoleic acid hydroperoxide (LA-13OOH levels. Their serum PON1 activity, cholesterol and triglyceride levels did not differ significantly, but symptomatic patients had significantly lower (28% serum HDL levels and higher (18% HbA1c levels. Thus LA-13OOH, a major atherogenic plaque element, showed significant negative correlations with serum PON1 activity and HDL levels, and a positive correlation with the prodiabetic atherogenic HbA1c. Plaque PON1 retains its activity and may decrease plaque atherogenicity by reducing specific oxidized lipids (e.g., LA-13OOH. The inverse correlation between plaque LA-13OOH level and serum HDL level and PON1 activity suggests a role for serum HDL and PON1 in LA-13OOH accumulation.

  14. Segmentation of ulcerated plaque: evaluation and optimization of a semiautomatic method for tracking the progression of carotid atherosclerosis

    Science.gov (United States)

    Gill, Jeremy D.; Ladak, Hanif M.; Fenster, Aaron

    2001-07-01

    A semi-automatic method for segmenting carotid lumen and plaque from three-dimensional vascular ultrasound (US) images has been developed. We examine its ability to distinguish changes in carotid vessel and plaque surface morphology, such as those caused by plaque ulceration. Two stenosed vessel phantoms were imaged using a 3D US imaging system. The phantoms were identical except for the inclusion of a hemispherical cut in the side of one of the vessels, in order to simulate the development of an ulceration. Ultrasound images of the phantoms were segmented using our algorithm, then the resulting surfaces were registered to one another using a rigid-body iterative closest point (ICP) algorithm. The volume of ulceration was determined by finding the difference between the two segmented surfaces in a region of interest surrounding the ulceration. Since the true volume of the ulceration was known a priori, an optimization strategy was used to tune the deformable model to better segment the ulceration. Analysis of ulceration volume as a function of the deformable model's parameters show that 1) large ulcerations are easily identified in our test case, and 2) the model is well behaved with respect to its parameters, suggesting that an automatic strategy for volumetric optimization is feasible.

  15. High-risk plaque features can be detected in non-stenotic carotid plaques of patients with ischaemic stroke classified as cryptogenic using combined {sup 18}F-FDG PET/MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Hyafil, Fabien [Technische Universitaet Muenchen, Department of Nuclear Medicine, Klinikum rechts der Isar, Munich (Germany); Bichat University Hospital, Department of Nuclear Medicine, Paris (France); Schindler, Andreas; Obenhuber, Tilman; Saam, Tobias [Ludwig Maximilians University Hospital Munich, Institute for Clinical Radiology, Munich (Germany); Sepp, Dominik; Hoehn, Sabine; Poppert, Holger [Technische Universitaet Muenchen, Department of Neurology, Klinikum rechts der Isar, Munich (Germany); Bayer-Karpinska, Anna [Ludwig Maximilians University Hospital Munich, Institute for Stroke and Dementia Research, Munich (Germany); Boeckh-Behrens, Tobias [Technische Universitaet Muenchen, Department of Neuroradiology, Klinikum Rechts der Isar, Munich (Germany); Hacker, Marcus [Medical University of Vienna, Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Nekolla, Stephan G. [Technische Universitaet Muenchen, Department of Nuclear Medicine, Klinikum rechts der Isar, Munich (Germany); Partner Site Munich Heart Alliance, German Centre for Cardiovascular Research (DZHK), Munich (Germany); Rominger, Axel [Ludwig Maximilians University Hospital Munich, Department of Nuclear Medicine, Munich (Germany); Dichgans, Martin [Technische Universitaet Muenchen, Department of Neurology, Klinikum rechts der Isar, Munich (Germany); Munich Cluster of Systems Neurology (SyNergy), Munich (Germany); Schwaiger, Markus [Technische Universitaet Muenchen, Department of Nuclear Medicine, Klinikum rechts der Isar, Munich (Germany)

    2016-02-15

    The aim of this study was to investigate in 18 patients with ischaemic stroke classified as cryptogenic and presenting non-stenotic carotid atherosclerotic plaques the morphological and biological aspects of these plaques with magnetic resonance imaging (MRI) and {sup 18}F-fluoro-deoxyglucose positron emission tomography ({sup 18}F-FDG PET) imaging. Carotid arteries were imaged 150 min after injection of {sup 18}F-FDG with a combined PET/MRI system. American Heart Association (AHA) lesion type and plaque composition were determined on consecutive MRI axial sections (n = 460) in both carotid arteries. {sup 18}F-FDG uptake in carotid arteries was quantified using tissue to background ratio (TBR) on corresponding PET sections. The prevalence of complicated atherosclerotic plaques (AHA lesion type VI) detected with high-resolution MRI was significantly higher in the carotid artery ipsilateral to the ischaemic stroke as compared to the contralateral side (39 vs 0 %; p = 0.001). For all other AHA lesion types, no significant differences were found between ipsilateral and contralateral sides. In addition, atherosclerotic plaques classified as high-risk lesions with MRI (AHA lesion type VI) were associated with higher {sup 18}F-FDG uptake in comparison with other AHA lesions (TBR = 3.43 ± 1.13 vs 2.41 ± 0.84, respectively; p < 0.001). Furthermore, patients presenting at least one complicated lesion (AHA lesion type VI) with MRI showed significantly higher {sup 18}F-FDG uptake in both carotid arteries (ipsilateral and contralateral to the stroke) in comparison with carotid arteries of patients showing no complicated lesion with MRI (mean TBR = 3.18 ± 1.26 and 2.80 ± 0.94 vs 2.19 ± 0.57, respectively; p < 0.05) in favour of a diffuse inflammatory process along both carotid arteries associated with complicated plaques. Morphological and biological features of high-risk plaques can be detected with {sup 18}F-FDG PET/MRI in non-stenotic atherosclerotic plaques ipsilateral

  16. High-risk plaque features can be detected in non-stenotic carotid plaques of patients with ischaemic stroke classified as cryptogenic using combined 18F-FDG PET/MR imaging

    International Nuclear Information System (INIS)

    The aim of this study was to investigate in 18 patients with ischaemic stroke classified as cryptogenic and presenting non-stenotic carotid atherosclerotic plaques the morphological and biological aspects of these plaques with magnetic resonance imaging (MRI) and 18F-fluoro-deoxyglucose positron emission tomography (18F-FDG PET) imaging. Carotid arteries were imaged 150 min after injection of 18F-FDG with a combined PET/MRI system. American Heart Association (AHA) lesion type and plaque composition were determined on consecutive MRI axial sections (n = 460) in both carotid arteries. 18F-FDG uptake in carotid arteries was quantified using tissue to background ratio (TBR) on corresponding PET sections. The prevalence of complicated atherosclerotic plaques (AHA lesion type VI) detected with high-resolution MRI was significantly higher in the carotid artery ipsilateral to the ischaemic stroke as compared to the contralateral side (39 vs 0 %; p = 0.001). For all other AHA lesion types, no significant differences were found between ipsilateral and contralateral sides. In addition, atherosclerotic plaques classified as high-risk lesions with MRI (AHA lesion type VI) were associated with higher 18F-FDG uptake in comparison with other AHA lesions (TBR = 3.43 ± 1.13 vs 2.41 ± 0.84, respectively; p < 0.001). Furthermore, patients presenting at least one complicated lesion (AHA lesion type VI) with MRI showed significantly higher 18F-FDG uptake in both carotid arteries (ipsilateral and contralateral to the stroke) in comparison with carotid arteries of patients showing no complicated lesion with MRI (mean TBR = 3.18 ± 1.26 and 2.80 ± 0.94 vs 2.19 ± 0.57, respectively; p < 0.05) in favour of a diffuse inflammatory process along both carotid arteries associated with complicated plaques. Morphological and biological features of high-risk plaques can be detected with 18F-FDG PET/MRI in non-stenotic atherosclerotic plaques ipsilateral to the stroke, suggesting a causal role

  17. Lower prevalence of carotid plaque hemorrhage in women, and its mediator effect on sex differences in recurrent cerebrovascular events.

    Directory of Open Access Journals (Sweden)

    Neghal Kandiyil

    Full Text Available Women are at lower risk of stroke, and appear to benefit less from carotid endarterectomy (CEA than men. We hypothesised that this is due to more benign carotid disease in women mediating a lower risk of recurrent cerebrovascular events. To test this, we investigated sex differences in the prevalence of MRI detectable plaque hemorrhage (MRI PH as an index of plaque instability, and secondly whether MRI PH mediates sex differences in the rate of cerebrovascular recurrence.Prevalence of PH between sexes was analysed in a single centre pooled cohort of 176 patients with recently symptomatic, significant carotid stenosis (106 severe [≥70%], 70 moderate [50-69%] who underwent prospective carotid MRI scanning for identification of MRI PH. Further, a meta-analysis of published evidence was undertaken. Recurrent events were noted during clinical follow up for survival analysis.Women with symptomatic carotid stenosis (50%≥ were less likely to have plaque hemorrhage (PH than men (46% vs. 70% with an adjusted OR of 0.23 [95% CI 0.10-0.50, P<0.0001] controlling for other known vascular risk factors. This negative association was only significant for the severe stenosis subgroup (adjusted OR 0.18, 95% CI 0.067-0.50 not the moderate degree stenosis. Female sex in this subgroup also predicted a longer time to recurrent cerebral ischemic events (HR 0.38 95% CI 0.15-0.98, P = 0.045. Further addition of MRI PH or smoking abolished the sex effects with only MRI PH exerting a direct effect. Meta-analysis confirmed a protective effect of female sex on development of PH: unadjusted OR for presence of PH = 0.54 (95% CI 0.45-0.67, p<0.00001.MRI PH is significantly less prevalent in women. Women with MRI PH and severe stenosis have a similar risk as men for recurrent cerebrovascular events. MRI PH thus allows overcoming the sex bias in selection for CEA.

  18. Correlation of plaque nitric oxide levels with plaque Streptococcus mutans, plaque pH and decayed, missing and filled teeth index of children of different age groups

    OpenAIRE

    Sawinderjit Saini; Hina Noorani; P K Shivaprakash

    2016-01-01

    Context: Dental plaque is considered one of the most important etiological factors for dental caries. Nitrate and Nitrite levels in saliva are considered protective against oral and gastrointestinal disease. Plaque nitric oxide (NO) levels and its role in dental caries has not be explored in the literature. Aim: Determine the correlation of the plaque nitric oxide (NO) with dental caries in vivo. Materials and Method: 75 healthy children between ages of 3-15 years were selected. The age, stat...

  19. 颈动脉粥样硬化斑块与血浆纤维蛋白原的关系%Relationship between Carotid Atherosclerotic Plaque and Plasma Fibrinogen

    Institute of Scientific and Technical Information of China (English)

    戴志刚; 王涛; 武文元

    2011-01-01

    [ Objective ] To study the relationship between carotid atherosclerosis and plasma fibrinogen. [ Methods] Color Doppler was carried out on carotid artery of 65 carotid atherosclerotic patients, recording position, echo intensity of artherosclerotic plaque,carotid artery intima-media thickness and vessel inside diameter. According to carotid artery stenosis, the patients were divided into 4 groups, and were re-divided into 2 groups ( hard plaque and soft plaque ) on the basis of character of atherosclerotic plaque, meanwhile, detecting the level of plasma fibrinogen, and performing statistical analysis. [ Results ] With the increasing level of plasma fibrinogen , the degree of carotid atherosclerotic stenosis was increased, showing positive correlation; the rate of plasma fibrinogen soft plaque of middle and high density groups is obviously higher than the lower density group. [ Conclusion ] Plasma fibrinogen level is closely correlated with characteristic of carotid atherosclerotic plaque. Plasma fibrinogen may determine the stability of carotid atherosclerotic plaque. And the increasing level of plasma fibrinogen is closely related with carotid atherosclerosis and plays an important role in its development.%目的 探讨患者颈动脉粥样硬化程度以及颈动脉粥样硬化性质与血浆纤维蛋白原的关系.方法 对存在颈动脉粥样硬化的65例患者进行颈动脉彩色多普勒检查,记录颈动脉粥样硬化斑块的部位、回声强度、颈总动脉分叉处内膜中层厚度及血管内径,并根据颈动脉狭窄程度分为4组,再根据超声检查动脉硬化斑块性质分为硬斑和软斑2组,同时检测血浆纤维蛋白原水平,进行统计学分析.结果 随着血浆纤维蛋白原水平的升高,动脉粥样硬化狭窄程度也随之增加,且呈正相关;中、高浓度纤维蛋白原组软斑发生率明显多于低浓度组.结论 血浆纤维蛋白原水平与颈动脉粥样硬化斑块的性质有关,血浆纤维蛋

  20. Imaging of inflamed carotid artery atherosclerotic plaques with the use of {sup 99m}Tc-HYNIC-IL-2 scintigraphy in end-stage renal disease patients

    Energy Technology Data Exchange (ETDEWEB)

    Opalinska, Marta; Pach, Dorota; Sowa-Staszczak, Anna; Glowa, Boguslaw; Hubalewska-Dydejczyk, Alicja [Jagiellonian University Medical School, Nuclear Medicine Unit, Department of Endocrinology, Cracow (Poland); Stompor, Tomasz [University of Warmia and Mazury in Olsztyn, Department of Nephrology, Hypertensiology and Internal Medicine, Faculty of Medicine, Olsztyn (Poland); Mikolajczak, Renata; Garnuszek, Piotr; Maurin, Michal; Karczmarczyk, Urszula [National Centre for Nuclear Research Radioisotope Centre POLATOM, Otwock (Poland); Fedak, Danuta [Jagiellonian University Medical School, Clinical Biochemistry, Cracow (Poland); Krzanowski, Marcin; Sulowicz, Wladyslaw [Jagiellonian University Medical School, Department of Nephrology, Cracow (Poland); Rakowski, Tomasz [Jagiellonian University Medical School, 2nd Department of Cardiology, Institute of Cardiology, Cracow (Poland)

    2012-04-15

    Identification of vulnerable plaques remains crucial for better cardiovascular risk assessment. At least 20% of inflammatory cells within unstable (vulnerable) plaques comprise T lymphocytes, which contain receptors for interleukin-2 (IL-2); those receptors can be identified by scintigraphy with radiolabelled IL-2.The aim of this study was to identify the ''inflamed'' (vulnerable) plaques by scintigraphy using IL-2 labelled with {sup 99m}Tc in the selected, high cardiovascular risk group of end-stage renal disease (ESRD) patients. A total of 28 patients (18 men, 10 women, aged 55.2 {+-} 9.6 years, 17 on peritoneal dialysis, 11 on haemodialysis) underwent common carotid artery (CCA) scintigraphy with the use of {sup 99m}Tc-hydrazinonicotinamide (HYNIC)-IL-2. In all cases, ultrasound examination of the CCA was performed and levels of selected proinflammatory factors, atherogenic markers and calcium-phosphate balance parameters were measured. Finally, the target to non-target (T/nT) ratio of IL-2 uptake in atherosclerotic plaques with intima-media thickness (IMT), classic cardiovascular risk factors and concentrations of the measured factors were compared. Increased {sup 99m}Tc-HYNIC-IL-2 uptake in atherosclerotic plaques in 38/41 (91%) cases was detected. The median T/nT ratio of focal {sup 99m}Tc-HYNIC-IL-2 uptake in atherosclerotic plaques was 2.35 (range 1.23-3.63). The mean IMT value on the side of plaques assessed by scintigraphy was 0.79 {+-} 0.18 mm (median 0.8, range 0.5-1.275). Correlations between T/nT ratio and homocysteine (R = 0.22, p = 0.037), apolipoprotein B (apoB) (R = 0.31, p = 0.008), apoB to apoA-I ratio (R = 0.29, p = 0.012) and triglyceride concentration (R = 0.26, p = 0.021) were detected. A lower T/nT ratio in patients with better parameters of nutritional status (haemoglobin, albumin, adiponectin) in comparison with patients with worse nutritional parameters (3.20 {+-} 0.5 vs 2.16 {+-} 0.68, p = 0.025) was revealed as well

  1. Correlation of plaque nitric oxide levels with plaque Streptococcus mutans, plaque pH and decayed, missing and filled teeth index of children of different age groups

    Directory of Open Access Journals (Sweden)

    Sawinderjit Saini

    2016-01-01

    Full Text Available Context: Dental plaque is considered one of the most important etiological factors for dental caries. Nitrate and Nitrite levels in saliva are considered protective against oral and gastrointestinal disease. Plaque nitric oxide (NO levels and its role in dental caries has not be explored in the literature. Aim: Determine the correlation of the plaque nitric oxide (NO with dental caries in vivo. Materials and Method: 75 healthy children between ages of 3-15 years were selected. The age, state of dentition and the level of caries in all individuals were determined by the same examiner, using DMFT/deft index. The plaque samples collected were subjected to nitric oxide estimation, streptococcus mutans count and pH for correlation. Statistical Analysis Used: SPSS computer based software was used for descriptive data analysis. ANOVA one way analysis and Karl pearson′s correlation was carried out. Results and Conclusion: Statistically significant relationship was observed between plaque nitric oxide and dental caries in all age groups. Similarly, significant correlation of nitric oxide was found in relation to plaque streptococcus mutans and plaque pH. Thus concluded, plaque nitric oxide can be considered as a risk assessment tool for prediction of dental caries.

  2. Automated image segmentation and registration of vessel wall MRI for quantitative assessment of carotid artery vessel wall dimensions and plaque composition

    OpenAIRE

    Klooster, Ronald van 't

    2014-01-01

    The main goal of this thesis was to develop methods for automated segmentation, registration and classification of the carotid artery vessel wall and plaque components using multi-sequence MR vessel wall images to assess atherosclerosis. First, a general introduction into atherosclerosis and different stages of the disease were described including the importance to differentiate between stable and vulnerable plaques. Several non-invasive imaging techniques were discussed and the advantages of...

  3. In-vivo quantitative T2 mapping of carotid arteries in atherosclerotic patients: segmentation and T2 measurement of plaque components

    OpenAIRE

    Biasiolli, Luca; Lindsay, Alistair C.; Chai, Joshua T.; Choudhury, Robin P.; Robson, Matthew D

    2013-01-01

    Background Atherosclerotic plaques in carotid arteries can be characterized in-vivo by multicontrast cardiovascular magnetic resonance (CMR), which has been thoroughly validated with histology. However, the non-quantitative nature of multicontrast CMR and the need for extensive post-acquisition interpretation limit the widespread clinical application of in-vivo CMR plaque characterization. Quantitative T2 mapping is a promising alternative since it can provide absolute physical measurements o...

  4. Autophagy in Atherosclerosis: A Phenomenon Found in Human Carotid Atherosclerotic Plaques

    Institute of Scientific and Technical Information of China (English)

    Huihui Liu; Yongjun Cao; Tong Tong; Jijun Shi; Yanlin Zhang; Yaping Yang; Chunfeng Liu

    2015-01-01

    Background:Autophagy has been found to be involved in animal and cell models ofatherosclerosis,but to date,it lacks general observation in human atherosclerotic plaques.Here,we investigated autophagy in smooth muscle cells (SMCs),endothelial cells (ECs),and macrophages in human atherosclerotic plaques via transmission electron microscopy (TEM),western blotting,and immunohistochemistry analysis.Methods:The histopathologic morphology of these plaques was observed via hematoxylin and eosin staining.The ultrastructural morphology of the SMCs,ECs,and macrophages in these plaques was observed via TEM.The localization ofmicrotubule-associated protein 1 light chain 3 (MAP 1-LC3),a relatively special maker ofautophagy,in plaques was observed by double fluorescent immunochemistty and western blotting.Results:All of these human atherosclerotic plaques were considered advanced and unstable in histologically observation.By double fluorescent immunochemistry,the expression of LC3-Ⅱ increased in the SMCs of the fibrous cap,the macrophages,and the microvascular ECs of the plaque shoulders.The protein level of LC3-Ⅱ by western blotting significantly increased in plaques compared with normal controls.In addition,TEM observation of plaques revealed certain features of autophagy in SMCs,ECs,and macrophages including the formation of myelin figures,vacuolization,and the accumulation of inclusions in the cytosol.These results indicate that autophagy is activated in SMCs,ECs,and macrophages in human advanced atherosclerotic plaques.Conclusions:Our study is to demonstrate the existence of autophagy in human atherosclerotic plaques by different methods,which may contribute to the development of pharmacological approaches to stabilize vulnerable and rupture-prone lesions.

  5. Actin Is a Target of T-Cell Reactivity in Patients with Advanced Carotid Atherosclerotic Plaques

    OpenAIRE

    Elisabetta Profumo; Brigitta Buttari; Linda Petrone; Giada Lacroce; Maria Chiara Tesori; Raffaele Capoano; Bruno Salvati; Rachele Riganò

    2013-01-01

    Atherosclerosis is a chronic inflammatory disease of the arterial wall associated with autoimmune reactions. In a previous study, we observed the presence of actin-specific antibodies in sera from patients with carotid atherosclerosis. To extend our previous results we evaluated the possible role of actin as antigenic target of cell-mediated immune reactions in carotid atherosclerosis. Peripheral blood mononuclear cells (PBMC) from 17 patients and 16 healthy subjects were tested by cell proli...

  6. Lack of Association between ABO, PPAP2B, ADAMST7, PIK3CG, and EDNRA and Carotid Intima-Media Thickness, Carotid Plaques, and Cardiovascular Disease in Patients with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Raquel López-Mejías

    2014-01-01

    Full Text Available Introduction. Rheumatoid arthritis (RA is a polygenic disease associated with accelerated atherosclerosis and increased cardiovascular (CV mortality. Recent studies have identified the ABO rs579459, PPAP2B rs17114036, and ADAMTS7 rs3825807 polymorphisms as genetic variants associated with coronary artery disease and the PIK3CG rs17398575 and EDNRA rs1878406 polymorphisms as the most significant signals related to the presence of carotid plaque in nonrheumatic Caucasian individuals. Accordingly, we evaluated the potential relationship between these 5 polymorphisms and subclinical atherosclerosis (assessed by carotid intima-media thickness (cIMT and presence/absence of carotid plaques and CV disease in RA. Material and Methods. 2140 Spanish RA patients were genotyped for the 5 polymorphisms by TaqMan assays. Subclinical atherosclerosis was evaluated in 620 of these patients by carotid ultrasonography technology. Results. No statistically significant differences were found when each polymorphism was assessed according to cIMT values and presence/absence of carotid plaques in RA, after adjusting the results for potential confounders. Moreover, no significant differences were obtained when RA patients were stratified according to the presence/absence of CV disease after adjusting for potential confounders. Conclusion. Our results do not confirm association between ABO rs579459, PPAP2B rs17114036, ADAMTS7 rs3825807, PIK3CG rs17398575, and EDNRA rs1878406 and subclinical atherosclerosis and CV disease in RA.

  7. Automated image segmentation and registration of vessel wall MRI for quantitative assessment of carotid artery vessel wall dimensions and plaque composition

    NARCIS (Netherlands)

    Klooster, Ronald van 't

    2014-01-01

    The main goal of this thesis was to develop methods for automated segmentation, registration and classification of the carotid artery vessel wall and plaque components using multi-sequence MR vessel wall images to assess atherosclerosis. First, a general introduction into atherosclerosis and differe

  8. A computer-simulation study on the effects of MRI voxel dimensions on carotid plaque lipid-core and fibrous cap segmentation and stress modeling

    NARCIS (Netherlands)

    Nieuwstadt, H.A.; Kassar, Z.A.M.; Van der Lugt, A.; Breeuwer, M.; Van der Steen, A.F.W.; Wentzel, J.J.; Gijsen, F.J.H.

    2015-01-01

    Background The benefits of a decreased slice thickness and/or in-plane voxel size in carotid MRI for atherosclerotic plaque component quantification accuracy and biomechanical peak cap stress analysis have not yet been investigated in detail because of practical limitations. Methods In order to p

  9. High-resolution black-blood MRI findings of carotid atherosclerotic plaque in initial and recurrent acute ischemic stroke: a comparison study

    International Nuclear Information System (INIS)

    Objective: To investigate MR imaging characteristics of carotid plaque in patients with first-time and recurrent acute ischemic stroke. Methods: During the period from Aug. 2009 to Nov. 2010, high-resolution black-blood MR scanning of carotid was carried out in 89 patients with recently-developed acute ischemic stroke, which included initial attack (n=51) and recurrent attack (n=38). The ipsilateral responsible carotid arteries were quantitatively and qualitatively analyzed. The carotid plaque burden and compositional features were compared between the initial and recurrent stroke patients. Results: Of the 89 patients, 51 had first-time stroke and 38 had recurrent stroke. The mean WA, WT and PWV were greater in patients with recurrent stroke than those in patients with first-time stroke (P<0.05). Compared with the first- time stroke patients, the recurrent stroke patients had significantly higher prevalence of calcification (44.7% versus 23.5%, P=0.035) and larger volume of LRNC as well (179.14±254.81 mm2 versus 71.65± 111.15 mm2, P=0.027). IPH and/or fibrous cap rupture were observed in 15.8% of patients with recurrent stroke and only 3.9% of patients with first-time stroke. Conclusion: Carotid plaques in patients with recurrent ischemic stroke are significantly worse than those in patients with first-time stroke. Monitoring the carotid plaques in patients with initial stroke by MR scanning may be helpful for the prevention of recurrent stroke. (authors)

  10. Reliability of digital panoramic radiographs in detecting calcified carotid artery atheromatous plaques: A clinical study

    Directory of Open Access Journals (Sweden)

    Neha Khambete

    2014-01-01

    Conclusion: To conclude, digital panoramic radiographs had good sensitivity and high specificity in detecting CCAAP. If properly trained, dentists can detect such plaques and can refer patients to physician for timely medical treatment.

  11. MR coil sensitivity inhomogeneity correction for plaque characterization in carotid arteries

    Science.gov (United States)

    Salvado, Olivier; Hillenbrand, Claudia; Suri, Jasjit; Wilson, David L.

    2004-05-01

    We are involved in a comprehensive program to characterize atherosclerotic disease using multiple MR images having different contrast mechanisms (T1W, T2W, PDW, magnetization transfer, etc.) of human carotid and animal model arteries. We use specially designed intravascular and surface array coils that give high signal-to-noise but suffer from sensitivity inhomogeneity. With carotid surface coils, challenges include: (1) a steep bias field with an 80% change; (2) presence of nearby muscular structures lacking high frequency information to distinguish bias from anatomical features; (3) many confounding zero-valued voxels subject to fat suppression, blood flow cancellation, or air, which are not subject to coil sensitivity; and (4) substantial noise. Bias was corrected using a modification of the adaptive fuzzy c-mean method reported by Pham et al. (IEEE TMI, 18:738-752), whereby a bias field modeled as a mechanical membrane was iteratively improved until cluster means no longer changed. Because our images were noisy, we added a noise reduction filtering step between iterations and used about 5 classes. In a digital phantom having a bias field measured from our MR system, variations across an area comparable to a carotid artery were reduced from 50% to carotid images were qualitatively improved and large regions of skeletal muscle were relatively flat. Other commonly applied techniques failed to segment the images or introduced strong edge artifacts. Current evaluations include comparisons to bias as measured by a body coil in human MR images.

  12. Actin Is a Target of T-Cell Reactivity in Patients with Advanced Carotid Atherosclerotic Plaques

    Directory of Open Access Journals (Sweden)

    Elisabetta Profumo

    2013-01-01

    Full Text Available Atherosclerosis is a chronic inflammatory disease of the arterial wall associated with autoimmune reactions. In a previous study, we observed the presence of actin-specific antibodies in sera from patients with carotid atherosclerosis. To extend our previous results we evaluated the possible role of actin as antigenic target of cell-mediated immune reactions in carotid atherosclerosis. Peripheral blood mononuclear cells (PBMC from 17 patients and 16 healthy subjects were tested by cell proliferation assay and by ELISA for cytokine production. Actin induced a proliferative response in 47% of patients’ PBMC samples, with SI ranging from 2.6 to 21.1, and in none of the healthy subjects’ samples (patients versus healthy subjects, P=0.02. The presence of diabetes in patients was significantly associated with proliferative response to actin (P=0.04. IFN-γ and TNF-α concentrations were higher in PBMC from patients than in those from healthy subjects and in PBMC proliferating to actin than in nonproliferating ones. Our data demonstrate for the first time a role of actin as a target autoantigen of cellular immune reactions in patients with carotid atherosclerosis. The preferential proinflammatory Th1 activation suggests that actin could contribute to endothelial dysfunction, tissue damage, and systemic inflammation in carotid atherosclerosis.

  13. IVUS-Based FSI Models for Human Coronary Plaque Progression Study: Components, Correlation and Predictive Analysis

    OpenAIRE

    WANG, LIANG; Wu, Zheyang; Yang, Chun; Zheng, Jie; Bach, Richard; Muccigrosso, David; Billiar, Kristen; Maehara, Akiko; Mintz, Gary S; Tang, Dalin

    2014-01-01

    Atherosclerotic plaque progression is believed to be associated with mechanical stress conditions. Patient follow-up in vivo intravascular ultrasound coronary plaque data were acquired to construct fluid-structure interaction (FSI) models with cyclic bending to obtain flow wall shear stress (WSS), plaque wall stress (PWS) and strain (PWSn) data and investigate correlations between plaque progression measured by wall thickness increase (WTI), cap thickness increase (CTI), lipid depth increase ...

  14. Mast cell degranulator compound 48-80 promotes atherosclerotic plaque in apolipoprotein E knockout mice with perivascular common carotid collar placement

    Institute of Scientific and Technical Information of China (English)

    TANG Ya-ling; YANG Yong-zong; WANG Shuang; HUANG Tao; TANG Chao-ke; XU Zeng-xiang; SUN Yu-hui

    2009-01-01

    Background Study of the relationship between mast cells and atherosclerosis is mostly dependent on pathological observation and cytology experiments. To investigate the effects of mast cells degranulation on plaque and their possible mechanisms we used apolipoprotein E knockout mice which had been placed perivascular common carotid collar with mast cells degranulator compound 48-80.Methods Forty apolipoprotein E knockout mice were fed a western-type diet and operated on with placement of perivascular right common carotid collar. Four weeks after surgery, the mice were intraperitoneally injected with compound 48-80 (0.5 mg/kg) or D-Hanks every other day for 4 times. The serum lipids and activity of tryptase were measured. Tissue sections were stained with hematoxylin and eosin. Corresponding sections were stained with toluidine blue and immunohistochemically with antibodies against macrophage-specific antigen, α-smooth muscle actin, interleukin-1β and van Willebrand factor. Simultaneously, basic fibroblast growth factor was detected by in situ hybridization and immunofluorescence.Results No pathological change was observed in common carotid non-collar placement but atherogenesis in common carotid collar placement of both groups. There was a significant increase in plaque area ((5.85±0.75)×104 vs (0.86±0.28)×104 μm2, P<0.05), the degree of lumen stenosis ((81±15)% vs (41±12)%, P <0.05), the activity of tryptase in serum ((0.57±0.13) U/L vs (0.36±0.10) U/L, P <0.05), and the percentage of degranulated mast cells ((80.6±17.8)% vs (13.5±4.1)%, P <0.05). The expressions of macrophage-specific antigen, α-smooth muscle actin, interleukin-1β, basic fibroblast growth factor and the density of neovessel in plaque were more in the compound 48-80 group than in the control group.Conclusions Perivascular common carotid collar placement can promote atherosclerotic plaque formation in apolipoprotein E knockout mice. Compound 48-80 increases plaque area and the degree

  15. Quantitative evaluation of high intensity signal on MIP images of carotid atherosclerotic plaques from routine TOF-MRA reveals elevated volumes of intraplaque hemorrhage and lipid rich necrotic core

    Directory of Open Access Journals (Sweden)

    Yamada Kiyofumi

    2012-11-01

    Full Text Available Abstract Background Carotid intraplaque hemorrhage (IPH and lipid rich necrotic core (LRNC have been associated with accelerated plaque growth, luminal narrowing, future surface disruption and development of symptomatic events. The aim of this study was to evaluate the quantitative relationships between high intensity signals (HIS in the plaque on TOF-MRA and IPH or LRNC volumes as measured by multicontrast weighted CMR. Methods Seventy six patients with a suspected carotid artery stenosis or carotid plaque by ultrasonography underwent multicontrast carotid CMR. HIS presence and volume were measured from TOF-MRA MIP images while IPH and LRNC volumes were separately measured from multicontrast CMR. Results For detecting IPH, HIS on MIP images overall had high specificity (100.0%, 95% CI: 93.0 – 100.0% but relatively low sensitivity (32%, 95% CI: 20.8 – 47.9%. However, the sensitivity had a significant increasing relationship with underlying IPH volume (p = 0.033 and degree of stenosis (p = 0.022. Mean IPH volume was 2.7 times larger in those with presence of HIS than in those without (142.8 ± 97.7 mm3 vs. 53.4 ± 56.3 mm3, p = 0.014. Similarly, mean LRNC volume was 3.4 times larger in those with HIS present (379.8 ± 203.4 mm3 vs. 111.3 ± 122.7 mm3, p = 0.001. There was a strong correlation between the volume of the HIS region and the IPH volume measured from multicontrast CMR (r = 0.96, p  Conclusion MIP images are easily reformatted from three minute, routine, clinical TOF sequences. High intensity signals in carotid plaque on TOF-MRA MIP images are associated with increased intraplaque hemorrhage and lipid-rich necrotic core volumes. The technique is most sensitive in patients with moderate to severe stenosis.

  16. Patient-Specific Carotid Plaque Progression Simulation Using 3D Meshless Generalized Finite Difference Models with Fluid-Structure Interactions Based on Serial In Vivo MRI Data.

    Science.gov (United States)

    Yang, Chun; Tang, Dalin; Atluri, Satya

    2011-01-01

    Previously, we introduced a computational procedure based on three-dimensional meshless generalized finite difference (MGFD) method and serial magnetic resonance imaging (MRI) data to quantify patient-specific carotid atherosclerotic plaque growth functions and simulate plaque progression. Structure-only models were used in our previous report. In this paper, fluid-stricture interaction (FSI) was added to improve on prediction accuracy. One participating patient was scanned three times (T1, T2, and T3, at intervals of about 18 months) to obtain plaque progression data. Blood flow was assumed to laminar, Newtonian, viscous and incompressible. The Navier-Stokes equations with arbitrary Lagrangian-Eulerian (ALE) formulation were used as the governing equations. Plaque material was assumed to be uniform, homogeneous, isotropic, linear, and nearly incompressible. The linear elastic model was used. The 3D FSI plaque model was discretized and solved using a meshless generalized finite difference (GFD) method. Growth functions with a) morphology alone; b) morphology and plaque wall stress (PWS); morphology and flow shear stress (FSS), and d) morphology, PWS and FSS were introduced to predict future plaque growth based on previous time point data. Starting from the T2 plaque geometry, plaque progression was simulated by solving the FSI model and adjusting plaque geometry using plaque growth functions iteratively until T3 is reached. Numerically simulated plaque progression agreed very well with the target T3 plaque geometry with errors ranging from 8.62%, 7.22%, 5.77% and 4.39%, with the growth function including morphology, plaque wall stress and flow shear stress terms giving the best predictions. Adding flow shear stress term to the growth function improved the prediction error from 7.22% to 4.39%, a 40% improvement. We believe this is the first time 3D plaque progression FSI simulation based on multi-year patient-tracking data was reported. Serial MRI-based progression

  17. An Objective Method to Optimize the MR Sequence Set for Plaque Classification in Carotid Vessel Wall Images Using Automated Image Segmentation

    OpenAIRE

    van ‘t Klooster, Ronald; Patterson, Andrew J.; Young, Victoria E.; Gillard, Jonathan H; Reiber, Johan H.C.; van der Geest, Rob J.

    2013-01-01

    A typical MR imaging protocol to study the status of atherosclerosis in the carotid artery consists of the application of multiple MR sequences. Since scanner time is limited, a balance has to be reached between the duration of the applied MR protocol and the quantity and quality of the resulting images which are needed to assess the disease. In this study an objective method to optimize the MR sequence set for classification of soft plaque in vessel wall images of the carotid artery using au...

  18. Correlation between Acute Coronary Syndrome Classification and Multi-detector CT Characterization of Plaque

    Institute of Scientific and Technical Information of China (English)

    Zhi-guo Wang; Lu-yue Gai; Jing-jing Gai; Ping Li; Xia Yang; Qin-hua Jin; Yun-dai Chen; Zhi-jun Sun; Zhi-wei Guan

    2011-01-01

    Objective To determine if multi-detector CT (MDCT) characterization of plaque is correlated with the classification of acute coronary syndrome (ACS). Methods Altogether 1900 patients were examined by MDCT from December 2007 to May 2009,of whom 95 patients fulfilled the criteria of ACS. Those patients were divided into the discrete plaque group (n=61) and diffuse plaque group (n=34) based on the findings in MDCT. The clinical diagnosis of ACS and CT results were analyzed, including segment stenosis score, segment involvement score, 3-vessel plaque score, left main score, calcification score, and remodeling index. The incidences of major adverse cardiac events in follow-up period were also recorded.Results The patients of the diffuse plaque group were older than those of the discrete plaque group (P<0.0001). The diffuse plaque group presented more cases of hypertension, peripheral artery disease, diabetes, and heart failure than discrete plaque group (all P<0.05). All the 5 patients with ST-segment elevation myocardial infarction were found in discrete plaque group. The segment stenosis score of the discrete plaque group was lower than that of the diffuse plaque group (5.15+3.55 vs. 14.91+5.37, P<0.001). The other four scores demonstrated significant inter-group difference as well (all P<0.05). The remodeling index of the discrete plaque group was higher (1.12+0.16 vs. 0.97+0.20, P<0.05). Follow-up data showed that major adverse cardiac events occurred more frequently in diffuse plaque group than in discrete group (29.41% vs.11.48%, P=0.0288).Conclusions Characteristics of discrete and diffuse plaques may be significandy different among different classes of ACS. The diffuse plaque may present higher risk, correlated to higher mortality. The diagnosis of discrete and diffuse plaques by MDCT would provide a new insight into the prognosis and treatment of ACS.

  19. Lack of Association between ABO, PPAP2B, ADAMST7, PIK3CG, and EDNRA and Carotid Intima-Media Thickness, Carotid Plaques, and Cardiovascular Disease in Patients with Rheumatoid Arthritis

    OpenAIRE

    Raquel López-Mejías; Fernanda Genre; Mercedes García-Bermúdez; Begoña Ubilla; Santos Castañeda; Javier Llorca; Carlos González-Juanatey; Alfonso Corrales; Miranda-Filloy, José A.; Trinitario Pina; Carmen Gómez-Vaquero; Luis Rodríguez-Rodríguez; Benjamín Fernández-Gutiérrez; Alejandro Balsa; Dora Pascual-Salcedo

    2014-01-01

    Introduction. Rheumatoid arthritis (RA) is a polygenic disease associated with accelerated atherosclerosis and increased cardiovascular (CV) mortality. Recent studies have identified the ABO rs579459, PPAP2B rs17114036, and ADAMTS7 rs3825807 polymorphisms as genetic variants associated with coronary artery disease and the PIK3CG rs17398575 and EDNRA rs1878406 polymorphisms as the most significant signals related to the presence of carotid plaque in nonrheumatic Caucasian individuals. Accordin...

  20. A computer-simulation study on the effects of MRI voxel dimensions on carotid plaque lipid-core and fibrous cap segmentation and stress modeling

    OpenAIRE

    Nieuwstadt, Harm; Kassar, Z.A.M.; van der Lugt, Aad; Breeuwer, M.; van der Steen, A. F. W.; Wentzel, Jolanda; Gijsen, Frank

    2015-01-01

    textabstractBackground The benefits of a decreased slice thickness and/or in-plane voxel size in carotid MRI for atherosclerotic plaque component quantification accuracy and biomechanical peak cap stress analysis have not yet been investigated in detail because of practical limitations. Methods In order to provide a methodology that allows such an investigation in detail, numerical simulations of a T1-weighted, contrast-enhanced, 2D MRI sequence were employed. Both the slice thickness (2 mm, ...

  1. A computer-simulation study on the effects of MRI voxel dimensions on carotid plaque lipid-core and fibrous cap segmentation and stress modeling

    OpenAIRE

    Nieuwstadt, H.A.; Kassar, Z.A.M.; van der Lugt, A.; Breeuwer, M.; van der Steen, A. F. W.; Wentzel, J.J.; Gijsen, F. J. H.

    2015-01-01

    Background The benefits of a decreased slice thickness and/or in-plane voxel size in carotid MRI for atherosclerotic plaque component quantification accuracy and biomechanical peak cap stress analysis have not yet been investigated in detail because of practical limitations. Methods In order to provide a methodology that allows such an investigation in detail, numerical simulations of a T1-weighted, contrast-enhanced, 2D MRI sequence were employed. Both the slice thickness (2 mm, 1 mm, and 0....

  2. A Computer-Simulation Study on the Effects of MRI Voxel Dimensions on Carotid Plaque Lipid-Core and Fibrous Cap Segmentation and Stress Modeling

    OpenAIRE

    2015-01-01

    Background The benefits of a decreased slice thickness and/or in-plane voxel size in carotid MRI for atherosclerotic plaque component quantification accuracy and biomechanical peak cap stress analysis have not yet been investigated in detail because of practical limitations. Methods In order to provide a methodology that allows such an investigation in detail, numerical simulations of a T1-weighted, contrast-enhanced, 2D MRI sequence were employed. Both the slice thickness (2 mm, 1 mm, and 0....

  3. Early complement activation follows eversion carotid endarterectomy and correlates with the time of clamping of the carotid artery

    DEFF Research Database (Denmark)

    Széplaki, Gábor; Hirschberg, Kristóf; Gombos, Tímea;

    2008-01-01

    intense increase in C3a levels were observed immediately after surgery (p<0.001), accompanied by a slight elevation in SC5b-9 levels (p<0.05). C3a levels remained elevated until 4h post-surgery, compared with the baseline values and with CAS patients. Peak C3a levels correlated with the time of carotid......BACKGROUND: Complement activation plays an important role in ischemia/reperfusion (I/R) injury. The objective of the present study was to detect the presence and mechanism of complement activation in patients who underwent carotid endarterectomy (CEA). METHODS: Complement activation products C1rsC1...

  4. 64Cu-DOTATATE PET/MRI for detection of activated macrophages in carotid atherosclerotic plaques

    DEFF Research Database (Denmark)

    Pedersen, Sune Folke; Sandholt, Benjamin Vikjær; Keller, Sune Høgild;

    2015-01-01

    selected markers of plaque vulnerability using real-time quantitative polymerase chain reaction. These results were compared with in vivo 64Cu-DOTATATE uptake calculated as the mean standardized uptake value. Univariate analysis of real-time quantitative polymerase chain reaction and PET showed that...... cluster of differentiation 163 (CD163) and CD68 gene expression correlated significantly but weakly with mean standardized uptake value in scans performed 85 minutes post injection (P<0.001 and P=0.015, respectively). Subsequent multivariate analysis showed that CD163 correlated independently with 64Cu...

  5. Relevance analysis of health behaviors and influencing factors for detection rate of carotid atherosclerotic plaque%影响颈动脉斑块检出率的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    蒋树中; 刘茹; 韩冰

    2014-01-01

    Objective To explore the relevance of health behaviors and influencing factors for detection rate of carotid plaques to prevent the formation of carotid plaque.Methods A total of 2 628 healthy subjects aged over 40 years were selected randomly from Department of Cardiology at our hospital from 2009-2010.A questionnaire survey was conducted on age , education level, marriage, occupation, income, diet, living habits and lifestyle factors.Logistic regression analysis was made for the influencing factors of internal carotid artery plaque.Results Single factor analysis showed that gender , age, smoking rate, fasting blood glucose , blood pressure , carotid artery intima-media thickness ( intima-media thickness , IMT), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol ( LDL-C ) had significant effects on plaque formation.Multivariate Logistic regression analysis showed that gender , age, TG, LDL-C, HDL-C and number of health behaviors were the major influencing factors for the formation of carotid plaque.Compared with the 5 ideal cardiovascular health behaviors/factors and occurrence of carotid plaques were 0.65, 0.45, 0.39 and 0.29 respectively.Conclusions The formation of carotid plaque is affected by many factors.The number of ideal cardiovascular health behaviors is negatively correlated with plaque formation and it can prevent the occurrence of carotid plaque .%目的:探讨影响颈内动脉斑块检出率的相关健康行为和相关因素。方法选取2009-2010年间在江苏省徐州市心血管病研究所心内科进行健康体检的人员作为研究对象。采用分层随机抽样的方法从中抽取40岁以上2628例纳入研究。制定调查问卷,并对年龄、文化程度、婚姻、职业、经济收入、饮食习惯、生活习惯、生活行为因素进行调查。应用Logistic回归分析对影响颈内动脉斑块的因素进行统计分析。结果单因素

  6. Carotid intima-media thickness correlation with lipid profile in patients with familial hypercholesterolemia versus controls

    International Nuclear Information System (INIS)

    To determine the variations in carotid intima-media thickness (CIMT) in familial hypercholesterolemia (FH) patients and its use as predictive marker for premature cardiovascular diseases. Familial hypercholesterolemia was clinically diagnosed by premature coronary diseases, xanthomas, arcus cornealis and family history of premature coronary heart diseases. Controls were age matched normal individuals without hypercholesterolemia. Their lipid profile was tested after overnight fasting. CIMT was measured in mm using B-mode ultrasonography using linear probe. Student t-test was applied to compare mean CIMT of cases and the control. The mean CIMT values of the FH cases were correlated with LDL using Pearson's correlation test. Forty cases with hypercholesterolemia gave consent to participate in the study. These patients had total cholesterol 200 mg/dL and LDL 160 mg/dL as compared to twenty controls of similar age with total cholesterol ? 200 mg/dL and LDL 130 mg/dL. Mean CIMT for the cases was 0.77 + 0.18 mm while mean CIMT for control was 0.59 + 0.08 mm. The mean CIMT for the cases ranged from 0.7-1.83 mm and 0.48-0.73 mm for controls. Among the FH cases, 25% (n=11) had arterial plaques. Mean CIMT was significantly correlated to LDL-cholesterol (r 0.725**, p < 0.001). In this study, CIMT was found to be significantly increased in familial hypercholesterolemia and it correlated with raised LDL-cholesterol. Both are predictive of premature cardiovascular diseases. (author)

  7. Correlation between Plaque Composition as assessed by Virtual Histology and C-reactive Protein

    International Nuclear Information System (INIS)

    Previous studies have shown that coronary plaque composition plays a pivotal role in plaque instability, and imaging modalities and serum biomarkers have been investigated to identify vulnerable plaque. Virtual histology IVUS (VH-IVUS) characterizes plaque components as calcified, fibrotic, fibrofatty, or necrotic core. C-reactive protein (hsCRP) is an independent risk factor and a powerful predictor of future coronary events. However, a relationship between inflammatory response indicated by CRP and plaque characteristics in ACS patients remains not well established. To determine, by using VH-IVUS, the relation between coronary plaque components and plasma high-sensitivity CRP levels in patients with acute coronary syndromes (ACS). 52 patients with ACS were enrolled in this prospective study. Electrocardiographically-gated VH-IVUS were performed in the culprit lesion before PCI. Blood sample was drawn from all patients before the procedure and after 24 hours, and hs-CRP levels were determined. Mean age was 55.3±4.9 years, 76.9% were men and 30.9% had diabetes. Mean MLA was 3.9±1.3 mm2, and plaque burden was 69±11.3%, as assessed by IVUS. VH-IVUS analysis at the minimum luminal site identified plaque components: fibrotic (59.6±15.8%), fibrofatty (7.6±8.2%), dense calcium (12.1±9.2%) and necrotic core (20.7±12.7%). Plasma hs-CRP (mean 16.02±18.07 mg/L) did not correlate with necrotic core (r=-0.089, p = 0.53) and other plaque components. In this prospective study with patients with ACS, the predominant components of the culprit plaque were fibrotic and necrotic core. Serum hs C-reactive protein levels did not correlate with plaque composition

  8. Correlation between Plaque Composition as assessed by Virtual Histology and C-reactive Protein

    Energy Technology Data Exchange (ETDEWEB)

    Siqueira, Dimytri Alexandre de Alvim, E-mail: dimytri@cardiol.br; Sousa, Amanda Guerra Moraes R.; Costa Junior, José de Ribamar; Costa, Ricardo Alves da; Staico, Rodolfo; Tanajura, Luis Fernando Leite; Centemero, Marinella Patrizia; Feres, Fausto; Abizaid, Alexandre Antonio Cunha; Sousa, J. Eduardo Moraes R. [Instituto Dante Pazzanese de Cardiologia, São Paulo, SP (Brazil)

    2013-07-15

    Previous studies have shown that coronary plaque composition plays a pivotal role in plaque instability, and imaging modalities and serum biomarkers have been investigated to identify vulnerable plaque. Virtual histology IVUS (VH-IVUS) characterizes plaque components as calcified, fibrotic, fibrofatty, or necrotic core. C-reactive protein (hsCRP) is an independent risk factor and a powerful predictor of future coronary events. However, a relationship between inflammatory response indicated by CRP and plaque characteristics in ACS patients remains not well established. To determine, by using VH-IVUS, the relation between coronary plaque components and plasma high-sensitivity CRP levels in patients with acute coronary syndromes (ACS). 52 patients with ACS were enrolled in this prospective study. Electrocardiographically-gated VH-IVUS were performed in the culprit lesion before PCI. Blood sample was drawn from all patients before the procedure and after 24 hours, and hs-CRP levels were determined. Mean age was 55.3±4.9 years, 76.9% were men and 30.9% had diabetes. Mean MLA was 3.9±1.3 mm{sup 2}, and plaque burden was 69±11.3%, as assessed by IVUS. VH-IVUS analysis at the minimum luminal site identified plaque components: fibrotic (59.6±15.8%), fibrofatty (7.6±8.2%), dense calcium (12.1±9.2%) and necrotic core (20.7±12.7%). Plasma hs-CRP (mean 16.02±18.07 mg/L) did not correlate with necrotic core (r=-0.089, p = 0.53) and other plaque components. In this prospective study with patients with ACS, the predominant components of the culprit plaque were fibrotic and necrotic core. Serum hs C-reactive protein levels did not correlate with plaque composition.

  9. Lumen segmentation and motion estimation in B-mode and contrast-enhanced ultrasound images of the carotid artery in patients with atherosclerotic plaque.

    Science.gov (United States)

    Carvalho, Diego D B; Akkus, Zeynettin; van den Oord, Stijn C H; Schinkel, Arend F L; van der Steen, Antonius F W; Niessen, Wiro J; Bosch, Johan G; Klein, Stefan

    2015-04-01

    In standard B-mode ultrasound (BMUS), segmentation of the lumen of atherosclerotic carotid arteries and studying the lumen geometry over time are difficult owing to irregular lumen shapes, noise, artifacts, and echolucent plaques. Contrast enhanced ultrasound (CEUS) improves lumen visualization, but lumen segmentation remains challenging owing to varying intensities, CEUS-specific artifacts and lack of tissue visualization. To overcome these challenges, we propose a novel method using simultaneously acquired BMUS&CEUS image sequences. Initially, the method estimates nonrigid motion (NME) from the image sequences, using intensity-based image registration. The motion-compensated image sequence is then averaged to obtain a single "epitome" image with improved signal-to-noise ratio. The lumen is segmented from the epitome image through an intensity joint-histogram classification and a graph-based segmentation. NME was validated by comparing displacements with manual annotations in 11 carotids. The average root mean square error (RMSE) was 112±73 μm . Segmentation results were validated against manual delineations in the epitome images of two different datasets, respectively containing 11 (RMSE 191±43 μm) and 10 (RMSE 351±176 μm ) carotids. From the deformation fields, we derived arterial distensibility with values comparable to the literature. The average errors in all experiments were in the inter-observer variability range. To the best of our knowledge, this is the first study exploiting combined BMUS&CEUS images for atherosclerotic carotid lumen segmentation. PMID:25423650

  10. The influence of constitutive law choice used to characterise atherosclerotic tissue material properties on computing stress values in human carotid plaques.

    Science.gov (United States)

    Teng, Zhongzhao; Yuan, Jianmin; Feng, Jiaxuan; Zhang, Yongxue; Brown, Adam J; Wang, Shuo; Lu, Qingsheng; Gillard, Jonathan H

    2015-11-01

    Calculating high stress concentration within carotid atherosclerotic plaques has been shown to be complementary to anatomical features in assessing vulnerability. Reliability of stress calculation may depend on the constitutive laws/strain energy density functions (SEDFs) used to characterize tissue material properties. Different SEDFs, including neo-Hookean, one-/two-term Ogden, Yeoh, 5-parameter Mooney-Rivlin, Demiray and modified Mooney-Rivlin, have been used to describe atherosclerotic tissue behavior. However, the capacity of SEDFs to fit experimental data and the difference in the stress calculation remains unexplored. In this study, seven SEDFs were used to fit the stress-stretch data points of media, fibrous cap, lipid and intraplaque hemorrhage/thrombus obtained from 21 human carotid plaques. Semi-analytic solution, 2D structure-only and 3D fully coupled fluid-structure interaction (FSI) analyses were used to quantify stress using different SEDFs and the related material stability examined. Results show that, except for neo-Hookean, all other six SEDFs fitted the experimental points well, with vessel stress distribution in the circumferential and radial directions being similar. 2D structural-only analysis was successful for all seven SEDFs, but 3D FSI were only possible with neo-Hookean, Demiray and modified Mooney-Rivlin models. Stresses calculated using Demiray and modified Mooney-Rivlin models were nearly identical. Further analyses indicated that the energy contours of one-/two-term Ogden and 5-parameter Mooney-Rivlin models were not strictly convex and the material stability indictors under homogeneous deformations were not always positive. In conclusion, considering the capacity in characterizing material properties and stabilities, Demiray and modified Mooney-Rivlin SEDF appear practical choices for mechanical analyses to predict the critical mechanical conditions within carotid atherosclerotic plaques. PMID:26472305

  11. Effect of calcification on the mechanical stability of plaque based on a three-dimensional carotid bifurcation model

    OpenAIRE

    Wong Kelvin KL; Thavornpattanapong Pongpat; Cheung Sherman CP; Sun Zhonghua; Tu Jiyuan

    2012-01-01

    Abstract Background This study characterizes the distribution and components of plaque structure by presenting a three-dimensional blood-vessel modelling with the aim of determining mechanical properties due to the effect of lipid core and calcification within a plaque. Numerical simulation has been used to answer how cap thickness and calcium distribution in lipids influence the biomechanical stress on the plaque. Method Modelling atherosclerotic plaque based on structural analysis confirms ...

  12. Increasing the Spatial Resolution of 3T Carotid MRI Has No Beneficial Effect for Plaque Component Measurement Reproducibility

    OpenAIRE

    van Wijk, Diederik F.; Strang, Aart C.; Duivenvoorden, Raphael; Enklaar, Dirk-Jan F.; Zwinderman, Aeilko H.; van der Geest, Rob J.; Kastelein, John J. P.; Groot, Eric; Stroes, Erik S. G.; Nederveen, Aart J.

    2015-01-01

    Purpose Different in-plane resolutions have been used for carotid 3T MRI. We compared the reproducibility, as well as the within- and between reader variability of high and routinely used spatial resolution in scans of patients with atherosclerotic carotid artery disease. Since no consensus exists about the optimal segmentation method, we analysed all imaging data using two different segmentation methods. Materials and Methods In 31 patient with carotid atherosclerosis a high (0.25 × 0.25 mm2...

  13. Correlation of restenosis after rabbit carotid endarterectomy and inflammatory cytokines

    Institute of Scientific and Technical Information of China (English)

    Jun-Jun Liang; Wei Xue; Li-Zhi Lou; Cheng Liu; Zhao-Fen Wang; Qing-Guo Li; Shao-Hua Huang

    2014-01-01

    Objective:To establish rabbit model of restenosis after carotid endarterectomy surgery, and to study tissue inflammatory cytokines(TNF-α,IL-6) involved in restenosis.Methods:A total of32 rabbits were randomly divided into two groups: model group and control group.The right common carotid artery in rabbits was damaged by carotid endar terectomy in model group.The tissues were harvested at different time points respectively, the pathological changes of the vascular wall after operation were observed at different time points.The changes of expression of tissue vascular wall inflammatory cytokines(TNF-α,IL-6) at different time points after the surgery was observed byRT-PCR, and the changes of serum inflammatory cytokines(TNF-α, IL -6) were detected byELISA.Results:The new intima appeared after7 daysof the injury and reached the peak on28 d which is uneven and significantly thicker than the control group (P<0.01).The tissue inflammatory cytokines(TNF-α,IL-6) were significantly increased after the rabbit common carotid artery injury, which was significant difference compared with normal control group(P<0.05).Conclusions:The tissue inflammatory factors significantly increase after the rabbit carotid artery injury, which suggests the mutual concurrent effects of inflammatory cytokines can result in the proliferation of vascular restenosis.

  14. Correlation Between the Intima-Media Thickness of the Proximal and Distal Common Carotids

    International Nuclear Information System (INIS)

    Increased IMT (intima-media thickness) in carotids is used as an early atherosclerosis marker and to evaluate the risk of cardiovascular problems. Ultrasound is used in the evaluation because it is accessible and low cost. Measurements for different carotid regions are described. To compare the proximal and distal region IMTs for the bilateral common carotid and guide its use in clinical practice. The IMT was measured in the proximal and distal common carotid arteries of 798 individuals (35-74 years old) of both genders using high-resolution ultrasound. Pearson's correlation coefficient was used to establish associations. The analyses were initially performed for the entire sample as well as subgroups with IMT <0.90 mm (49% of the sample) and ≥0.90 mm for at least one measurement site. The statistical significance was p < 0.05. The correlations investigated were significant. In the group with an IMT <0.90 mm, the correlations were between 0.44 and 0.62. In the subgroup with an IMT ≥0.90 mm, the correlations were significantly reduced to between 0.20 and 0.40. The data suggest that the IMT is more uniform along the carotid during early development and tends develop focally as it progresses. Therefore, in clinical evaluations of patients, the common carotid length should be investigated bilaterally to better use the available software and discern the IMT

  15. The effect of lipid regulation with atorvastatin on the blood lipid levels and carotid artery plaques in patients with atherosclerotic cerebral infarction

    Directory of Open Access Journals (Sweden)

    Shu XU

    2015-11-01

    Full Text Available Objective To analyze the effect of intensive lipid regulation treatment with atorvastatin on the blood lipid levels and carotid artery plaques in patients with atherosclerotic cerebral infarction.  Methods Ninety-two patients with atherosclerotic cerebral infarction were randomly divided into two groups: observation group (treated by atorvastatin calcium with the dosage of 20 mg/d, N = 46 and control group (treated by diet without lipid-rich food, N=46. Besides, other drugs given to the patients in two groups were the same. The blood lipid levels and the changes of carotid artery plaques in two groups were analyzed and compared before treatment and 3 months after treatment. Results After treatment, the concentrations of total cholesterol [TC, (4.23 ± 0.92 mmol/L vs (5.24 ± 0.68 mmol/L], triglyceride [TG, (2.46 ± 0.28 mmol/L vs (3.33 ± 0.47 mmol/L], low-density lipoprotein cholesterol [LDL-C, (2.52 ± 0.38 mmol/L vs (4.78 ± 0.86 mmol/L] in the patients of observation group were all decreased and significantly lower than those in the control group (P = 0.000, for all, and the concentration of high-density lipoprotein cholesterol [HDL-C, (1.13 ± 0.41 mmol/L vs (0.85 ± 0.32 mmol/L] in the patients of observation group was increased and significantly than that in the control group (P = 0.003. The carotid artery plaque size [(20.25 ± 0.32 mm2 vs (24.42 ± 10.33 mm2] and thickness [(0.59 ± 0.13 mm vs (1.93 ± 0.23 mm] of carotid artery plaques and intima?media thickness [IMT, (1.32 ± 0.67 mm vs (1.63 ± 0.56 mm] of common carotid artery (CCA in the patients of observation group were all significantly lower than those in patients in the control group (P = 0.000, 0.000, 0.010, respectively. Comparing serum alanine aminotransferase (ALT, aspartate aminotransferase (AST, creatine kinase (CK and creatinine (Cr levels after treatment with before treatment, there was no significant difference between 2 groups (P > 0.05, for all.  Conclusions

  16. An objective method to optimize the MR sequence set for plaque classification in carotid vessel wall images using automated image segmentation.

    Science.gov (United States)

    van 't Klooster, Ronald; Patterson, Andrew J; Young, Victoria E; Gillard, Jonathan H; Reiber, Johan H C; van der Geest, Rob J

    2013-01-01

    A typical MR imaging protocol to study the status of atherosclerosis in the carotid artery consists of the application of multiple MR sequences. Since scanner time is limited, a balance has to be reached between the duration of the applied MR protocol and the quantity and quality of the resulting images which are needed to assess the disease. In this study an objective method to optimize the MR sequence set for classification of soft plaque in vessel wall images of the carotid artery using automated image segmentation was developed. The automated method employs statistical pattern recognition techniques and was developed based on an extensive set of MR contrast weightings and corresponding manual segmentations of the vessel wall and soft plaque components, which were validated by histological sections. Evaluation of the results from nine contrast weightings showed the tradeoff between scan duration and automated image segmentation performance. For our dataset the best segmentation performance was achieved by selecting five contrast weightings. Similar performance was achieved with a set of three contrast weightings, which resulted in a reduction of scan time by more than 60%. The presented approach can help others to optimize MR imaging protocols by investigating the tradeoff between scan duration and automated image segmentation performance possibly leading to shorter scanning times and better image interpretation. This approach can potentially also be applied to other research fields focusing on different diseases and anatomical regions. PMID:24194941

  17. Correlation analysis between the carotid artery ather osclerosis severity of patients with lacunar infarct and the level of serum uric acid, high-sensitivity C-reactive protein

    Directory of Open Access Journals (Sweden)

    WANG Shu

    2013-01-01

    Full Text Available Background Nowadays, clinical practice shows that the number of patients with cerebral infarction increases year by year in young and middle-aged adults with unclear causes. This paper aims to investigate the correlation between the level of serum uric acid (UA, high-sensitivity C-reactive protein (hsCRP and the degree of carotid atherosclerosis by detecting the level of UA, hsCRP and carotid intima-media thickness (IMT in young and middle-aged patients with lacunar infarct. Methods By using Holland Philips HT-11 color Doppler ultrasonic diagnostic apparatus with linear type probe and 7.50MHz frequency, IMT of end-diastolic distal and bifurcation of arteria carotis communis and proximal internal carotid artery were measured respectively on 186 patients with definitely diagnosed lacunar infarct. As a result, average values were taken as the IMT values. IMT < 1.00 mm was regarded as negative result and 1.00 mm ≤IMT < 1.20 mm was thickening of carotid artery intima. Carotid artery plaque formation was regarded with echo structure existing in the lumen or abnormal blood flow deficits into the lumen, or local IMT ≥1.20 mm at vertical and horizontal scan. At the same time, the levels of UA and hsCRP were detected, and correlation analysis was made between them and IMT. Results The values of UA, hsCRP and IMT in the case group were higher than that in the control group (P = 0.000. The differences among the case subgroups including IMT thickening group, plaque formation group and IMT normal group were statistically significant (P < 0.01, for all. There was linear correlation between the levels of UA, hsCRP and IMT ( r = 0.923, P = 0.000; r = 0.955, P = 0.008. Conclusion UA and hsCRP involve in the formation of atherosclerosis plaque and play an important role in the first-onset lacunar infarct patients without hypertension and other risk factors.

  18. 血浆同型半胱氨酸水平与缺血性脑血管病患者颈动脉粥样硬化斑块的相关性研究%Relationship of plasma homocysteine and carotid atherosclerotic plaque in patients with ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    李世敬; 金亚娟; 赵玉燕

    2016-01-01

    目的:研究血浆同型半胱氨酸水平和缺血性脑血管病患者颈动脉粥样硬化斑块的相关性。方法:选择2014年10月~2015年11月在我院进行诊治的缺血性脑血管病患者500例,进行颈动脉彩色多普勒超声检查后,根据超声结果分为无斑块组(106例)、不稳定斑块组(261例)与稳定斑块组(133例),检测血浆同型半胱氨酸水平,并分析其与颈动脉粥样硬化斑块的相关性。结果:500例患者中发现无斑块106例(21.2%),颈动脉斑块394例(78.8%);稳定斑块组和不稳定斑块组的血浆同型半胱氨酸水平较无斑块组明显升高;不稳定斑块组与稳定斑块组相比,同型半胱氨酸水平均明显升高;易损斑块组血浆同型半胱氨酸浓度和高同型半胱氨酸血症发生率均明显高于非易损斑块组;Logistic 回归分析结果显示同型半胱氨酸的水平与颈动脉硬化斑块呈正性相关关系,OR 为1.23,95% CI 为1.021.22,差异有统计学意义。结论:颈动脉斑块的形成及其稳定性与同型半胱氨酸水平关系紧密,同型半胱氨酸水平升高是颈动脉斑块形成的独立危险因子。%Objective To investigate the relationship of plasma homocysteine and carotid atherosclerotic plaque in patients with ischemic cerebrovascular disease. Methods Selected 5000 cases of patients with ischemic cerebrovascular disease who were treated in our hospital from September 2014 to November 2015. According to the results of carotid color Doppler ultra-sound examination, divided into no plaque group (106 cases), unstable plaque group (261 cases) and stable plaque group (133 cases). Detected the levels of plasma homocysteine and analyzed their correlation with carotid atherosclerosis plaque. Results Of the 500 patients, 106 patients (21.2%) had no plaque, and 394 patients (78.8%) had carotid plaques no plaque was found in 106 cases(21.2%), 394 cases (78.8%) of carotid

  19. New insight of molecular imaging into the atheroma biology: (18)F-fluoride PET/CT and 18F-FDG PET/CT of 3 carotid plaques in a symptomatic neurologic patient.

    Science.gov (United States)

    Quirce, Remedios; Banzo, Ignacio; Martínez-Rodríguez, Isabel; Jiménez-Bonilla, Julio F; Rebollo, Mariano; Rubio-Vassallo, Adriana; Carril, José M

    2013-06-01

    In a 75-year-old patient admitted with a middle cerebral artery stroke, a contrast-enhanced CT showed 3 atheroma plaques. Five days after the stroke, a F-fluoride PET/CT to evaluate calcification and, 24 hours later, a F-FDG PET/CT to evaluate inflammation were carried out. The different metabolic behavior of both radiotracers, showing different intensities and distribution in each plaque, may represent different phases of the atherogenesis and in combination could provide new information for the early identification of the carotid unstable plaque. PMID:23579977

  20. Selective expansion of influenza A virus-specific T cells in symptomatic human carotid artery atherosclerotic plaques

    OpenAIRE

    Keller, Tymen; Meer, Jelger; Teeling, Peter; Sluijs, Koenraad; Idu, Mirza; Rimmelzwaan, Guus; Levi, Michael; Wal, Allard; Boer, Onno

    2008-01-01

    textabstractBACKGROUND AND PURPOSE - Evidence is accumulating that infection with influenza A virus contributes to atherothrombotic disease. Vaccination against influenza decreases the risk of atherosclerotic syndromes, indicating that inflammatory mechanisms may be involved. We tested the hypothesis that influenza A virus-specific T cells contribute to atherosclerotic plaque inflammation, which mediates the onset of plaque rupture. METHODS - T-cell cultures were generated from atheroscleroti...

  1. Clinical Study on Effect of Garlicin in Stabilizing the Carotid Artery Atherosclerotic Plaque in Patients with Primary Hypertension and Coronary Artery Disease

    Institute of Scientific and Technical Information of China (English)

    CHENG Wen-li; KE Yuan-nan; SHI Zai-xiang; WANG Ying; CHEN Li; JU Gao; FAN Shu-ying

    2006-01-01

    Objective: To investigate the effect of garlicin in treating carotid artery atherosclerotic plaque (CAAP) in patients with primary hypertension and coronary heart disease (PHT-CHD). Methods: Seventynine patients with PHT-CHD were randomly divided into the treated group (39 patients) treated with garlicin and fosinopril and the control group (40 patients) treated with fosinopril alone. The change of CAAP was evaluated by high frequency ultrasonic examination every six months, and the changes of intercellular adhesion molecule-1 (ICAM-1) and high sensitive C-reactive protein (hs-CRP) were measured by ELISA, with the observation proceeding for 52 weeks totally. Results: By the end of the experiment, the number of complex plaques, Crouse integrals, intima-media thickness, serum ICAM-1 and hs-CRP were significantly lower in the treated group than those in the control group with significant difference (P<0.05). Conclusion; Garlicin could stabilize CAAP to a certain extent and shows a definite vascular protective effect in patients with PHT-CHD.

  2. Human coronary plaque wall thickness correlated positively with flow shear stress and negatively with plaque wall stress: an IVUS-based fluid-structure interaction multi-patient study

    OpenAIRE

    Fan, Rui; Tang, Dalin; Yang, Chun; Zheng, Jie; Bach, Richard; WANG, LIANG; Muccigrosso, David; Billiar, Kristen; Zhu, Jian; Ma, Genshan; Maehara, Akiko; Mintz, Gary S

    2014-01-01

    Background Atherosclerotic plaque progression and rupture are believed to be associated with mechanical stress conditions. In this paper, patient-specific in vivo intravascular ultrasound (IVUS) coronary plaque image data were used to construct computational models with fluid-structure interaction (FSI) and cyclic bending to investigate correlations between plaque wall thickness and both flow shear stress and plaque wall stress conditions. Methods IVUS data were acquired from 10 patients afte...

  3. Prevalence of carotid artery calcification in postmenopausal women and its correlation with atherogenic risk factors

    OpenAIRE

    Patil, Santosh R.

    2015-01-01

    Aim: The aim of the present study was to determine the prevalence of carotid artery calcification (CAC) in postmenopausal females on panoramic radiographs and to study the correlation of CAC with possible risk factors such as hypertension, osteoporosis, and hypercholesterolemia, among others. Materials and Methods: Totally, 1214 panoramic radiographs of postmenopausal females attending the Department of Oral Medicine and Radiology were examined for the presence of CAC. The subjects were also ...

  4. High-normal blood pressure and carotid atherosclerotic plaque formation: The results from stroke population screening in Dongying, Shandong province%正常高值血压与颈动脉粥样硬化斑块形成:来自山东东营卒中筛查人群的结果

    Institute of Scientific and Technical Information of China (English)

    吴德云; 刘迎春; 高宗恩; 李楠; 杨志杰

    2014-01-01

    目的 探讨不同血压水平与颈动脉粥样斑块形成的相关性.方法 从2012年9月至2013年1月期间参加东营市卒中筛查的人群中,选取符合理想血压[收缩压(systolic blood pressure,SBP)< 120 mm Hg且舒张压(diastolic blood pressure,DBP)< 80 mm Hg,1 mm Hg =0.133 kPa]、正常血压[SBP 120~129 mm Hg和(或)DBP 80 ~84 mm Hg]和正常高值血压[SBP 130~139 mm Hg和(或)DBP 85~89 mm Hg]诊断标准的人群为研究对象,进行间卷调查、体格检查、血生化检查及颈部血管超声检查.比较正常血压组、正常高值血压组与理想血压组之间颈动脉斑块检出率,进行多变量logistic回归分析确定颈动脉斑块的独立危险因素.结果 正常血压组和正常高值血压组男性和糖尿病的构成比以及体质指数(body mass index,BMI)和空腹血糖(fasting blood glucose,FBG)水平均显著性高于理想血压组(P均<0.05).理想血压组、正常血压组和正常高值血压组颈动脉斑块检出率分别为12.41%、38.14%和49.45%.颈动脉斑块形成组男性构成比以及年龄、SBP、FBG和高半胱氨酸(homocysteine,Hcy)水平均显著性高于无颈动脉斑块形成组(P均<0.05).多变量logistic回归分析显示,年龄、SBP、FBG和Hcy为颈动脉粥样斑块形成的独立危险因素,女性为独立保护因素.在校正性别、年龄、FBG和Hcy等危险因素后,正常高值血压组斑块形成风险显著性高于理想血压组(优势比1.354,95%可信区间1.028~1.783;P=0.031),而正常血压组与理想血压组无显著性差异.结论 正常高值血压与颈动脉斑块形成风险增高显著相关,是颈动脉斑块形成的独立危险因素.%Objective To investigate the correlation between different blood pressure levels and carotid atherosclerotic plaque formation.Methods The population participated in stroke screening were selected from September 2012 to January 2013 in Dongying,Shandong province.The subjects met the

  5. Plasma Homocysteine Levels Predict the Risk of Acute Cerebral Infarction in Patients with Carotid Artery Lesions.

    Science.gov (United States)

    Wu, Wei; Guan, Yi; Xu, Kan; Fu, Xi-Jia; Lei, Xiao-Feng; Lei, Li-Jian; Zhang, Zhi-Qing; Cheng, Yan; Li, Yun-Qian

    2016-05-01

    This study examined the association between elevated plasma homocysteine (Hcy) levels and the risk of acute cerebral infarction in patients with carotid artery lesions. A total of 78 patients were divided into two groups, the high Hcy group (n = 38; Hcy levels >15 umol/L) and the low Hcy group (n = 40; Hcy levels ≤15 umol/L). High-resolution B-mode ultrasounds were performed to assess intima media thickness (IMT), infarcts, plaques, and stenosis in the extracranial carotid artery of these patients. All patients underwent 3 T MR scanners to evaluate cerebral artery stenosis in the intracranial cerebral artery. The plasma Hcy levels did not show any statistically significant differences when comparisons were based on gender, age, blood pressure, diabetes, hyperlipidemia, and systolic and diastolic pressures. Importantly, the incidence of carotid plaque and severe stenosis of intracranial and extracranial artery were significantly higher in the high Hcy group compared to the low Hcy group. Pearson's test indicated that plasma Hcy levels positively correlated with IMT, total number of plaques and unstable plaques. Overall, the elevated plasma Hcy levels correlated with increased frequency of carotid plaque formation, extra- and intracranial arterial stenosis, and the degree of stenosis. In conclusion, we find a significant correlation between elevated plasma Hcy levels and the increased incidence of acute cerebral infarction in patients with carotid artery lesions. PMID:26063590

  6. Measurement of carotid artery stenosis: correlation analysis between B-mode ultrasonography and contrast arteriography

    OpenAIRE

    Lee, Kyo Won; Park, Yang Jin; Rho, Young-Nam; Kim, Dong-Ik; Kim, Young-Wook

    2011-01-01

    Purpose To evaluate the efficacy of B-mode ultrasonography (US) in measurement of carotid stenosis% (CS%). Methods One hundred and thirth-three carotid arteries in 96 patients who underwent both carotid US and carotid arteriography (CA) were included in this retrospective study. To measure CS% on US, a cross sectional view of the most stenotic segment of the internal carotid artery was captured and residual diameter and original diameter of that segment were measured with electronic caliper o...

  7. STUDY OF CAROTID INTIMA MEDIA THICKNESS IN PATIENTS WITH ACUTE ISCHEMIC STROKE AND ITS CORRELATION WITH RISK FACTORS OF ISCHEMIC STROKE - A CASE CONTROL STUDY

    Directory of Open Access Journals (Sweden)

    Rajeev

    2013-10-01

    Full Text Available ABSTRACT: Stroke is the leading cause of mortality worldwide. Carotid Intima Media Thickness (CIMT is a marker of atherosclerosis and is also a marker for ischemic stroke. AIMS: 1 To assess the value of carotid intima media thickness at which patients with risk factors can develop acute ischemic stroke. 2 To correlate carotid intima media thickness with risk factors of acute ischemic stroke. MATERIAL & METHODS: This study was done at KIMS Hospital, Bangalore between December 2010 to September 2012. This is a case control observational study which has a sample size of 50 cases and 50 controls. Method of collection of data was by patient evaluation which was done by taking detailed history, clinical examination and laboratory investigations throu gh a proforma specially designed for this study. Cases were subjects who had ischemic stoke and Infarct proven by CT/MRI of brain, Controls were subjects without stroke matched to cases by age, gender and risk factors like diabetes, hypertension, smoking a nd dyslipidemia. S ubjects in both groups underwent carotid Doppler investigation with 7.5 Mhz linear superficial array probe to determine CIMT and presence of plaques. RESULTS: Out of 50 cases, 46 had CIMT between 0.06 - 0.20 cm [92%] and out of 50 controls, 45 had CIMT between 0.06 - 0.20 cm[90%]. Most of our cases had CIMT above 0.06 cm, so we can hypothesize that people with risk factors having CIMT above 0.06 cm are more prone for ischemic cerebro vascular accidents. Mean CIMT in cases with risk factors is significantly increased when compared to controls with risk factors. CONCLUSION: People with risk factors [ age > 50 years, DM , HTN , Smoking and Dyslipidemia] having CIMT above 0.06 cm are more prone for ischemic CVA, so people with risk factors should u ndergo screening for CIMT measurement by Carotid Doppler which is non invasive and cost effective and if their CIMT is above 0.06 cm they should undergo early medical intervention to take care

  8. Correlation of Color Doppler with Multidetector CT Angiography Findings in Carotid Artery Stenosis

    Directory of Open Access Journals (Sweden)

    Živorad N. Savic

    2010-01-01

    Full Text Available The aim of this paper was to examine the correlation between the Color Doppler ultrasound (CD-US and multidetector CT angiography (MDCTA diagnostic methods, and to define the degree and extent of stenosis in patients with internal carotid artery stenosis. This was a cross-sectional study with a consecutive series of patients. All US examinations were always carried out by the same physician-angiologist, while all CT examinations were always carried out by the same physician-radiologist. Both worked independently from each other. The stenosis area was measured at the narrowest point by NASCET criteria for US/CT. Peak systolic velocity (PSV over 210 cm/sec and end diastolic velocity (EDV over 110 cm/sec criteria were applied for stenoses with lumen narrowed over 70%, while PSV under 130 cm/sec and EDV under 100 cm/sec criteria were applied for those with lumen narrowed under 70%. A total of 124 carotid arteries were observed; namely, 89 narrowed and 68 surgically treated. All patients were reviewed by US and then by MDCTA; patients with 70–99% stenosis underwent surgery. The correlation coefficient between stenosis degree measured by US and MDCTA was 0.922; p 0.05. The US and CT matching level for stenoses from 70 to 99% was very high (κ = 0.778, p < 0.01. In conclusion, there is a highly significant statistical correlation among both diagnostic methods when measuring stenosis degree and extent. US is more dependent on the physician, while MDCTA is more objective and independent from the physician. We think it would be appropriate to undertake an MDCTA exam for those patients who are candidates for carotid endarterectomy.

  9. 中老年人群颈动脉斑块的检出率及其影响因素%The detection rate and influential factors of carotid artery plaque in the elderly population

    Institute of Scientific and Technical Information of China (English)

    李雯; 周勇; 刘雪梅; 刘秀荣; 吴寿岭; 赵性泉; 朱颖

    2012-01-01

    目的 探讨中老年人群颈动脉斑块的检出情况及影响因素.方法 随机分层抽取唐山开滦(集团)有限责任公司≥40岁、既往无脑卒中、短暂性脑缺血发作(TIA)、心肌梗死的在职及离退休职工共6330人为调查对象,进行统一问卷调查、血液生化及颈动脉超声检查,并对相关危险因素进行多因素Logistic回归分析.结果 研究人群中颈动脉斑块的检出率为41.3%,不稳定斑块检出率为22.1%,稳定斑块的检出率为19.2%.随着年龄的增长颈动脉斑块检出率增加(P<0.01).多因素分析结果提示:男性、高龄(50~<60,60~<70,≥70岁)、高收缩压、高空腹血糖、高低密度脂蛋白胆固醇(LDL-C)是稳定斑块的危险因素,其OR值分别为1.774、2.357、4.191、8.968、1.751、1.499、1.446;男性、高龄(50~<60,60~<70,≥70岁)、高收缩压、高空腹血糖、高三酰甘油、吸烟是不稳定斑块的危险因素,其OR值分别为2,017、3.570、10.776、48.526、1.777、1.974、1.614、1.616.结论 中老年人群中颈动脉斑块的检出率为41.3%.颈动脉稳定斑块的影响因素为:性别、高龄、收缩压、空腹血糖、LDL-C.颈动脉不稳定斑块的影响因素为:性别、年龄、收缩压、空腹血糖、三酰甘油、吸烟.%Objective To study the detection rate and influential factors of carotid artery plaque in the elderly population. Methods A total of 6330 employees being employed retired from Tangshan Kailuan company who were beyond 40 years old were identified to take part in the study through stratified random sampling. Subjects with previous stroke, transient ischemic attack (TIA), myocardial infarction were excluded. All information were obtained from the unified questionnaire, measure of blood biochemistry and carotid artery ultrasonography. Multivariate Logistic regression analysis was used to analyze the factors affect the carotid artery plaque. Results The detection rate of

  10. Increased ADRP expression in human atherosclerotic lesions correlates with plaque instability

    OpenAIRE

    Xu, Bin; Zhao, Huiying; Wang, Shengnan; Sun, Xiwei; Qin, Xiujiao

    2015-01-01

    Adipose differentiation-related protein (ADRP) is intrinsically associated with the surface of lipid droplets implicated in the development of atherosclerosis. We analyzed expression of ADRP in human popliteal artery plaques. Atherosclerotic plaque tissue from the popliteal artery was obtained from 18 patients undergoing lower extremity amputation for arteriosclerosis obliterans, and with either stable (n = 6) or unstable (n = 12) atherosclerotic plaques. Plaques were histologically classifie...

  11. The stability of the atherosclerotic plaque depends on the extent of injured endothelium: results from a novel model of ischemia /reperfusion induced atherosclerosis in carotid artery of rats

    Institute of Scientific and Technical Information of China (English)

    晋学庆

    2014-01-01

    Objective To observe the atherogenic lesion progress in a novel ischemia/reperfusion induced atherosclerosis model in the carotid artery of rats.Methods Rats were divided into normal control,sham-operated control and ischemia-reperfusion injury(IRI)groups(n=10each).IRI was induced by 30 min carotid artery occlusion with a 2 cm

  12. Prevalence of carotid and pulp calcifications: a correlation using digital panoramic radiographs

    International Nuclear Information System (INIS)

    To compare the prevalence of pulp calcification with that of carotid calcification using digital panoramic dental radiographs. Digital panoramic radiographs of patients at a dental oncology clinic were included if (1) the carotid artery bifurcation region was visible bilaterally and (2) the patient had non-restored or minimally restored molars and/or canines. An endodontist evaluated the images for pulpal calcifications in the selected teeth. An oral and maxillofacial radiologist independently evaluated the same images for calcifications in the carotid bifurcation region. Odds-ratio and Pearson χ2 were used for data analysis. Presence of pulpal calcification was also evaluated as a screening test for the presence of carotid calcification. A total of 247 panoramic radiographs were evaluated. 32% (n=80) had pulpal calcifications and 25% (n=61) had carotid calcifications with 12% (n=29) having both carotid and pulp calcifications. A significantly higher prevalence of both pulp and carotid calcification was found in subjects older than age 60 years compared to younger age groups. Accuracy of pulpal calcification in screening for carotid calcification was 66.4%. Both pulp and carotid calcifications were more prevalent in older individuals. The presence of pulp calcification was not a strong predictor for the presence of carotid calcification. (orig.)

  13. Prevalence of carotid and pulp calcifications: a correlation using digital panoramic radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Clark, Stephen J. [School of Dentistry, University of Louisville, Department of Periodontics, Endodontics and Dental Hygiene, Louisville, KY (United States); Scheetz, James P.; Khan, Zafrulla [University of Louisville, Department of Diagnostic Sciences, Prosthodontics and Restorative Dentistry, School of Dentistry, Louisville, KY (United States); Farman, Allan G. [School of Dentistry, University of Louisville, Department of Periodontics, Endodontics and Dental Hygiene, Louisville, KY (United States); Horsley, Scott H.; Beckstrom, Brice

    2009-03-15

    To compare the prevalence of pulp calcification with that of carotid calcification using digital panoramic dental radiographs. Digital panoramic radiographs of patients at a dental oncology clinic were included if (1) the carotid artery bifurcation region was visible bilaterally and (2) the patient had non-restored or minimally restored molars and/or canines. An endodontist evaluated the images for pulpal calcifications in the selected teeth. An oral and maxillofacial radiologist independently evaluated the same images for calcifications in the carotid bifurcation region. Odds-ratio and Pearson {chi}{sup 2} were used for data analysis. Presence of pulpal calcification was also evaluated as a screening test for the presence of carotid calcification. A total of 247 panoramic radiographs were evaluated. 32% (n=80) had pulpal calcifications and 25% (n=61) had carotid calcifications with 12% (n=29) having both carotid and pulp calcifications. A significantly higher prevalence of both pulp and carotid calcification was found in subjects older than age 60 years compared to younger age groups. Accuracy of pulpal calcification in screening for carotid calcification was 66.4%. Both pulp and carotid calcifications were more prevalent in older individuals. The presence of pulp calcification was not a strong predictor for the presence of carotid calcification. (orig.)

  14. Natriuretic Peptide Receptor-C is Up-Regulated in the Intima of Advanced Carotid Artery Atherosclerosis

    Science.gov (United States)

    Zayed, Mohamed A; Harring, Scott D; Abendschein, Dana R; Vemuri, Chandu; Lu, Dongsi; Detering, Lisa; Liu, Yongjian; Woodard, Pamela K

    2016-01-01

    Objective Natriuretic peptide receptor-C (NPR-C/NPR-3) is a cell surface protein involved in vascular remodelling that is up-regulated in atherosclerosis. NPR-C expression has not been well characterized in human carotid artery occlusive lesions. We hypothesized that NPR-C expression correlates with intimal features of vulnerable atherosclerotic carotid artery plaque. Methods To test this hypothesis, we evaluated NPR-C expression by immunohistochemistry (IHC) in carotid endarterectomy (CEA) specimens isolated from 18 patients. The grade, location, and co-localization of NPR-C in CEA specimens were evaluated using two tissue analysis techniques. Results Relative to minimally diseased CEA specimens, we observed avid NPR-C tissue staining in the intima of maximally diseased CEA specimens (65%; p=0.06). Specifically, maximally diseased CEA specimens demonstrated increased NPR-C expression in the superficial intima (61%, p=0.17), and deep intima (138% increase; p=0.05). In the superficial intima, NPR-C expression significantly co-localized with vascular smooth muscle cells (VSMCs) and macrophages. The intensity of NPR-C expression was also higher in the superficial intima plaque shoulder and cap regions, and significantly correlated with atheroma and fibroatheroma vulnerable plaque regions (β=1.04, 95% CI=0.46, 1.64). Conclusion These findings demonstrate significant NPR-C expression in the intima of advanced carotid artery plaques. Furthermore, NPR-C expression was higher in vulnerable carotid plaque intimal regions, and correlate with features of advanced disease. Our findings suggest that NPR-C may serve as a potential biomarker for carotid plaque vulnerability and progression, in patients with advanced carotid artery occlusive disease.

  15. The content of copper and zinc in human ulcered atherosclerotic plaque

    Directory of Open Access Journals (Sweden)

    Radak Đorđe

    2004-01-01

    significant difference among groups was found for blood pressure and smoking. However, patients with carotid endarterectomy had significantly more diabetes mellitus (p<0.05, obesity (p<0.01 and hypercholesterolemia (p<0.01. DISCUSSION Our study showed significantly lower total copper value in the group with human ulcered atherosclerotic plaque in comparison with the control group (p<0.05. We also found significantly lower total zinc value in the group with human ulcered atherosclerotic plaque in comparison with the control group (p<0.05. CONCLUSION Our study revealed significant difference in copper and zinc content between human ulcered atherosclerotic plaque and normal carotid tissue. Closer correlation of these oligoelements and endothelial dysfunction will be established in future investigations.

  16. Carotid tomography with ultrasound

    International Nuclear Information System (INIS)

    It seemed desirable to develop an atraumatic method for a good visualization of carotid arteries. This examination should show, at an early stage, atheromatous plaques undetectable by other non-invasive tests, and complete doubtful arteriographies on which small plaques are suspected. Real-time high resolution echotomographies and Doppler blood flow visualization are the most interesting techniques under development in this new field. (orig./VJ)

  17. Serum Osteopontin Level Correlates with Carotid-Femoral Pulse Wave Velocity in Geriatric Persons

    Directory of Open Access Journals (Sweden)

    Chung-Jen Lee

    2014-01-01

    Full Text Available Osteopontin (OPN is involved in the regulation of vascular calcification processes. The aim of this study was to evaluate the relationship between fasting serum OPN concentration and carotid-femoral pulse wave velocity (cfPWV in geriatric persons. Fasting blood samples were obtained from 93 geriatric persons. cfPWV were performed by SphygmoCor system. Serum OPN levels were measured using a commercially available enzyme-linked immunosorbent assay. Geriatric adults who had diabetes (P=0.007 or dyslipidemia (P=0.029 had higher cfPWV levels than those without diabetes or dyslipidemia. The univariable linear regression analysis showed that age (P=0.002, waist circumference (P=0.048, body mass index (P=0.004, systolic blood pressure (P=0.001, diastolic blood pressure (P=0.036, pulse pressure (P=0.017, creatinine (P=0.002, and log-OPN level (P=0.001 were positively correlated with cfPWV levels, while the high-density lipoprotein cholesterol (HDL-cholesterol level (P=0.007 and glomerular filtration rate (P=0.001 were negatively correlated with cfPWV levels among the geriatric adults. Multivariable forward stepwise linear regression analysis of the significant variables also showed that log-OPN (β=0.233, R2=0.123, regression coefficient: 1.868, P=0.011 was still an independent predictor of cfPWV levels in geriatric persons.

  18. Correlation between carotid parameters measured by ultrasonography and cerebral infarction or left ventricular diastolic function in chronic hemodialysis patients

    International Nuclear Information System (INIS)

    Many studies have reported that carotid parameters measured by ultrasonography are predictors for cerebral infarction in nondialysis patients. Using a cross-sectional design, this study investigated whether those carotid parameters are also associated with cerebral infarction and left ventricular diastolic function in chronic hemodialysis (HD) patients. We studied 63 HD patients aged 61.4±11.5 years who underwent regular hemodialysis in Hidaka Hospital. All subjects underwent carotid ultrasound measurements when they performed brain magnetic resonance imaging (MRI) or computed tomography (CT). Cerebral infarction was detected significantly more frequently in patients with max intima-media thickness of common carotid artery (IMT) >2.2 mm (Odds ratio=3.14, 95% confidence interval (CI)=1.11-8.92). There was a positive correlation between PS and E/E' (r=0.322, p=0.009). These findings suggest that max IMT is significantly associated with the presence of cerebral infarction, while PS is related to left ventricular diastolic function in chronic HD patients. (author)

  19. Evaluation of carotid artery stenosis with three-dimensional CT angiography and surgical revascularization

    Energy Technology Data Exchange (ETDEWEB)

    Ohtaki, Masafumi; Tanabe, Sumiyoshi; Uede, Teiji; Hashi, Kazuo [Sapporo Medical Univ. (Japan). School of Medicine

    1996-11-01

    The accuracy of three-dimensional CT angiography (3D-CTA) for delineating atherosclerotic carotid stenosis was examined in comparison with digital subtraction angiography (DSA) in symptomatic patients. In cases undergoing carotid endarterectomy (CEA), the clinical usefulness of 3D-CTA for surgical planning was also evaluated in the light of intraoperative findings. From July 1992 to Jun 1995, 52 patients suffering from internal carotid ischemia and/or presenting carotid bruit were evaluated to detect carotid bifurcation stenosis by 3D-CTA. Shaded surface reconstruction (SSR) for three-dimensional display and maximum intensity projection (MIP) were employed in multiple projection to evaluate sites of stenosis. DSA was performed in 18 out of 31 patients having atherosclerotic carotid stenosis shown by 3D-CTA. MIP reconstructions accurately delineated sites of stenosis close to DSA and allowed precise depiction of ulcerated plaque and intramural calcification. The percentage of carotid stenosis was determined by comparing the narrowest point to the internal carotid artery (ICA) beyond the bulb on both 3D-CTA and DSA. Assessment of carotid stenosis was highly correlated between 3D-CTA and DSA (r=0.987, p< 0.0001). In this series, 9 carotid arteries in 8 patients underwent CEA for severe stenosis. 3 patients with ICA occlusion and 1 patient with elongated severe stenosis underwent STA-MCA anastomosis. Using MIP reconstructions and two-dimensional original images it was found that ICA occlusion was apparently distinguished from high grade ICA stenosis. SSR provided valuable informations during CEA for atherosclerotic plaque regarding anatomical relationship with the internal jugular vein and bony structures. This advanced means of 3D-CTA can be adequate as a screening method to detect carotid stenosis in symptomatic patients and useful for surgical planning of CEA and post-operative follow-up examination. (author)

  20. Evaluation of carotid artery stenosis with three-dimensional CT angiography and surgical revascularization

    International Nuclear Information System (INIS)

    The accuracy of three-dimensional CT angiography (3D-CTA) for delineating atherosclerotic carotid stenosis was examined in comparison with digital subtraction angiography (DSA) in symptomatic patients. In cases undergoing carotid endarterectomy (CEA), the clinical usefulness of 3D-CTA for surgical planning was also evaluated in the light of intraoperative findings. From July 1992 to Jun 1995, 52 patients suffering from internal carotid ischemia and/or presenting carotid bruit were evaluated to detect carotid bifurcation stenosis by 3D-CTA. Shaded surface reconstruction (SSR) for three-dimensional display and maximum intensity projection (MIP) were employed in multiple projection to evaluate sites of stenosis. DSA was performed in 18 out of 31 patients having atherosclerotic carotid stenosis shown by 3D-CTA. MIP reconstructions accurately delineated sites of stenosis close to DSA and allowed precise depiction of ulcerated plaque and intramural calcification. The percentage of carotid stenosis was determined by comparing the narrowest point to the internal carotid artery (ICA) beyond the bulb on both 3D-CTA and DSA. Assessment of carotid stenosis was highly correlated between 3D-CTA and DSA (r=0.987, p< 0.0001). In this series, 9 carotid arteries in 8 patients underwent CEA for severe stenosis. 3 patients with ICA occlusion and 1 patient with elongated severe stenosis underwent STA-MCA anastomosis. Using MIP reconstructions and two-dimensional original images it was found that ICA occlusion was apparently distinguished from high grade ICA stenosis. SSR provided valuable informations during CEA for atherosclerotic plaque regarding anatomical relationship with the internal jugular vein and bony structures. This advanced means of 3D-CTA can be adequate as a screening method to detect carotid stenosis in symptomatic patients and useful for surgical planning of CEA and post-operative follow-up examination. (author)

  1. Analysis of the correlation between osteoporosis and carotid atherosclerosis in postmenopausal women%绝经后妇女骨质疏松与颈动脉粥样硬化的相关性分析

    Institute of Scientific and Technical Information of China (English)

    赵英; 任全刚; 郭海; 解春生; 陈奇; 李霞

    2012-01-01

    目的 探讨绝经期妇女骨质疏松与颈动脉粥样硬化斑块之间的相关性.为此类患者的综合诊治和预防寻找科学依据,进一步提高她们的健康水平和生活质量.方法绝经期妇女30例及对照组30例,均采用PHILIPS IU22彩色多普勒超声显像仪,选择频率7~12 MHz线阵专用血管探头,于前、侧颈部两个方向行连续纵、横切面探查,测定双侧颈总动脉、颈内动脉内膜-中层厚度(IMT),同时观察颈总动脉、颈内动脉斑块的数量,软硬斑块及其形态;对所有病例均检测骨钙素(BGP),并用双能X线测定骨形态发生蛋白(BMD),用SMAC技术检测碱性磷酸酶(ALP)、Ca、P含量.结果绝经期妇女BGP、BMD明显降低的同时,超声特点表现突出的为软斑块,突出于管腔内膜面,局部呈不同程度的低回声,硬斑块为局部回声增强,BGP、BMD与对照组比较差异有高度统计学意义(P < 0.01),ALP增高(P < 0.05).Ca、P无变化.结论 绝经期妇女BGP、BMD降低的同时伴有颈动脉粥样硬化斑块形成,雌激素水平降低,与骨代谢、骨密度密切相关,与软、硬斑块的形态有关.因此检测BGP、BMD及彩色多普勒超声检查,对提高健康水平和生活质量有重要的临床意义.%Objective To study the correlation between osteoporosis and carotid atherosclerosis in postmenopausal women in order to find a scientific basis on comprehensive treatment and prevention and further improve their health and quality of life. Methods Intima- media thickness of bilateral common carotid arteries and internal carotid artery were examined with PHILIPS IU22 color Doppler ultrasound, the number of plaque, the hard and soft plaque and its form were observed in 30 cases of postmenopausal women and 30 cases of controls. BGP, BMD, ALP, Ca and P were measured. Results BGP and BMD decreased significantly in postmenopausal women, soft plaque was the outstanding ultrasonic characteristic, outstanding on tube antrum face

  2. Correlation between blood biochemical indexes and common carotid ultrasound traits in males with metabolic syndrome

    International Nuclear Information System (INIS)

    Objective: To determine the independent predictors of common carotid intima-media thickness (CC-IMT) and to establish the optimum binary classification equation of CC-IMT in males with metabolic syndrome (MS). Methods: The study retrospectively analyzed some indexes of 153 male adults (109 patients with MS and 44 healthy controls) who underwent the B-mode ultrasonography test. Results: The level of lumen Diameter of common carotid artery was significantly increased (Pmean of common carotid artery reduced remarkably (Pmean entered the optimum binary classification equation. Conclusion: The components of MS, especially BMI, can thicken CC-IMT and slow down Vmean. (authors)

  3. [A Case of Carotid Free-Floating Thrombus Treated by Carotid Ultrasonography-Guided Endovascular Approach].

    Science.gov (United States)

    Otawa, Masato; Kinkori, Takeshi; Watanabe, Kenichi; Ando, Ryo; Tambara, Masao; Arima, Toru

    2016-06-01

    We experienced a case of carotid free-floating thrombus treated by carotid ultrasonography-guided endovascular approach. A 63-year-old man was brought to our hospital with the chief complaint of sudden onset left hemiplegia. MRI revealed acute infarction of the right MCA territory due to the right M1 occlusion. Carotid ultrasonography showed a pedunculated, polypoid mobile plaque floating with the cardiac beat. We attempted ultrasonography-guided endovascular treatment. Under proximal balloon protection, the floating plaque was successfully aspirated into the Penumbra aspiration catheter. Carotid stent was also placed to stabilize the residual pedicle of the plaque. Aspirated plaque was identified as fresh thrombus by pathological examination. Carotid ultrasonography-guided endovascular approach was effective for getting the picture of real-time dynamics of the carotid FFT. PMID:27270147

  4. Computer simulation of the carotid artery

    OpenAIRE

    Santos, A.; Sousa, L. de; Tavares, J.; Santos, R.; Castro, P.; Azevedo, E.

    2012-01-01

    Background: Disturbed flow conditions at the bifurcation of common carotid artery and proximal internal carotid artery plays an important role in the development of local atherosclerotic plaques, which are important causes of stroke. Being able to build 3D models based on ultrasound imaging can improve diagnostic assessment and support interventions like endarterectomy or carotid stenting. Our aim was to describe a carotid segmentation algorithm to build these 3D models.Methods: We developed ...

  5. Correlations of coronary plaque wall thickness with wall pressure and wall pressure gradient: a representative case study

    OpenAIRE

    Liu Biyue; Zheng Jie; Bach Richard; Tang Dalin

    2012-01-01

    Abstract Background There are two major hemodynamic stresses imposed at the blood arterial wall interface by flowing blood: the wall shear stress (WSS) acting tangentially to the wall, and the wall pressure (WP) acting normally to the wall. The role of flow wall shear stress in atherosclerosis progression has been under intensive investigation, while the impact of blood pressure on plaque progression has been under-studied. Method The correlations of wall thickness (WT) with wall pressure (WP...

  6. Non-invasive imaging of atherosclerotic plaque macrophage in a rabbit model with F-18 FDG PET: a histopathological correlation

    International Nuclear Information System (INIS)

    Coronary atherosclerosis and its thrombotic complications are the major cause of mortality and morbidity throughout the industrialized world. Thrombosis on disrupted atherosclerotic plaques plays a key role in the onset of acute coronary syndromes. Macrophages density is one of the most critical compositions of plaque in both plaque vulnerability and thrombogenicity upon rupture. It has been shown that macrophages have a high uptake of 18F-FDG (FDG). We studied the correlation of FDG uptake with histopathological macrophage accumulation in atherosclerotic plaques in a rabbit model. Atherosclerosis was induced in rabbits (n = 6) by a combination of atherogenic diet and balloon denudation of the aorta. PET imaging was performed at baseline and 2 months after atherogenic diet and coregistered with magnetic resonance (MR) imaging. Normal (n = 3) rabbits served as controls. FDG uptake by the thoracic aorta was expressed as concentration (μCi/ml) and the ratio of aortic uptake-to-blood radioactivity. FDG uptake and RAM-11 antibody positive areas were analyzed in descending aorta. Atherosclerotic aortas showed significantly higher uptake of FDG than normal aortas. The correlation of aortic FDG uptake with macrophage areas assessed by histopathology was statistically significant although it was not high (r = 0.48, p < 0.0001). When uptake was expressed as the ratio of aortic uptake-to-blood activity, it correlated better (r = 0.80, p < 0.0001) with the macrophage areas, due to the correction for residual blood FDG activity. PET FDG activity correlated with macrophage content within aortic atherosclerosis. This imaging approach might serve as a useful non-invasive imaging technique and potentially permit monitoring of relative changes in inflammation within the atherosclerotic lesion

  7. The infarction patterns and the compensatory effect of collateral circulation in patients with internal carotid artery occlusion: a correlative study

    International Nuclear Information System (INIS)

    Objective: To investigate the infarction patterns and the collateral circulation in patients with internal carotid artery occlusion with diffusion-weighted imaging and DSA, to analyze the mechanism of stroke caused by internal carotid artery occlusion and to discuss the correlation between the infarction patterns and the compensatory effect of collateral circulation. Methods: A total of 45 patients with acute cerebral infarction due to DSA-confirmed unilateral internal carotid artery occlusion, who were admitted to the hospital during the period from Jan. 2009 to Sep. 2010, were enrolled in this study. Diffusion-weighted imaging and DSA were performed in all patients. The infarction regions and the findings of PCoA/ACoA were recorded, and the ipsilateral infarction patterns were evaluated. The relationship between the infarction patterns and the compensatory effect of collateral circulation was statistically analyzed. Results: The ipsilateral infarction patterns caused by internal carotid artery occlusion were classified as small cortical infarcts (84.4%), internal watershed infarcts (48.9%), territory infarcts (46.7%), posterior watershed infarcts (22.2%), anterior watershed infarcts (13.3%), perforating artery infarcts (22.2%). Among them, 23 patients had small cortical infarcts together with cerebral watershed infarcts (60.5%). No territory infarcts were found in the patients with patent ACoA (0%, P=0.013), while 91.7% of the patients showing no patent PCoA and/or ACoA had territory infarcts (11/12, p=0.003). Conclusion: Both artery-to-artery embolism and hypoperfusion with impaired emboli clearance are involved in the mechanism of ipsilateral infarctions caused by internal carotid artery occlusion. Patent ACoA can reduce the incidence of territory infarcts, and it maybe protect patients from territory infarcts. (authors)

  8. Indium-111-labeled platelet scintigraphy in carotid atherosclerosis

    International Nuclear Information System (INIS)

    We evaluated platelet accumulation in carotid arteries by means of a dual-radiotracer method, using indium-111-labeled platelets and technetium-99m-labeled human serum albumin, in 123 patients (92 men, 31 women; median age 60 years). Sixty patients had symptoms of transient ischemic carotid artery disease, and 63 patients with peripheral arterial occlusive disease served as controls. Antiplatelet treatment with acetylsalicylic acid was taken by 53 of the 123 patients. In 36 of the 60 symptomatic patients, platelet scintigraphy was repeated 3-4 days after carotid endarterectomy. Comparison of different scintigraphic parameters (platelet accumulation index and percent of the injected dose of labeled platelets at the carotid bifurcation) showed no significant differences between symptomatic and asymptomatic patients, and the severity of stenosis and the presence of plaque ulceration also had no influence on the parameters. There was no difference between patients with a short (less than 4 weeks) or long (greater than 4 weeks) interval from the last transient ischemic attack to scintigraphy and no difference between patients with or without antiplatelet treatment. Classifying the patients according to plaque morphology judged by high-resolution real-time ultrasonography also demonstrated no differences. No significant correlation was found between any scintigraphic parameter and other platelet function parameters such as platelet survival time, platelet turnover rate, and concentration of platelet-specific proteins. Quantification of platelet deposition after carotid endarterectomy in 36 patients demonstrated a significant increase of the median platelet accumulation index and the percent injected dose index

  9. Correlative Light and Electron Microscopy to Study Microglial Interactions with β-Amyloid Plaques.

    Science.gov (United States)

    Bisht, Kanchan; El Hajj, Hassan; Savage, Julie C; Sánchez, Maria G; Tremblay, Marie-Ève

    2016-01-01

    A detailed protocol is provided here to identify amyloid Aβ plaques in brain sections from Alzheimer's disease mouse models before pre-embedding immunostaining (specifically for ionized calcium-binding adapter molecule 1 (IBA1), a calcium binding protein expressed by microglia) and tissue processing for electron microscopy (EM). Methoxy-X04 is a fluorescent dye that crosses the blood-brain barrier and selectively binds to β-pleated sheets found in dense core Aβ plaques. Injection of the animals with methoxy-X04 prior to sacrifice and brain fixation allows pre-screening and selection of the plaque-containing brain sections for further processing with time-consuming manipulations. This is particularly helpful when studying early AD pathology within specific brain regions or layers that may contain very few plaques, present in only a small fraction of the sections. Post-mortem processing of tissue sections with Congo Red, Thioflavin S, and Thioflavin T (or even with methoxy-X04) can label β-pleated sheets, but requires extensive clearing with ethanol to remove excess dye and these procedures are incompatible with ultrastructural preservation. It would also be inefficient to perform labeling for Aβ (and other cellular markers such as IBA1) on all brain sections from the regions of interest, only to yield a small fraction containing Aβ plaques at the right location. Importantly, Aβ plaques are still visible after tissue processing for EM, allowing for a precise identification of the areas (generally down to a few square millimeters) to examine with the electron microscope. PMID:27286292

  10. Close association of arterial plaques with left ventricular hypertrophy and ejection fraction in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Mowlaie Morteza

    2014-01-01

    Full Text Available Introduction: In renal failure patients, cardiovascular complications are a major clinical problem. Objectives: This study aimed to test, the possible association of left ventricular hypertrophy and ejection fraction with plaques of carotid and femoral artery hemodialysis. Patients and Methods: Sixty-one patients, who were on regular hemodialysis were selected. For all patients echocardiography and B-mode Ultrsonographic assessment of carotid-femoral arteries for plaque occurrence were conducted. Results: In this study there was a positive correlation between left ventricular hypertrophy with the duration of hemodialysis treatment (p<0.05. Significant positive association between left ventricular hypertrophy and plaque score and also a significant positive association between left ventricular hypertrophy with presence of chest pain was found (p<0.05. Association of diabetes mellitus with the presence of chest pain was positive. Positive correlation between hypertension with plaque score was demonstrated too (p<0.05. Also an inverse association of plaque score with left ventricular ejection fraction was detected too (p<0.05. Furthermore, the correlation of plaque score with the presence of diabetes mellitus was positive. Conclusion: The present investigations, documents parallel cardiac and vascular adaptation in hemodialysis patients and shows the potential contribution of structural and functional large artery alteration to the pathogenesis of left ventricular hypertrophy which needs more attention in patients on hemodialysis.

  11. Carotid stenting

    International Nuclear Information System (INIS)

    Full text: The annual incidence of stroke is estimated around 2 cases per 1000 in the general population and 80% of strokes are ischemic. [1] Atherosclerotic disease resulting in stenosis of common and/or internal carotid arteries is an established risk factor for acute cerebrovascular events. [2] In the majority of the cases ischemic stroke is caused by atherosclerotic plaque rupture and subsequent thrombus formation resulting in carotid occlusion or/and distal thromboembolization. Today, two invasive methods are available in order to reduce the risk of severe ischemic events: surgical carotid artery endarterectomy (CEA) and percutaneous carotid artery stenting (CAS). More recently amassed high-level scientific data coming from randomized controlled trials (RCTs) and meta-analysis comparing CAS with CEA have emerged. [3] Initial RTCs included the French EVA 3S, which investigated 527 symptomatic patients in 30 different centers, the German SPACE investigating 1.200 patients and the International ICSS which randomized 1710 patients. In EVA 3S the 30-day rate of any stroke death was significantly lower in the CEA group (3.9 vs. 9.6%, HR: 2.5). However the trial was prematurely stopped and severely criticized. [4] The SPACE trial resulted in a similar rate of ipsilateral stroke or death at 30-days and 2 years follow-up (6.8% CAS vs. 6.3% CEA), while in the ICSS trial the primary endpoint of all strokes, death and myocardial infarction (MI) was significantly lower in the CAS group (5.2% vs. 8.5%). Finally, the most recent CREST (Carotid Revascularization Endarterectomy vs. Stenting) trial randomized 2.502 patients (1.321 symptomatic). The composite primary endpoint of any stroke, death and MI was similar between the two methods (CAS: 7.2% vs. CEA: 6.8%; HR=1.11), while both methods demonstrated similar short- and longer-term outcomes. However significant differences between the components were detected (stroke 4.1% vs. 2.3%, P=0.012; and MI 1.1% vs. 2.3%, p=0.032, CAS

  12. Atherosclerotic Calcification Detection: A Comparative Study of Carotid Ultrasound and Cone Beam CT

    Directory of Open Access Journals (Sweden)

    Fisnik Jashari

    2015-08-01

    Full Text Available Background and Aim: Arterial calcification is often detected on ultrasound examination but its diagnostic accuracy is not well validated. The aim of this study was to determine the accuracy of carotid ultrasound B mode findings in detecting atherosclerotic calcification quantified by cone beam computed tomography (CBCT. Methods: We analyzed 94 carotid arteries, from 88 patients (mean age 70 ± 7 years, 33% females, who underwent pre-endarterectomy ultrasound examination. Plaques with high echogenic nodules and posterior shadowing were considered calcified. After surgery, the excised plaques were examined using CBCT, from which the calcification volume (mm3 was calculated. In cases with multiple calcifications the largest calcification nodule volume was used to represent the plaque. Carotid artery calcification by the two imaging techniques was compared using conventional correlations. Results: Carotid ultrasound was highly accurate in detecting the presence of calcification; with a sensitivity of 88.2%. Based on the quartile ranges of calcification volumes measured by CBCT we have divided plaque calcification into four groups: <8; 8–35; 36–70 and >70 mm3. Calcification volumes ≥8 were accurately detectable by ultrasound with a sensitivity of 96%. Of the 21 plaques with <8 mm3 calcification volume; only 13 were detected by ultrasound; resulting in a sensitivity of 62%. There was no difference in the volume of calcification between symptomatic and asymptomatic patients. Conclusion: Carotid ultrasound is highly accurate in detecting the presence of calcified atherosclerotic lesions of volume ≥8 mm3; but less accurate in detecting smaller volume calcified plaques. Further development of ultrasound techniques should allow better detection of early arterial calcification.

  13. Atherosclerotic Calcification Detection: A Comparative Study of Carotid Ultrasound and Cone Beam CT

    Science.gov (United States)

    Jashari, Fisnik; Ibrahimi, Pranvera; Johansson, Elias; Ahlqvist, Jan; Arnerlöv, Conny; Garoff, Maria; Levring Jäghagen, Eva; Wester, Per; Henein, Michael Y.

    2015-01-01

    Background and Aim: Arterial calcification is often detected on ultrasound examination but its diagnostic accuracy is not well validated. The aim of this study was to determine the accuracy of carotid ultrasound B mode findings in detecting atherosclerotic calcification quantified by cone beam computed tomography (CBCT). Methods: We analyzed 94 carotid arteries, from 88 patients (mean age 70 ± 7 years, 33% females), who underwent pre-endarterectomy ultrasound examination. Plaques with high echogenic nodules and posterior shadowing were considered calcified. After surgery, the excised plaques were examined using CBCT, from which the calcification volume (mm3) was calculated. In cases with multiple calcifications the largest calcification nodule volume was used to represent the plaque. Carotid artery calcification by the two imaging techniques was compared using conventional correlations. Results: Carotid ultrasound was highly accurate in detecting the presence of calcification; with a sensitivity of 88.2%. Based on the quartile ranges of calcification volumes measured by CBCT we have divided plaque calcification into four groups: 70 mm3. Calcification volumes ≥8 were accurately detectable by ultrasound with a sensitivity of 96%. Of the 21 plaques with <8 mm3 calcification volume; only 13 were detected by ultrasound; resulting in a sensitivity of 62%. There was no difference in the volume of calcification between symptomatic and asymptomatic patients. Conclusion: Carotid ultrasound is highly accurate in detecting the presence of calcified atherosclerotic lesions of volume ≥8 mm3; but less accurate in detecting smaller volume calcified plaques. Further development of ultrasound techniques should allow better detection of early arterial calcification. PMID:26307978

  14. In vivo and in vitro evidence that Tc-99m-HYNIC-interleukin-2 is able to detect T lymphocytes in vulnerable atherosclerotic plaques of the carotid artery

    NARCIS (Netherlands)

    Glaudemans, Andor W. J. M.; Bonanno, Elena; Galli, Filippo; Zeebregts, Clark J.; de Vries, Erik; Koole, Michel; Luurtsema, Gert; Boersma, Hendrikus H.; Taurino, Maurizio; Slart, Riemer H. J. A.; Signore, Alberto

    2014-01-01

    Purpose Recent advances in basic science have established that inflammation plays a pivotal role in the pathogenesis of atherosclerosis. Inflammatory cells are thought to be responsible for the transformation of a stable plaque into a vulnerable one. Lymphocytes constitute at least 20 % of infiltrat

  15. Breast arterial calcification on mammogram: correlation with carotid arterial atherosclerosis on ultrasonogram

    International Nuclear Information System (INIS)

    To investigate the incidence of breast arterial calcification in Korean women, and to determine its association with systemic diseases and carotid arterial atherosclerosis. One thousand seven hundred and thirteen female subjects who underwent mammography at a health care center between May 1999 and May 2000 were included in this study. Of the total, 172 were found to have breast arterial calcification, and were classified according to age. The coincidence of hypertension, diabetes mellitus and hyperlipidemia was examined in both the subject group and the control group selected on the same age basis. To investigate the presence and degree of carotid atherosclerosis, sonographic imaging was performed and the findings were compared between the two groups. The incidence of breast arterial calcification showed statistically significant differences according to age, with a higher incidence in older patients (p<0.05). However, there was no statistical difference in the incidence of hypertension, hyperlipidemia, and diabetes mellitus between groups. Carotid atherosclerosis was subjects more prevalent among subjects than in the control group (p<0.05), though there was no statistically significant difference in the degree of luminal stenosis. The most common pathologic cause of breast arterial calcification is arteriosclerosis. Breast arterial calcification is demonstrated at mammography, along with other clinical risk factors for atherosclerosis or coincidental neurologic symptoms. We stress that further evaluation of the carotid artery is necessary

  16. Breast arterial calcification on mammogram: correlation with carotid arterial atherosclerosis on ultrasonogram

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Nam Ju; Suh, Jung Ho [School of Medicine, Ajou Univ., Suwon (Korea, Republic of); Kim, Ji Hyung [College of Medicine, KonYang Univ., Nonsan (Korea, Republic of)

    2002-01-01

    To investigate the incidence of breast arterial calcification in Korean women, and to determine its association with systemic diseases and carotid arterial atherosclerosis. One thousand seven hundred and thirteen female subjects who underwent mammography at a health care center between May 1999 and May 2000 were included in this study. Of the total, 172 were found to have breast arterial calcification, and were classified according to age. The coincidence of hypertension, diabetes mellitus and hyperlipidemia was examined in both the subject group and the control group selected on the same age basis. To investigate the presence and degree of carotid atherosclerosis, sonographic imaging was performed and the findings were compared between the two groups. The incidence of breast arterial calcification showed statistically significant differences according to age, with a higher incidence in older patients (p<0.05). However, there was no statistical difference in the incidence of hypertension, hyperlipidemia, and diabetes mellitus between groups. Carotid atherosclerosis was subjects more prevalent among subjects than in the control group (p<0.05), though there was no statistically significant difference in the degree of luminal stenosis. The most common pathologic cause of breast arterial calcification is arteriosclerosis. Breast arterial calcification is demonstrated at mammography, along with other clinical risk factors for atherosclerosis or coincidental neurologic symptoms. We stress that further evaluation of the carotid artery is necessary.

  17. Relationship of color ultrasonic indexes of carotid and blood marker with the formation of carotid plaque in patients with cardiovascular disease%心血管疾病患者颈动脉彩色超声参数及血液指标与颈动脉斑块形成的关系

    Institute of Scientific and Technical Information of China (English)

    徐秋华; 周辉红; 杨静; 燕山

    2005-01-01

    incidence of atherosclerosis, color ultrasound becomes the first method to evaluate carotid and angiopathical lesion of the whole body.OBJECTIVE: To investigate the initial mechanism and earlier symptom of carotid plaque with the analysis of the findings of color ultrasound of carotid artery in comparison with blood lipid, blood glucose and blood viscosity of patients with cardiovascular disease.DESIGN: Case-controlled study.SETTING: Department of Ultrasonic Diagnosis and Department of Cardiology, the Ninth People's Hospital Affiliated to Shanghai Second Medical University.PARTICIPANTS: Totally 154 patients with cardiovascular disease were selected from the Cardiological Department of the Ninth People's Hospital Affiliated to Shanghai Second Medical University from October 2002 to December 2003. All patients agreed to participate in the investigation.METHODS: Carotid artery was scanned from longitudinal section to transverse section with LOGIQ700 and DU-5 color ultrasound. Blood markers of patients were measured, such as total cholesterol, triacylglycerol,fructosamine, blood serum, blood glucose, high density lipoprotein, low density of lipoprotein and hematocrit; meanwhile, their relationships with plaque formation were also evaluated.carotid artery and indexes of blood test at thyroid.RESULTS: Totally 154 patient entered the final analysis without any loss.diameter of common carotid artery was (9.10±0.94) mm, and transverse diameter was (9.02±1.03) mm. There were 25 cases with curvature, especially single curvature. The most obvious thickening tunica intima-media in carotid canal wall was 4.9 mm. Totally 64 cases had plaque with the bigger of blood test: Serum total cholesterol and triacylglycerol were significantly different during the formation of plaque (x2=4.686, 4.529, P < 0.05). Level of serum total cholesterol and triacylglycerol of patients in the plaque group was in a normal range [(4.45±0.98), (1.36±0.60) mmol/L (superior limit of mon carotid artery of

  18. Ultrasound evaluation of intima media thickness of carotid arteries in dialysis patients and correlation with proposed risk factors

    Directory of Open Access Journals (Sweden)

    Damjanović Tatjana

    2003-01-01

    Full Text Available Atherosclerosis is significant risk factor for cardiovascular morbidity and mortality in dialysis patients. Aim of the study was ultrasound evaluation of intima media thickness on carotid arteries (as a marker of atherosclerosis, in dialysis patients and its correlation with proposed risk factors. Intima media thickness was measured in 45 dialysis patients with no signs of cardiovascular diseases (15 on peritoneal dialysis, group I,30 on hemodialysis, group II and 20 healthy controls. The mean carotid artery intima media thickness was significantly higher in dialysis patients than in control group. According to intima media thickness, dialysis patients were divided in group A (patient with intima media thickness less or equal 0,720 mm and group B (intima media thickness higher then 0,720mm. Intima media thickness in bout group was correlated with proposed risk factors. In group A there was not significant correlation of intima media thickness with risk factors. In group B significant correlation have been found between intima media thickness and LDL, VLDL cholesterol, body mass index and systolic, diastolic and mean blood pressure. Although atherosclerosis was not the only cause for cardiovascular morbidity and mortality, it has a dominant role in dialysis patients. Augmented intima media thickness could be early marker of atherosclerosis. The risk factors of great influence on intima media thickness are lipid disturbances, obesity and hypertension.

  19. Prediction of fibre architecture and adaptation in diseased carotid bifurcations.

    LENUS (Irish Health Repository)

    Creane, Arthur

    2011-12-01

    Many studies have used patient-specific finite element models to estimate the stress environment in atherosclerotic plaques, attempting to correlate the magnitude of stress to plaque vulnerability. In complex geometries, few studies have incorporated the anisotropic material response of arterial tissue. This paper presents a fibre remodelling algorithm to predict the fibre architecture, and thus anisotropic material response in four patient-specific models of the carotid bifurcation. The change in fibre architecture during disease progression and its affect on the stress environment in the plaque were predicted. The mean fibre directions were assumed to lie at an angle between the two positive principal strain directions. The angle and the degree of dispersion were assumed to depend on the ratio of principal strain values. Results were compared with experimental observations and other numerical studies. In non-branching regions of each model, the typical double helix arterial fibre pattern was predicted while at the bifurcation and in regions of plaque burden, more complex fibre architectures were found. The predicted change in fibre architecture in the arterial tissue during plaque progression was found to alter the stress environment in the plaque. This suggests that the specimen-specific anisotropic response of the tissue should be taken into account to accurately predict stresses in the plaque. Since determination of the fibre architecture in vivo is a difficult task, the system presented here provides a useful method of estimating the fibre architecture in complex arterial geometries.

  20. A study of plaque vascularization and inflammation using quantitative contrast-enhanced US and PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Hjelmgren, Ola, E-mail: ola.hjelmgren@wlab.gu.se [Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Department of Molecular and Clinical Medicine, Clinical Physiology, Gothenburg (Sweden); Sahlgrenska University Hospital, Department of Clinical Physiology, Gothenburg (Sweden); Johansson, Lars, E-mail: lars.johansson@radiol.uu.se [Uppsala University, Department of Radiology, Uppsala (Sweden); Prahl, Ulrica, E-mail: ulrica-prahl-gullberg@wlab.gu.se [Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Department of Molecular and Clinical Medicine, Clinical Physiology, Gothenburg (Sweden); Schmidt, Caroline, E-mail: caroline.schmidt@wlab.gu.se [Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Department of Molecular and Clinical Medicine, Clinical Physiology, Gothenburg (Sweden); Fredén-Lindqvist, Johan, E-mail: johan.freden-lindqvist@vgregion.se [Sahlgrenska University Hospital, Department of Clinical Physiology, Gothenburg (Sweden); Bergström, Göran M.L., E-mail: goran.bergstrom@hjl.gu.se [Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Department of Molecular and Clinical Medicine, Clinical Physiology, Gothenburg (Sweden); Sahlgrenska University Hospital, Department of Clinical Physiology, Gothenburg (Sweden)

    2014-07-15

    Background: Contrast-enhanced ultrasound (CEUS) is an in vivo methodology to quantify carotid plaque vascularization. Increased metabolism in plaques, measured as FDG uptake in PET/CT examination, has been associated with markers of inflammation in histological samples. In this study, we tested the association between FDG uptake and vascularization measured by CEUS to assess whether CEUS can be used as an in vivo marker of plaque vulnerability. Methods: After informed consent, subjects aged >60 years with carotid plaque height exceeding 2.5 mm were recruited. CEUS was performed and analyzed using earlier described protocol and software, Contrast Quantification Program, which calculates the fraction of the plaque being contrast positive (CQP value). PET/CT examination was performed within 3 months of CEUS (median time 7 days). PET/CT images were acquired 90 min after FDG injection (2.7 MBq/kg). FDG uptake was measured as tissue background index (TBI), calculated using Spearman's rho as mean standard uptake value (SUV) of the plaque divided by mean SUV in the jugular vein (mean of 7 measuring points). Local ethics committee approved the study. Results: We recruited 13 subjects (5 women) with a mean age of 71 years, 6 had a history of stroke or TIA, 1 had a history of ipsilateral stroke. CQP values showed a significant, positive correlation with TBI of carotid plaques, r = 0.67, p < 0.02. Conclusions: Plaque vascularization measured by CEUS correlates positively with FDG uptake measured by PET/CT in humans. This indicates an association between vascularization and inflammation and/or hypoxia, supporting the use of CEUS as a non-invasive method to detect plaque vulnerability.

  1. A study of plaque vascularization and inflammation using quantitative contrast-enhanced US and PET/CT

    International Nuclear Information System (INIS)

    Background: Contrast-enhanced ultrasound (CEUS) is an in vivo methodology to quantify carotid plaque vascularization. Increased metabolism in plaques, measured as FDG uptake in PET/CT examination, has been associated with markers of inflammation in histological samples. In this study, we tested the association between FDG uptake and vascularization measured by CEUS to assess whether CEUS can be used as an in vivo marker of plaque vulnerability. Methods: After informed consent, subjects aged >60 years with carotid plaque height exceeding 2.5 mm were recruited. CEUS was performed and analyzed using earlier described protocol and software, Contrast Quantification Program, which calculates the fraction of the plaque being contrast positive (CQP value). PET/CT examination was performed within 3 months of CEUS (median time 7 days). PET/CT images were acquired 90 min after FDG injection (2.7 MBq/kg). FDG uptake was measured as tissue background index (TBI), calculated using Spearman's rho as mean standard uptake value (SUV) of the plaque divided by mean SUV in the jugular vein (mean of 7 measuring points). Local ethics committee approved the study. Results: We recruited 13 subjects (5 women) with a mean age of 71 years, 6 had a history of stroke or TIA, 1 had a history of ipsilateral stroke. CQP values showed a significant, positive correlation with TBI of carotid plaques, r = 0.67, p < 0.02. Conclusions: Plaque vascularization measured by CEUS correlates positively with FDG uptake measured by PET/CT in humans. This indicates an association between vascularization and inflammation and/or hypoxia, supporting the use of CEUS as a non-invasive method to detect plaque vulnerability

  2. Intraplaque hemorrhage is associated with higher structural stresses in human atherosclerotic plaques: an in vivo MRI-based 3d fluid-structure interaction study

    Directory of Open Access Journals (Sweden)

    Canton Gador

    2010-12-01

    Full Text Available Abstract Background Studies using medical images have shown that intraplaque hemorrhage may accelerate plaque progression and may produce a stimulus for atherosclerosis development by increasing lipid core and plaque volume and creating new destabilizing factors. Image-based 3D computational models with fluid-structure interactions (FSI will be used to perform plaque mechanical analysis and investigate possible associations between intraplaque hemorrhage and both plaque wall stress (PWS and flow shear stress (FSS. Methods In vivo MRI data of carotid plaques from 5 patients with intraplaque hemorrhage confirmed by histology were acquired. 3D multi-component FSI models were constructed for each plaque to obtain mechanical stresses. Plaque Wall Stress (PWS and Flow Shear Stress (FSS were extracted from all nodal points on the lumen surface of each plaque for analysis. Results The mean PWS value from all hemorrhage nodes of the 5 plaques combined was higher than that from non-hemorrhage nodes (75.6 versus 68.1 kPa, P = 0.0003. The mean PWS values from hemorrhage nodes for each of the 5 plaques were all significantly higher (5 out of 5 than those from non-hemorrhage nodes (P 2, P = 0.0002. However, the mean flow shear stress values from individual cases showed mixed results: only one out of five plaques showed mean FSS value from hemorrhage nodes was higher than that from non-hemorrhage nodes; three out of five plaques showed that their mean FSS values from hemorrhage nodes were lower than those from non-hemorrhage nodes; and one plaque showed that the difference had no statistical significance. Conclusion The results of this study suggested that intraplaque hemorrhage nodes were associated with higher plaque wall stresses. Compared to flow shear stress, plaque wall stress has a better correlation with plaque component feature (hemorrhage linked to plaque progression and vulnerability. With further validation, plaque stress analysis may provide

  3. Automated IMT estimation and BMI correlation using a low-quality carotid ultrasound image database from India

    OpenAIRE

    Molinari, Filippo; Meiburger, Kristen Mariko

    2013-01-01

    This paper presents AtheroEdgeLowRes (AELR), an extention of AtheroEdge™ from AtheroPoint™, and a solution to carotid ultrasound IMT measurement in low-resolution and overall low quality images. The images were collected using a low-end ultrasound machine during a screening study in India. We aim to demonstrate the accuracy and reproducibility of the AELR system by benchmarking it against an expert Reader's manual tracing and to show the correlation between the automatically measured intima m...

  4. Plasma Lipoprotein-associated Phospholipase A2 in Patients with Metabolic Syndrome and Carotid Atherosclerosis

    Directory of Open Access Journals (Sweden)

    Mao Yong-jun

    2011-01-01

    Full Text Available Abstract Background Lipoprotein-associated phospholipase A2 (Lp-PLA2 is a recently identified and potentially useful plasma biomarker for cardiovascular and atherosclerotic diseases. However, the correlation between the Lp-PLA2 activity and carotid atherosclerosis remains poorly investigated in patients with metabolic syndrome (MetS. The present study aimed to evaluate the potential role of Lp-PLA2 as a comprehensive marker of metabolic syndrome in individuals with and without carotid atherosclerosis. Methods We documented 118 consecutive patients with MetS and 70 age- and sex-matched healthy subjects served as controls. The patients were further divided into two groups: 39 with carotid plaques and 79 without carotid plaques to elucidate the influence of Lp-PLA2 on carotid atherosclerosis. The plasma Lp-PLA2 activity was measured by using ELISA method and carotid intimal-media thickness (IMT was performed by ultrasound in all participants. Results Lp-PLA2 activity was significantly increased in MetS subgroups when compared with controls, and was higher in patients with carotid plaques than those without plaques (P 2 was obtained between patients with three and four disorders of metabolic syndrome (P P = 0.029, LDL-cholesterol (β = 0.401, P = 0.000 and waist-hip ratio (β = 0.410, P = 0.000 emerged as significant and independent determinants of Lp-PLA2 activity. Multiple stepwise regression analysis revealed that LDL-cholesterol (β = 0.309, P = 0.000, systolic blood pressure (β = 0.322, P = 0.002 and age (β = 0.235, P = 0.007 significantly correlated with max IMT, and Lp-PLA2 was not an independent predictor for carotid IMT. Conclusions Lp-PLA2 may be a modulating factor for carotid IMT via age and LDL-cholesterol, not independent predictor in the pathophysiological process of carotid atherosclerosis in patients with MetS.

  5. Correlation between dental caries experience and mutans streptococci counts using saliva and plaque as microbial risk indicators in 3-8 year old children. A cross Sectional study

    OpenAIRE

    Nanda, Jasmine; Sachdev, Vinod; Sandhu, Meera; Deep-Singh-Nanda, Kanwar

    2015-01-01

    Objectives: Determination of the relative amounts of mutans streptococcus in both saliva and plaque and to study its correlation with dental caries in children. Study Design: The study comprised of 60 children aged 3-8 years divided into 2 groups (30 children in each): Group A- Children with more than 4 carious teeth and Group B- Children without caries. Saliva and plaque was collected from children of both the groups with the help of Dentocult SM strip test kit (Orion Diagnostic). Following ...

  6. Correlations of coronary plaque wall thickness with wall pressure and wall pressure gradient: a representative case study

    Directory of Open Access Journals (Sweden)

    Liu Biyue

    2012-07-01

    Full Text Available Abstract Background There are two major hemodynamic stresses imposed at the blood arterial wall interface by flowing blood: the wall shear stress (WSS acting tangentially to the wall, and the wall pressure (WP acting normally to the wall. The role of flow wall shear stress in atherosclerosis progression has been under intensive investigation, while the impact of blood pressure on plaque progression has been under-studied. Method The correlations of wall thickness (WT with wall pressure (WP, blood pressure on the lumen wall and spatial wall pressure gradient (WPG in a human atherosclerotic right coronary artery were studied. The pulsatile blood flow was simulated using a three dimensional mathematical model. The blood was treated as an incompressible viscous non-Newtonian fluid. The geometry of the artery was re-constructed using an in vivo intravascular ultrasound (IVUS 44-slice dataset obtained from a patient with consent obtained. The WT, the WP and the WPG were averaged on each slice, respectively, and Pearson correlation analysis was performed on slice averaged base. Each slice was then divided into 8 segments and averaged vessel WT, WP and WPG were collected from all 352 segments for correlation analysis. Each slice was also divided into 2 segments (inner semi-wall of bend and outer semi-wall of bend and the correlation analysis was performed on the 88 segments. Results Under mean pressure, the Pearson coefficient for correlation between WT and WP was r = − 0.52 (p  Conclusions Results from this representative case report indicated that plaque wall thickness correlated negatively with wall pressure (r = −0.81 by slice and positively with wall pressure gradient (r = 0.45. The slice averaged WT has a strong linear relationship with the slice averaged WP. Large-scale patient studies are needed to further confirm our findings.

  7. Correlation of dental pulp stones, carotid artery and renal calcifications using digital panoramic radiography and ultrasonography

    OpenAIRE

    Garima Yeluri; C Anand Kumar; Namita Raghav

    2015-01-01

    Background: The human tissues continuously undergo modification as deposition of calcium (CA) salts either in an organized or disorganized pattern. The latter pattern usually occurs in the soft tissues such as in arteries, brain, kidneys, lungs, and dental pulp. The purpose of this study is to evaluate the presence of pulp calcification and carotid artery calcification (CDC) as a marker for renal calcification and altered serum biomarkers such as serum CA, phosphorus (P), and alkaline phospha...

  8. Homocysteine and carotid intima-media thickness in ischemic stroke patients are not correlated

    OpenAIRE

    Ntaios, George; Savopoulos, Christos; Hatzitolios, Apostolos; Ekonomou, Ippoliti; Destanis, Evangelos; Chryssogonidis, Ioannis; Chatzinikolaou, Anastasia; Pidonia, Ifigenia; Karamitsos, Dimitrios

    2008-01-01

    Introduction Hyperhomocysteinemia has been linked to cardiovascular morbidity and mortality by numerous authors. Whether this association is causal or not remains uncertain. The aim of the study was to investigate the association of hyperhomocysteinemia with the degree of carotid atherosclerosis in stroke patients. Methods We studied 97 Greek patients in our stroke unit who were hospitalized as a result of ischemic stroke between March 2006 and May 2007. The patients were divided into two gro...

  9. Advances in MRI for the evaluation of carotid atherosclerosis.

    Science.gov (United States)

    Makris, G C; Teng, Z; Patterson, A J; Lin, J-M; Young, V; Graves, M J; Gillard, J H

    2015-08-01

    Carotid artery atherosclerosis is an important source of mortality and morbidity in the Western world with significant socioeconomic implications. The quest for the early identification of the vulnerable carotid plaque is already in its third decade and traditional measures, such as the sonographic degree of stenosis, are not selective enough to distinguish those who would really benefit from a carotid endarterectomy. MRI of the carotid plaque enables the visualization of plaque composition and specific plaque components that have been linked to a higher risk of subsequent embolic events. Blood suppressed T1 and T2 weighted and proton density-weighted fast spin echo, gradient echo and time-of-flight sequences are typically used to quantify plaque components such as lipid-rich necrotic core, intraplaque haemorrhage, calcification and surface defects including erosion, disruption and ulceration. The purpose of this article is to review the most important recent advances in MRI technology to enable better diagnostic carotid imaging. PMID:25826233

  10. 血管壁磁共振成像在老年颈动脉粥样硬化患者术前评估中的应用%The value of carotid plaque magnetic resonance imaging and sequence optimization in preoperative assessment in elderly patients with carotid atherosclerosis

    Institute of Scientific and Technical Information of China (English)

    宋焱; 陈敏; 周诚; 黄娟; 罗南; 邓玉辉; 傅元

    2011-01-01

    Objective To study the value of carotid plaque magnetic resonance imaging (MRI) in pre-operation assessment in the elderly patients with carotid atherosclerosis and explore the possibility of minimizing the contrast weightings to gain sweeptime. Methods Totally 70 elderly patients with cerebral ischemia (average age of 68.8 years) underwent carotid MRI and digital subtraction angiography (DSA) due to the appearance of carotid plaque detected by ultrasound. Carotid plaque MRI was acquired with 3.0T MR scanner and 8 channel surface coil. The standard carotid plague MRI program included pre-and post-contrast T1 weighted imaging (T1WI), T2 weighted imaging, proton density weighted imaging and 3D time of flight MR angiography (3D TOF MRA). All these program were divided into two combinations: the 5-sequence MRI (all the sequences) and 2-sequence MRI (T1WI and TOF MRA). Digital subtraction angiography (DSA) in coronal and lateral views of carotid artery was performed with GE Advantx LCN+. The software SPSS 13.0 was used to statistically analyze the difference between MRI and DSA, and that of two sequence combinations was used in the detection of luminal stenosis and fibrous cap (FC) rupture. Results Totally 135 arteries were analyzed while 3 arteries in one patient were excluded due to the poor quality image and stent placement. The degree of luminal stenosis were (38.3±31.0)% and (38.5±30.9)%, respectively, detected by the two MRI sequence-combination with no significant difference (t=2.447, P>0.05) and was (35.1±31.8)% by DSA. There was a good concordance between MRI and DSA in luminal stenosis detection (Kappa value: 0.773). No statistical difference was found between two MR sequence combinations in detecting FC rupture (both in 36 vessels). DSA detected FC rupture of 16 vessels, showing remarkably difference contrast to MRI(χ2=12.0, P<0.01). Conclusions MRI can accurately detect the luminal stenosis and FC rupture. The short time scanning resulting from

  11. Correlative assessment of cerebral blood flow obtained with perfusion CT and positron emission tomography in symptomatic stenotic carotid disease

    International Nuclear Information System (INIS)

    Twelve patients with ICA stenosis underwent dynamic perfusion computed tomography (CT) and positron emission tomography (PET) studies at rest and after acetazolamide challenge. Cerebral blood flow (CBF) maps on perfusion CT resulted from a deconvolution of parenchymal time-concentration curves by an arterial input function (AIF) in the anterior cerebral artery as well as in both anterior choroidal arteries. CBF was measured by [15O]H2O PET using multilinear least-squares minimization procedure based on the one-compartment model. In corresponding transaxial PET scans, CBF values were extracted using standardized ROIs. The baseline perfusion CT-CBF values were lower in perfusion CT than in PET (P>0.05). CBF values obtained by perfusion CT were significantly correlated with those measured by PET before (P<0.05) and after (P<0.01) acetazolamide challenge. Nevertheless, the cerebrovascular reserve capacity was overestimated (P=0.05) using perfusion CT measurements. The AIF selection relative to the side of carotid stenosis did not significantly affect calculated perfusion CT-CBF values. In conclusion, the perfusion CT-CBF measurements correlate significantly with the PET-CBF measurements in chronic carotid stenotic disease and contribute useful information to the evaluation of the altered cerebral hemodynamics. (orig.)

  12. Correlation of dental pulp stones, carotid artery and renal calcifications using digital panoramic radiography and ultrasonography

    Directory of Open Access Journals (Sweden)

    Garima Yeluri

    2015-01-01

    Full Text Available Background: The human tissues continuously undergo modification as deposition of calcium (CA salts either in an organized or disorganized pattern. The latter pattern usually occurs in the soft tissues such as in arteries, brain, kidneys, lungs, and dental pulp. The purpose of this study is to evaluate the presence of pulp calcification and carotid artery calcification (CDC as a marker for renal calcification and altered serum biomarkers such as serum CA, phosphorus (P, and alkaline phosphatase (ALP. Materials and Methods: Digital panoramic radiographs of 50 patients with the presence of pulp stones and suspected CAC were subjected to carotid artery and renal ultrasonography (USG examination for the presence of vascular calcification and also to evaluate the alterations in serum CA, P, and ALP levels. Data were analyzed statistically using Chi-square test. Results: Panoramic radiographs of 50 patients showed 88.28% of teeth with the presence of pulp stones stones and 91% carotid arteries with calcification. The sensitivity of panoramic radiograph was greater than that of USG (93.67%, but the specificity of USG was more than the panoramic radiograph (44.44% in detecting CAC. The prevalence rate of renal calcification on USG was 92%. The statistical difference between the patients with or without alteration in serum Ca levels was not significant (χ2 = 0.581 and P = 0.446. On comparison of serum P and ALP, the difference was found to be statistically significant. Conclusion: Presence of pulp stones and CAC's on panoramic radiograph have remarkably proved to establish the chances of renal artery calcification associated with alterations in serum CA levels.

  13. Ultrasound Tissue Characterization of Vulnerable Atherosclerotic Plaque

    Directory of Open Access Journals (Sweden)

    Eugenio Picano

    2015-05-01

    Full Text Available A thrombotic occlusion of the vessel fed by ruptured coronary atherosclerotic plaque may result in unstable angina, myocardial infarction or death, whereas embolization from a plaque in carotid arteries may result in transient ischemic attack or stroke. The atherosclerotic plaque prone to such clinical events is termed high-risk or vulnerable plaque, and its identification in humans before it becomes symptomatic has been elusive to date. Ultrasonic tissue characterization of the atherosclerotic plaque is possible with different techniques—such as vascular, transesophageal, and intravascular ultrasound—on a variety of arterial segments, including carotid, aorta, and coronary districts. The image analysis can be based on visual, video-densitometric or radiofrequency methods and identifies three distinct textural patterns: hypo-echoic (corresponding to lipid- and hemorrhage-rich plaque, iso- or moderately hyper-echoic (fibrotic or fibro-fatty plaque, and markedly hyperechoic with shadowing (calcific plaque. Hypoechoic or dishomogeneous plaques, with spotty microcalcification and large plaque burden, with plaque neovascularization and surface irregularities by contrast-enhanced ultrasound, are more prone to clinical complications than hyperechoic, extensively calcified, homogeneous plaques with limited plaque burden, smooth luminal plaque surface and absence of neovascularization. Plaque ultrasound morphology is important, along with plaque geometry, in determining the atherosclerotic prognostic burden in the individual patient. New quantitative methods beyond backscatter (to include speed of sound, attenuation, strain, temperature, and high order statistics are under development to evaluate vascular tissues. Although not yet ready for widespread clinical use, tissue characterization is listed by the American Society of Echocardiography roadmap to 2020 as one of the most promising fields of application in cardiovascular ultrasound imaging

  14. Monocyte Subsets and Related Chemokines in Carotid Artery Stenosis and Ischemic Stroke

    Science.gov (United States)

    Grosse, Gerrit M.; Schulz-Schaeffer, Walter J.; Teebken, Omke E.; Schuppner, Ramona; Dirks, Meike; Worthmann, Hans; Lichtinghagen, Ralf; Maye, Gerrit; Limbourg, Florian P.; Weissenborn, Karin

    2016-01-01

    Carotid stenosis (CS) is an important cause of ischemic stroke. However, reliable markers for the purpose of identification of high-risk, so-called vulnerable carotid plaques, are still lacking. Monocyte subsets are crucial players in atherosclerosis and might also contribute to plaque rupture. In this study we, therefore, aimed to investigate the potential role of monocyte subsets and associated chemokines as clinical biomarkers for vulnerability of CS. Patients with symptomatic and asymptomatic CS (n = 21), patients with cardioembolic ischemic strokes (n = 11), and controls without any cardiovascular disorder (n = 11) were examined. Cardiovascular risk was quantified using the Essen Stroke Risk Score (ESRS). Monocyte subsets in peripheral blood were measured by quantitative flow cytometry. Plaque specimens were histologically analyzed. Furthermore, plasma levels of monocyte chemotactic protein 1 (MCP-1) and fractalkine were measured. Intermediate monocytes (Mon2) were significantly elevated in symptomatic and asymptomatic CS-patients compared to controls. Mon2 counts positively correlated with the ESRS. Moreover, stroke patients showed an elevation of Mon2 compared to controls, independent of the ESRS. MCP-1 levels were significantly higher in patients with symptomatic than in those with asymptomatic CS. Several histological criteria significantly differed between symptomatic and asymptomatic plaques. However, there was no association of monocyte subsets or chemokines with histological features of plaque vulnerability. Due to the multifactorial influence on monocyte subsets, the usability as clinical markers for plaque vulnerability seems to be limited. However, monocyte subsets may be critically involved in the pathology of CS. PMID:27023515

  15. Stroke from an External Carotid: Lesion Pattern and Mechanisms.

    Science.gov (United States)

    Nicolas, Kagan; Hubert, Lathelyse; Leclère, Franck Marie; Etienne, Marchand; Robert, Martinez

    2016-04-01

    Traditionally, patients with symptomatic external carotid stenosis present with neck or face pain, retinal ischemic symptoms or jaw claudication and rarely as ipsilateral cerebrovascular events. In this present case, our patient suffered a stroke from a paradoxical embolism from the external carotid, without involvement of the internal carotid artery. A plaque ulceration of the external carotid's origin was the cause of this cerebral emboli. Duplex ultrasound showed a pathologic left external carotid, with a floating thrombus in the internal carotid. The diagnostic was confirmed by a computerized tomography scan. An external carotid thromboendarterectomy was performed 6 days after symptom onset, and intraoperative findings confirmed the plaque rupture with an extensive clot in the carotid bifurcation. PMID:26802301

  16. Correlation between lipid profile & carotid intima media thickness in cerebral ischemia.

    Science.gov (United States)

    Sengupta, Debalina; Bardhan, Jayati; Baran, Anil; Mahapatra, Singha; Banerjee, Joyshree; Rout, Jayanta Kumar

    2014-01-01

    Cerebrovascular accident or stroke is defined by an abrupt onset of neurological deficit that is attributable to a focal vascular cause. Stroke is a major cause of morbidity and mortality worldwide. This may result from brain infarction or hemorrhage. Carotid atherosclerosis is a reasonable risk factor for cerebral ischemic stroke. Deranged lipid metabolism due to various modifiable and non-modifiable risk factors leads to the pathogenesis of atherosclerosis. This study is intended to find out any association between altered lipid metabolism (Cholesterol, Triglycerides, LDL : HDL ratio) and development of cerebral ischemia. An observational case control study was conducted with 50 cases of cerebral ischemia and 50 age & sex matched healthy controls within age group 50-70 years. After inclusion of cases and controls and taking informed consent they underwent history taking, proper clinical examination & biochemical investigations (lipid profile). Then data were collected and results were statistically analyzed using Chi-square test & Independent Sample "T-test". The study showed altered lipid profile is associated with cerebral ischemia by increasing carotid intima media thickness (IMT). There was significant (p cerebral ischemic stroke thereby reducing morbidity and mortality. PMID:26215001

  17. Carotid endarterectomy for atherosclerotic carotid artery stenosis

    International Nuclear Information System (INIS)

    Several randomized controlled trials (RCTs) have demonstrated carotid endarterectomy (CEA) to be more beneficial for the prevention of recurrent or first-ever ischemic stroke than treatment with antiplatelet agents in patients with moderate-severe stenosis of the cervical internal carotid artery. CEA is the standard treatment for such lesions; however, other RCTs have demonstrated carotid artery stenting (CAS) with a protective device to be comparable to CEA in patients with or without radiological or medical high-risks for CEA, although the selection criteria among these treatments have not yet been established in clinical practice. This review compares the results of RCTs valuating the superiority of CEA over medical treatment or CAS, preoperative examination, procedures of CEA, perioperative management and complications, long-term results, and indications for CEA based on the currently available evidence-based publications. A preoperative evaluation of the patients' medical condition, including atherosclerosis, is therefore important to minimize the perioperative complications of CEA, because myocardial infarction during the perioperative period is frequently observed in patients undergoing CEA. A through radiological examination such as plaque imaging is essential for selecting appropriate treatment strategies involving revascularization or medical treatment for atherosclerotic carotid artery stenosis. In addition, the surgical indications, particularly for asymptomatic lesions, should be carefully considered in light of the recent improvements in medical treatments including antihypertensive agents and statins. (author)

  18. Enhanced base excision repair capacity in carotid atherosclerosis may protect nuclear DNA but not mitochondrial DNA

    DEFF Research Database (Denmark)

    Skarpengland, Tonje; B. Dahl, Tuva; Skjelland, Mona;

    2016-01-01

    carotid plaques, 8 disease-free carotid specimens from patients with carotid plaques and 10 non-atherosclerotic control arteries. Genomic integrity, mitochondrial (mt) DNA copy number, oxidative DNA damage and BER proteins were evaluated in a subgroup of plaques and controls. Our major findings were: (i...... response of BER genes in atherosclerosis may contribute to lesional nuclear DNA stability but appears insufficient to maintain mtDNA integrity, potentially influencing mitochondrial function in cells within the atherosclerotic lesion....

  19. Association between both triglyceride level, newly identified carotid plaque and middle-aged and elderly population, Beijing%北京市中老年人群甘油三酯水平与颈动脉新发斑块关系的研究

    Institute of Scientific and Technical Information of China (English)

    张晓婷; 赵冬; 刘静; 冯立群; 孙佳艺; 王淼; 刘军; 王薇

    2012-01-01

    目的 探讨甘油三酯(TG)水平与北京市中老年人群5年颈动脉新发斑块的关系,分析TG合并心血管疾病传统危险因素对颈动脉新发斑块的预测作用.方法 应用队列研究方法,选取北京市两社区人群TG指标和基线复查两次颈动脉超声检测数据完整者共1949人作为研究对象.将基线TG分为4组:组1(<1.13 mmol/L)、组2(1.13~1.69 mmol/L)、组3(1.70 ~2.25 mmol/L)及组4(≥2.26 mmol/L),以颈动脉新发斑块作为动脉粥样硬化进展的评价指标,分析基线TG水平与颈动脉新发斑块的关系.结果 不同TG水平组间新发斑块率比较,新发斑块率随着基线TG水平的上升而增加(分别为30.8%、38.8%、41.9%和44.2%,x2=21.22,P<0.01).单因素分析显示:与组1相比,TG≥1.13 mmol/L可增加颈动脉新发斑块风险(组2、3、4分别增加了42%、62%和78%):调整年龄、性别及传统危险因素后,TG水平在2.26 mmol/L以上人群,颈动脉新发斑块风险增加37%.结论 北京市中老年人群颈动脉新发斑块率随着基线TG水平的上升而增加.高TG(≥2.26 mmol/L)可增加中老年人群颈动脉新发斑块的危险.%Objective To evaluate the association between triglyceride(TG) level and newly identified 5-year carotid plaque and to explore the prediction value of TG level on the newlyidentified carotid plaque with risk factors of traditional atherosclerosis.Methods A cohort study was adopted.The baseline survey including CVD risk factors and B-mode ultrasound of carotid artery was performed in 2002,and the second follow-up examination was performed in 2007.We evaluated 1949participants with lipid measurements and B-mode ultrasound of carotid arteries in the two surveys (with mean age as 57.9 ± 8.1 years and 39.2% were men).The baseline TG levels were divided into four groups:group 1 (TG<1.13 mmol/L),group 2 (TG=1.13-1.69 mmol/L),group 3 (TG=1.70-2.25 mmol/L) and group 4 (TG≥2.26 mmol/L).Newly identified

  20. Morphological and Stress Vulnerability Indices for Human Coronary Plaques and Their Correlations with Cap Thickness and Lipid Percent: An IVUS-Based Fluid-Structure Interaction Multi-patient Study.

    Directory of Open Access Journals (Sweden)

    Liang Wang

    2015-12-01

    Full Text Available Plaque vulnerability, defined as the likelihood that a plaque would rupture, is difficult to quantify due to lack of in vivo plaque rupture data. Morphological and stress-based plaque vulnerability indices were introduced as alternatives to obtain quantitative vulnerability assessment. Correlations between these indices and key plaque features were investigated. In vivo intravascular ultrasound (IVUS data were acquired from 14 patients and IVUS-based 3D fluid-structure interaction (FSI coronary plaque models with cyclic bending were constructed to obtain plaque wall stress/strain and flow shear stress for analysis. For the 617 slices from the 14 patients, lipid percentage, min cap thickness, critical plaque wall stress (CPWS, strain (CPWSn and flow shear stress (CFSS were recorded, and cap index, lipid index and morphological index were assigned to each slice using methods consistent with American Heart Association (AHA plaque classification schemes. A stress index was introduced based on CPWS. Linear Mixed-Effects (LME models were used to analyze the correlations between the mechanical and morphological indices and key morphological factors associated with plaque rupture. Our results indicated that for all 617 slices, CPWS correlated with min cap thickness, cap index, morphological index with r = -0.6414, 0.7852, and 0.7411 respectively (p<0.0001. The correlation between CPWS and lipid percentage, lipid index were weaker (r = 0.2445, r = 0.2338, p<0.0001. Stress index correlated with cap index, lipid index, morphological index positively with r = 0.8185, 0.3067, and 0.7715, respectively, all with p<0.0001. For all 617 slices, the stress index has 66.77% agreement with morphological index. Morphological and stress indices may serve as quantitative plaque vulnerability assessment supported by their strong correlations with morphological features associated with plaque rupture. Differences between the two indices may lead to better plaque

  1. Improved MR imaging of extracranial carotid artery disease

    International Nuclear Information System (INIS)

    Flow-related and phase-encoding artifacts and a nonorthogonal vessel course frequently degrade MR images of the extracranial carotid artery. Employing out-of-field saturation pulses has significantly improved imaging of the vascular wall and lumen on spin-echo sequences. Flow-related and phase-encoding artifacts have virtually been eliminated. Oblique imaging of the proximal internal carotid has achieved truer axial views of this segment. Ten patients with documented extracranial vascular disease underwent MR evaluation with this imaging protocol. There was excellent correlation between the degree of luminal stenosis on the MR image and on the angiogram. Vessel wall pathology on the endarterectomy specimen correlated with the in vivo MR appearance of the wall. Signal alterations in the plaque representing hemorrhage and calcification were detected

  2. In vivo semi-automatic segmentation of multicontrast cardiovascular magnetic resonance for prospective cohort studies on plaque tissue composition: initial experience.

    Science.gov (United States)

    Yoneyama, Taku; Sun, Jie; Hippe, Daniel S; Balu, Niranjan; Xu, Dongxiang; Kerwin, William S; Hatsukami, Thomas S; Yuan, Chun

    2016-01-01

    Automatic in vivo segmentation of multicontrast (multisequence) carotid magnetic resonance for plaque composition has been proposed as a substitute for manual review to save time and reduce inter-reader variability in large-scale or multicenter studies. Using serial images from a prospective longitudinal study, we sought to compare a semi-automatic approach versus expert human reading in analyzing carotid atherosclerosis progression. Baseline and 6-month follow-up multicontrast carotid images from 59 asymptomatic subjects with 16-79 % carotid stenosis were reviewed by both trained radiologists with 2-4 years of specialized experience in carotid plaque characterization with MRI and a previously reported automatic atherosclerotic plaque segmentation algorithm, referred to as morphology-enhanced probabilistic plaque segmentation (MEPPS). Agreement on measurements from individual time points, as well as on compositional changes, was assessed using the intraclass correlation coefficient (ICC). There was good agreement between manual and MEPPS reviews on individual time points for calcification (CA) (area: ICC; 0.85-0.91; volume: ICC; 0.92-0.95) and lipid-rich necrotic core (LRNC) (area: ICC; 0.78-0.82; volume: ICC; 0.84-0.86). For compositional changes, agreement was good for CA volume change (ICC; 0.78) and moderate for LRNC volume change (ICC; 0.49). Factors associated with LRNC progression as detected by MEPPS review included intraplaque hemorrhage (positive association) and reduction in low-density lipoprotein cholesterol (negative association), which were consistent with previous findings from manual review. Automatic classifier for plaque composition produced results similar to expert manual review in a prospective serial MRI study of carotid atherosclerosis progression. Such automatic classification tools may be beneficial in large-scale multicenter studies by reducing image analysis time and avoiding bias between human reviewers. PMID:26169389

  3. Automated IMT estimation and BMI correlation using a low-quality carotid ultrasound image database from India.

    Science.gov (United States)

    Molinari, Filippo; Gupta, Vipin; Prabhakaran, Poornima; Meiburger, Kristen M; Saba, Luca; Acharya, U Rajendra; Ledda, Giuseppe; Radha Krishna, K V; Walia, Gagandeep Kaur; Kinra, Sanjay; Nicolaides, Andrew; Ebrahim, Shah; Suri, Jasjit S

    2013-01-01

    This paper presents AtheroEdgeLowRes (AELR), an extention of AtheroEdge™ from AtheroPoint™, and a solution to carotid ultrasound IMT measurement in low-resolution and overall low quality images. The images were collected using a low-end ultrasound machine during a screening study in India. We aim to demonstrate the accuracy and reproducibility of the AELR system by benchmarking it against an expert Reader's manual tracing and to show the correlation between the automatically measured intima media thickness (IMT) and the subjects' cardiovascular risk factors (i.e. body mass index--BMI). We introduced an innovative penalty function (PF) to our dual-snake segmentation technique, necessary due to the low image resolution. We processed 512 images from 256 patients, and correlated the AELR IMT values with the patients' age and BMI. AELR processed all 512 images, and the IMT measurement error was 0.011±0.099 mm with the PF correction and 0.173±0.127 mm without. AELR IMT values correlated with the Reader's values (r = 0.883) and also correlated with the subject's BMI and age. The AELR system showed accuracy and reproducibility levels that make it suitable to be used in large epidemiological and screening studies in emerging countries. PMID:24110444

  4. Regional calcium distribution and ultrasound images of the vessel wall in human carotid arteries

    Science.gov (United States)

    Szikszai, Z.; Kertész, Zs.; Uzonyi, I.; Szíki, G. Á.; Magyar, M. T.; Molnár, S.; Ida, Y.; Csiba, L.

    2005-04-01

    Arterial calcification can take place at two sites in the vessel wall: the intima and the media. Intimal calcification occurs exclusively within atherosclerotic plaques, while medial calcification may develop independently. Extensive calcified plaques in the carotid arteries can be easily detected by B-mode ultrasonic imaging. The calcium content might correlate with the ultrasound reflectance of the vessel wall, and could be a surrogate marker for arteriosclerosis. In this study, segments of human carotid arteries collected at autopsy were examined by ultrasonography in vitro and calcium distributional maps of sections from the same segments were determined by particle induced X-ray emission. Our aim was to make a first step towards investigating the relationship between the calcium distributional maps and the respective ultrasound images.

  5. 18F-FDG imaging of human atherosclerotic carotid plaques reflects gene expression of the key hypoxia marker HIF-1α

    DEFF Research Database (Denmark)

    Pedersen, Sune Folke; Græbe, Martin; Hag, Anne Mette F;

    2013-01-01

    and CD68 gene expression co-variated and accordingly when entering the variables into multivariate linear regression models with SUV-values as dependent variables, HIF-1α was eliminated in the final models. (18)F-FDG-uptake (SUVmax) is correlated with HIF-1α gene expression indicating an association...

  6. Serum Inflammatory Biomarkers and Plaque Inflammation Assessed by 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the dal-PLAQUE Study

    Science.gov (United States)

    Duivenvoorden, Raphaël; Mani, Venkatesh; Woodward, Mark; Kallend, David; Suchankova, Gabriela; Fuster, Valentin; Rudd, James H.F.; Tawakol, Ahmed; Farkouh, Michael E.; Fayad, Zahi A.

    2013-01-01

    OBJECTIVES To longitudinally investigate the relationship between a broad spectrum of serum inflammatory biomarkers and plaque inflammation assessed by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). BACKGROUND Both plaque inflammation and serum biomarkers of inflammation are associated with atherothrombotic events; however, the relationship between them is unclear. METHODS We conducted a post-hoc analysis of the dal-PLAQUE study – a randomized, placebo-controlled study of dalcetrapib, a cholesteryl ester transfer protein inhibitor, in 130 patients with coronary heart disease, or coronary heart disease risk equivalents on stable lipid-lowering therapy. Baseline and change after 3 months’ follow-up in inflammatory biomarker levels, and baseline and change after 3 months’ follow-up in aorta and carotid 18F-FDG PET/CT (mean maximum target to background ratio of the most diseased segment (TBRmds), were analyzed. RESULTS Baseline myeloperoxidase (MPO) positively correlated with baseline carotid TBRmds (rho 0.25, p = 0.02). This correlation remained at 3 months’ and was independent of traditional cardiovascular disease risk factors. Baseline lipoprotein-associated phospholipase A2 mass correlated with aorta TBRmds (rho 0.21, p = 0.03). However, this correlation disappeared at 3 months’ and was not independent of cardiovascular disease risk factors. There was no association between change from baseline in MPO or lipoprotein-associated phospholipase A2 mass and change from baseline in aorta and carotid TBRmds. Baseline and change from baseline in high sensitivity C-reactive protein, interleukin 6, soluble P-selectin, soluble E-selectin, soluble intracellular adhesion molecule 1, soluble vascular cell adhesion molecule 1, and matrix-metalloproteinase 3 and 9 did not correlate with baseline or change from baseline in carotid or aorta TBRmds. CONCLUSION Our data show that, in patients with coronary heart disease or at high

  7. 99mTc-interleukin-2 scintigraphy for the in vivo imaging of vulnerable atherosclerotic plaques

    International Nuclear Information System (INIS)

    Several histopathological studies have demonstrated that vulnerable plaques are enriched in inflammatory cells. The aims of this study were: (1a) to test the ability of 99mTc-labelled interleukin-2 (99mTc-IL2) to bind to IL2R-positive (IL2R+) cells in carotid plaques and (1b) to correlate the plaque uptake of 99mTc-IL2, measured in vivo, with the number of IL2R+ cells within the plaque, measured ex vivo by histology (transversal study, TS), and (2) to evaluate changes in 99mTc-IL2 uptake in plaques, before and after treatment with a statin or a hypocholesterolaemic diet (longitudinal study, LS). Ultrasound scan was performed for plaque characterisation and localisation. Fourteen patients (16 plaques) eligible for endoarterectomy were recruited for the TS and underwent 99mTc-IL2 scintigraphy before surgery. Nine patients (13 plaques) were recruited for the LS; these patients received atorvastatin or a standard hypocholesterolaemic diet and 99mTc-IL2 scintigraphy was performed before and after 3 months of treatment. The degree of 99mTc-IL2 uptake was expressed as the plaque/background (T/B) ratio. In patients from TS, T/B ratios correlated with the percentage of IL2R+ cells at histology (r=0.707; p=0.002) and the number of IL2R+ cells at flow cytometry (r=0.711; p=0.006). No correlations were observed between ultrasound scores and either scintigraphic or histological findings. In patients from the LS, the mean 99mTc-IL2 uptake decreased in statin-treated patients (1.75±0.50 vs 2.16±0.44; p=0.012), while it was unchanged in the patients on the hypocholesterolaemic diet (2.33±0.45 vs 2.34±0.5). 99mTc-IL2 accumulates in vulnerable carotid plaques; this accumulation is correlated with the amount of IL2R+ cells and is influenced by lipid-lowering treatment with a statin. (orig.)

  8. Relation between diagnosis of atheromatous plaque from orthopantomographs and cardiovascular risk factors. A study of cases and control subjects

    OpenAIRE

    Barona Dorado, Cristina; Gutiérrez Bonet, Carmen; Leco Berrocal, María Isabel; Fernández Cáliz, Fernando; Martínez González, José María

    2015-01-01

    Background In recent years the use of orthopantomography has been proposed as a low-cost, reliable and non-invasive diagnostic medium for detecting atheromatous plaque. The purpose of this study was to correlate the presence of carotid calcifications (atheroma) in orthopantomographs with specific risk factors for cerebrovascular accidents (previous cerebrovascular accidents, arterial hypertension, and diabetes). Material and Methods The methods used in this observational study of cases and co...

  9. Three-dimensional reconstructions of carotid bifurcation from CT images: evaluation of different rendering methods

    International Nuclear Information System (INIS)

    Three-dimensional computed tomographic angiography (3D-CTA) and digital subtraction angiography of the cervical carotid artery were performed bilaterally in 15 patients with suspected stenoses. A new semi-automatic segmentation and new rendering methods were used. The degree of stenosis of internal carotid arteries, as determined both by axial slices and 3D images (surface, integral, maximum-intensity-projection, and raysum-rendered images), was compared qualitatively and quantitatively to angiographic findings. In correlation to angiography, the accuracy in determining the stenosis classification of internal carotid arteries was of 97% for axial slices and 59-90% for 3D images, respectively. Raysum (pseudoradiograph) rendering was found to be the most reliable rendering method and gave the most similar results to angiography. The accuracy of all rendering methods was improved by applying calcification removing algorithm, with a statistically significant difference between surface rendering without plaque removal and raysum rendering using the removing algorithm. (orig.)

  10. Three-dimensional reconstructions of carotid bifurcation from CT images: evaluation of different rendering methods

    Energy Technology Data Exchange (ETDEWEB)

    Tarjan, Z. [Dept. of Radiology, Univ. Hospital of Trieste, Ospedale di Cattinara, Trieste (Italy); Pozzi Mucelli, F. [Dept. of Radiology, Univ. Hospital of Trieste, Ospedale di Cattinara, Trieste (Italy); Frezza, F. [Dept. of Radiology, Univ. Hospital of Trieste, Ospedale di Cattinara, Trieste (Italy); Pozzi Mucelli, R. [Dept. of Radiology, Univ. Hospital of Trieste, Ospedale di Cattinara, Trieste (Italy)

    1996-06-01

    Three-dimensional computed tomographic angiography (3D-CTA) and digital subtraction angiography of the cervical carotid artery were performed bilaterally in 15 patients with suspected stenoses. A new semi-automatic segmentation and new rendering methods were used. The degree of stenosis of internal carotid arteries, as determined both by axial slices and 3D images (surface, integral, maximum-intensity-projection, and raysum-rendered images), was compared qualitatively and quantitatively to angiographic findings. In correlation to angiography, the accuracy in determining the stenosis classification of internal carotid arteries was of 97% for axial slices and 59-90% for 3D images, respectively. Raysum (pseudoradiograph) rendering was found to be the most reliable rendering method and gave the most similar results to angiography. The accuracy of all rendering methods was improved by applying calcification removing algorithm, with a statistically significant difference between surface rendering without plaque removal and raysum rendering using the removing algorithm. (orig.)

  11. Quantification of carotid vessel atherosclerosis

    Science.gov (United States)

    Chiu, Bernard; Egger, Micaela; Spence, J. D.; Parraga, Grace; Fenster, Aaron

    2006-03-01

    Atherosclerosis is characterized by the development of plaques in the arterial wall, which ultimately leads to heart attacks and stroke. 3D ultrasound (US) has been used to screen patients' carotid arteries. Plaque measurements obtained from these images may aid in the management and monitoring of patients, and in evaluating the effect of new treatment options. Different types of measures for ultrasound phenotypes of atherosclerosis have been proposed. Here, we report on the development and application of a method used to analyze changes in carotid plaque morphology from 3D US images obtained at two different time points. We evaluated our technique using manual segmentations of the wall and lumen of the carotid artery from images acquired in two US scanning sessions. To incorporate the effect of intraobserver variability in our evaluation, manual segmentation was performed five times each for the arterial wall and lumen. From this set of five segmentations, the mean wall and lumen surfaces were reconstructed, with the standard deviation at each point mapped onto the surfaces. A correspondence map between the mean wall and lumen surfaces was then established, and the thickness of the atherosclerotic plaque at each point in the vessel was estimated to be the distance between each correspondence pairs. The two-sample Student's t-test was used to judge whether the difference between the thickness values at each pair corresponding points of the arteries in the two 3D US images was statistically significant.

  12. Data Mining of Atherosclerotic Plaque Transcriptomes Predicts STAT1-Dependent Inflammatory Signal Integration in Vascular Disease

    Directory of Open Access Journals (Sweden)

    Krzysztof Sikorski

    2014-08-01

    Full Text Available Atherosclerotic plaque development involves multiple extra- and intra-cellular signals engaging cells from the immune system and from the vasculature. Pro-inflammatory pathways activated by interferon gamma (IFNγ and toll-like receptor 4 (TLR4 ligands are profoundly involved in plaque formation and have been shown to involve cross-talk in all atheroma-interacting cell types leading to increased activation of signal transducer and activator of transcription-1 (STAT1 and elevated expression of pro-inflammatory mediators. Here we demonstrate that in Gene Expression Omnibus repository (GEO deposited microarray datasets, obtained from human coronary and carotid atherosclerotic plaques, a significant increase in expression of pro-inflammatory and immunomodulatory genes can be detected. Moreover, increased expression of multiple chemokines, adhesion molecules and matrix-remodeling molecules was commonly detected in both plaque types and correlated with the presence of putative STAT1 binding sites in their promoters, suggesting strong involvement of STAT1 in plaque development. We also provide evidence to suggest that STAT1-nuclear factor kappa-light-chain-enhancer of activated B cells (NFκB or STAT1-interferon-regulated factor (IRF regulatory modules are over-represented in the promoters of these inflammatory genes, which points to a possible contribution of IFNγ and TLR4 cross-talk in the process of atherogenesis. Finally, a subset of these genes encodes for secreted proteins that could serve as a basis of a non-invasive diagnostic assay. The results of our in silico analysis in vitro provide potential evidence that STAT1-dependent IFNγ-TLR4 cross-talk plays a crucial role in coronary and carotid artery plaque development and identifies a STAT1-dependent gene signature that could represent a novel diagnostic tool to monitor and diagnose plaque progression in human atherosclerosis.

  13. Carotid artery image segmentation using modified spatial fuzzy c-means and ensemble clustering.

    Science.gov (United States)

    Hassan, Mehdi; Chaudhry, Asmatullah; Khan, Asifullah; Kim, Jin Young

    2012-12-01

    Disease diagnosis based on ultrasound imaging is popular because of its non-invasive nature. However, ultrasound imaging system produces low quality images due to the presence of spackle noise and wave interferences. This shortcoming requires a considerable effort from experts to diagnose a disease from the carotid artery ultrasound images. Image segmentation is one of the techniques, which can help efficiently in diagnosing a disease from the carotid artery ultrasound images. Most of the pixels in an image are highly correlated. Considering the spatial information of surrounding pixels in the process of image segmentation may further improve the results. When data is highly correlated, one pixel may belong to more than one clusters with different degree of membership. In this paper, we present an image segmentation technique namely improved spatial fuzzy c-means and an ensemble clustering approach for carotid artery ultrasound images to identify the presence of plaque. Spatial, wavelets and gray level co-occurrence matrix (GLCM) features are extracted from carotid artery ultrasound images. Redundant and less important features are removed from the features set using genetic search process. Finally, segmentation process is performed on optimal or reduced features. Ensemble clustering with reduced feature set outperforms with respect to segmentation time as well as clustering accuracy. Intima-media thickness (IMT) is measured from the images segmented by the proposed approach. Based on IMT measured values, Multi-Layer Back-Propagation Neural Networks (MLBPNN) is used to classify the images into normal or abnormal. Experimental results show the learning capability of MLBPNN classifier and validate the effectiveness of our proposed technique. The proposed approach of segmentation and classification of carotid artery ultrasound images seems to be very useful for detection of plaque in carotid artery. PMID:22981822

  14. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification

    DEFF Research Database (Denmark)

    Nicolaides, Andrew N; Kakkos, Stavros K; Kyriacou, Efthyvoulos;

    2010-01-01

    The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis....

  15. Magnetization transfer magnetic resonance of human atherosclerotic plaques ex vivo detects areas of high protein density

    Directory of Open Access Journals (Sweden)

    Qiao Ye

    2011-11-01

    Full Text Available Abstract Background Proteins are major plaque components, and their degradation is related to the plaque instability. We sought to assess the feasibility of magnetization transfer (MT magnetic resonance (MR for identifying fibrin and collagen in carotid atherosclerotic plaques ex vivo. Methods Human carotid artery specimens (n = 34 were obtained after resection from patients undergoing endarterectomy. MR was completed within 12 hr after surgery on an 11.7T MR microscope prior to fixation. Two sets of T1W spoiled gradient echo images were acquired with and without the application of a saturation pulse set to 10 kHz off resonance. The magnetization transfer ratio (MTR was calculated, and the degree of MT contrast was correlated with histology. Results MT with appropriate calibration clearly detected regions with high protein density, which showed a higher MTR (thick fibers (collagen type I (54 ± 8% compared to regions with a low amount of protein including lipid (46 ± 8% (p = 0.05, thin fibers (collagen type III (11 ± 6% (p = 0.03, and calcification (6.8 ± 4% (p = 0.02. Intraplaque hemorrhage (IPH with different protein density demonstrated different MT effects. Old (rich in protein debris and recent IPH (rich in fibrin had a much higher MTR 69 ± 6% and 55 ± 9%, respectively, compared to fresh IPH (rich in intact red blood cells(9 ± 3%. Conclusions MT MR enhances plaque tissue contrast and identifies the protein-rich regions of carotid artery specimens. The additional information from MTR of IPH may provide important insight into the role of IPH on plaque stability, evolution, and the risk for future ischemic events.

  16. Atherosclerotic Plaque Inflammation Varies Between Vascular Sites and Correlates With Response to Inhibition of Lipoprotein‐Associated Phospholipase A2

    Science.gov (United States)

    Fenning, Robert S.; Burgert, Mark E.; Hamamdzic, Damir; Peyster, Eliot G.; Mohler, Emile R.; Kangovi, Shreya; Jucker, Beat M.; Lenhard, Stephen C.; Macphee, Colin H.; Wilensky, Robert L.

    2015-01-01

    Background Despite systemic exposure to risk factors, the circulatory system develops varying patterns of atherosclerosis for unclear reasons. In a porcine model, we investigated the relationship between site‐specific lesion development and inflammatory pathways involved in the coronary arteries (CORs) and distal abdominal aortas (AAs). Methods and Results Diabetes mellitus (DM) and hypercholesterolemia (HC) were induced in 37 pigs with 3 healthy controls. Site‐specific plaque development was studied by comparing plaque severity, macrophage infiltration, and inflammatory gene expression between CORs and AAs of 17 DM/HC pigs. To assess the role of lipoprotein‐associated phospholipase A2 (Lp‐PLA2) in plaque development, 20 DM/HC pigs were treated with the Lp‐PLA2 inhibitor darapladib and compared with the 17 DM/HC untreated pigs. DM/HC caused site‐specific differences in plaque severity. In the AAs, normalized plaque area was 4.4‐fold higher (P<0.001) and there were more fibroatheromas (9 of the 17 animals had a fibroatheroma in the AA and not the COR, P=0.004), while normalized macrophage staining area was 1.5‐fold higher (P=0.011) compared with CORs. DM/HC caused differential expression of 8 of 87 atherosclerotic genes studied, including 3 important in inflammation with higher expression in the CORs. Darapladib‐induced attenuation of normalized plaque area was site‐specific, as CORs responded 2.9‐fold more than AAs (P=0.045). Conclusions While plaque severity was worse in the AAs, inflammatory genes and inflammatory pathways that use Lp‐PLA2 were more important in the CORs. Our results suggest fundamental differences in inflammation between vascular sites, an important finding for the development of novel anti‐inflammatory therapeutics. PMID:25672369

  17. Relationship Between Serum Fetuin-A Levels and Carotid Intima-media Thickness in Turkish Patients with Mild to Moderate Psoriasis. A Case-control Study

    OpenAIRE

    Belkız Uyar; Muhittin Akyıldız; Aynur Solak; Berhan Genç; Ali Saklamaz

    2015-01-01

    Previous studies have associated severe psoriasis and psoriatic arthritis with an increased risk of atherosclerosis. However, the association between patients with mild-to-moderate plaque-type psoriasis and atherosclerosis has yet to be studied in depth. This study investigates a) possible correlations between carotid intima-media thickness (CIMT) and serum fetuin-A levels in patients with mild-to-moderate psoriasis and b) correlations between psoriasis severity index (PASI) and fetuin-A leve...

  18. Relationship between the characteristics of atherosclerotic plaque of carotid artery and cardiovascular events in a senior cohort of Renqiu region,Hebei%河北省任丘市城乡老年居民颈动脉斑块特征与心脑血管事件的相关性研究

    Institute of Scientific and Technical Information of China (English)

    张广波; 于凯; 冀瑞俊; 王拥军; 高素颖; 颜应琳

    2016-01-01

    Objective To investigate the potential relationship between the characteristics of atherosclerotic plaque of carotid artery and cardiovascular events in a senior cohort of Renqiu region,Hebei.Methods A random cluster sampling method was used to identify study population among 60 -70 years old residence in Renqiu region, Hebei.In the face of health questionnaire survey,neck vascular ultrasound examination,a total of 4 413 cases,inclu-ding 1 876 males and 2 537 females,the occurrence of carotid artery plaque and stenosis were detected by ultrasound. Carotid ultrasound was used to identify the characteristic of atherosclerotic plaque of bilateral carotid arteries,which were categorized as with and without plaque,single and multiple plaque,homogenous and heterogeneous plaque,and with and without stenosis.Cardiovascular events were defined as composite events of myocardial infarction,cardiovas-cular death,fatal or non -fatal stroke during the subsequent 2 years follow -up after initial evaluation.Multiple Logis-tic regression was performed to identify the association between the characteristics of bilateral carotid arteries and cardiovascular events.Results A total of 4 413 case enrolled in the study.With carotid ultrasound,2 438 cases (55.2%)were found to be with atherosclerotic plaque formation and 235(5.3%)were with carotid artery stenosis. The proportion of single,multiple,homogeneous and heterogeneous plaques were 1 024cases(23.2%),1 114cases (32.0%),1 106cases(25.1%)and 1 333cases(30.2%),respectively.Among them,the single plaque and new cardiovascular and cerebrovascular events occured in 83 cases(P =0.168),the multiple plaques and new cardiovascular and cerebrovascular events occured in 161 cases(P <0.001 ),the homogeneous patch and new cerebral vascular events occured in 98 cases(P =0.032),the non -homogeneous patch and new cerebral vascular events occured in 146 cases(P <0.001),the stenosis and cerebral vascular events occured in 42 cases(P <0.001).Taken the

  19. Genotype-phenotype correlations in a prospective cohort study of paediatric plaque psoriasis: lack of correlation between HLA-C*06 and family history of psoriasis.

    Science.gov (United States)

    Oostveen, Annet M; Bergboer, Judith G M; van de Kerkhof, Peter C M; Zeeuwen, Patrick L J M; de Jong, Elke M G J; Schalkwijk, Joost; Seyger, Marieke M B

    2014-11-01

    This study aims to investigate associations between observed clinical parameters and known genetic risk factors of psoriasis in a well-defined prospective cohort of paediatric patients with plaque psoriasis (n = 151). Significant associations were found for paediatric-onset psoriasis with ERAP1 (p = 0.002), IL23R (p = 0.01), LCE3C_LCE3B-del (p = 0.00049) and HLA-C*06 (p = 3.15 × 10(-30)). Psoriasis severity was associated with the single nucleotide polymorphisms tagging IFIH1 and ERAP1 (p < 0.05). An onset before 10 years of age was associated with IL12B (p = 0.02). Nail psoriasis was more often seen in HLA-C*06-negative patients (p = 0.008). Remarkably, family history is clearly not associated with HLA-C*06 in this specific group. The large proportion of patients with a positive family history in HLA-C*06 negative patients (and the lack of correlation between the two) indicates that other genes, either alone or interaction between two or more genes, may have significant effects on heritability. PMID:24791935

  20. Aterofisiol® in carotid plaque evolution

    OpenAIRE

    Amato B; Compagna R; Amato M.; Gallelli L; de Franciscis S.; Serra R

    2015-01-01

    Bruno Amato,1,2,* Rita Compagna,1,2,* Maurizio Amato,2 Luca Gallelli,3 Stefano de Franciscis,1,4,* Raffaele Serra1–4,*1Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Catanzaro, 2Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, 3Department of Health Sciences, University of Catanzaro, Catanzaro, 4Department of Medical a...

  1. The usefulness of computed tomography angiography comparing to Duplex Doppler Ultrasound in the diagnosis of carotid artery stenosis in patients with cerebral circulation insufficiency symptoms

    International Nuclear Information System (INIS)

    To compare diagnostic usefulness of CT angiography (angioCT) vs. Dupplex Doppler Ultrasound (US) in the evaluation of extracranial internal carotid stenosis. The results of extracranial carotid angioCT and US were compared in 70 cases of patients with cerebral circulation insufficiency syndromes. The degree of stenosis was measured according to NASCET. Correlation, contingency and regression coefficients were used to assess the convergence between angioCT and US. The morphology of atherosclerotic plaque depicted in angioCT was assessed as well, and the results were compared to US. Additionally, in 33 patients cerebral angioCT was performed to exclude surgery contraindications. The value of correlation coefficient, which measures the angioCT vs. US convergence in the assessment of carotid artery stenosis, is 0.96. The results correspond best in following groups of cases: normal arteries and occluded arteries (CC contingency coefficient values are 0.68 and 0.65). A statistically significant dependence occurs also in atherosclerotic plaque morphology imaging (Chi=42.114; p=0.0001; CC=0.636). The high degree of convergence between angioCT and US in assessing the extracranial carotid artery stenosis was recorded. AngioCT is useful as the complementary diagnostic method in cases of difficult anatomy, artery loops or kinking. A precise assessment of 'soft' atherosclerotic plaques morphology is not possible with angioCT, but artery wall calcifications are better depicted with this method. (author)

  2. Carotid intervention: stent or surgery? A prospective audit

    OpenAIRE

    Robbs, JV; Mulaudzi, T; Paruk, N; Pillay, B; Rajaruthnam, P

    2009-01-01

    Summary This study represents a prospective audit comparing carotid artery stenting (CAS) with carotid endarterectomy (CEA), performed by a single surgical team. Between January 2005 and December 2008, 440 patients were referred; 177 had CAS and 263 CEA. Selection of procedure was individualised and contra-indications for CAS included internal carotid artery (ICA) stenosis > 85–90%, intraluminal thrombus, ICA tortuosity, gross surface ulceration of plaque and excessive calcification. Type III...

  3. Subclinical carotid atherosclerosis and cardiovascular risk factors in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    Wiesława Kwiatkowska

    2011-11-01

    Full Text Available Background:HIV infected patients, especially those treated with antiretroviral (ARV drugs, show an increased risk and incidence of cardiovascular disease.Objectives:The aim of this study was to evaluate the progression of subclinical atherosclerosis in the carotid arteries, expressed as the value of carotid intima-media thickness (cIMT and the amount of atherosclerotic plaques, and to analyze the correlation between cIMT and risk factors for cardiovascular diseases in a cohort of HIV infected patients.Methods:The analysis included 72 HIV infected patients, mean age 39.4 years, and 27 healthy HIV negative individuals, matched for age and sex. The data collected included evaluation of the infection, ARV treatment, past cardiovascular events, assessment of traditional and nontraditional risk factors for cardiovascular diseases, cIMT measurements and amount of atherosclerotic plaques in the carotid arteries.Results:HIV infected patients show more advanced subclinical atherosclerosis in the carotid arteries (cIMT and plaques incidence. The cardiovascular risk profile of the HIV infected patients is significantly different from HIV negative people. Among the HIV positive group lower body mass index (BMI and higher waist/hip ratio (WHR are observed. The concentration of all cholesterol fractions is lower, whereas the concentration of triglycerides is higher. Cigarette smoking is more common among HIV-infected individuals. A strong statistical correlation between cIMT and age, hypertension, non-high-density lipoprotein (non-HDL cholesterol and ARV time were found. Total and LDL cholesterol, and lifetime smoking exposure also affect the cIMT. The relationship between cIMT and current HIV RNA may indicate the impact of the current infection status on the cIMT dynamics in this subpopulation.

  4. {sup 99m}Tc-interleukin-2 scintigraphy for the in vivo imaging of vulnerable atherosclerotic plaques

    Energy Technology Data Exchange (ETDEWEB)

    Annovazzi, Alessio; D' Alessandria, Calogero; Scopinaro, Francesco [University La Sapienza, Nuclear Medicine, 2nd Faculty of Medicine, Rome (Italy); Bonanno, Elena; Spagnoli, Luigi G. [University Tor Vergata, Department of Biopathology and Diagnostic Imaging, Rome (Italy); Arca, Marcello [University La Sapienza, Department of Clinical and Applied Medical Therapy, 1st Faculty of Medicine, Rome (Italy); Marcoccia, Antonella; Violi, Francesco [University La Sapienza, Medical Clinical Institute 1, 1st Faculty of Medicine, Rome (Italy); Toma, Giorgio De [University La Sapienza, Department of Surgery Pietro Valdoni, 1st Faculty of Medicine, Rome (Italy); Signore, Alberto [University La Sapienza, Nuclear Medicine, 2nd Faculty of Medicine, Rome (Italy); University of Groningen, Department of Nuclear Medicine, Groningen (Netherlands); Ospedale S. Andrea, Nuclear Medicine, Roma (Italy)

    2006-02-01

    Several histopathological studies have demonstrated that vulnerable plaques are enriched in inflammatory cells. The aims of this study were: (1a) to test the ability of {sup 99m}Tc-labelled interleukin-2 ({sup 99m}Tc-IL2) to bind to IL2R-positive (IL2R+) cells in carotid plaques and (1b) to correlate the plaque uptake of {sup 99m}Tc-IL2, measured in vivo, with the number of IL2R+ cells within the plaque, measured ex vivo by histology (transversal study, TS), and (2) to evaluate changes in {sup 99m}Tc-IL2 uptake in plaques, before and after treatment with a statin or a hypocholesterolaemic diet (longitudinal study, LS). Ultrasound scan was performed for plaque characterisation and localisation. Fourteen patients (16 plaques) eligible for endoarterectomy were recruited for the TS and underwent {sup 99m}Tc-IL2 scintigraphy before surgery. Nine patients (13 plaques) were recruited for the LS; these patients received atorvastatin or a standard hypocholesterolaemic diet and {sup 99m}Tc-IL2 scintigraphy was performed before and after 3 months of treatment. The degree of {sup 99m}Tc-IL2 uptake was expressed as the plaque/background (T/B) ratio. In patients from TS, T/B ratios correlated with the percentage of IL2R+ cells at histology (r=0.707; p=0.002) and the number of IL2R+ cells at flow cytometry (r=0.711; p=0.006). No correlations were observed between ultrasound scores and either scintigraphic or histological findings. In patients from the LS, the mean {sup 99m}Tc-IL2 uptake decreased in statin-treated patients (1.75{+-}0.50 vs 2.16{+-}0.44; p=0.012), while it was unchanged in the patients on the hypocholesterolaemic diet (2.33{+-}0.45 vs 2.34{+-}0.5). {sup 99m}Tc-IL2 accumulates in vulnerable carotid plaques; this accumulation is correlated with the amount of IL2R+ cells and is influenced by lipid-lowering treatment with a statin. (orig.)

  5. Characteristics of virtual histology-intravascular unltrasound of infarction-related artery atheromatous plaque and pregnancy-associated plasma protein A level: a correlation study

    International Nuclear Information System (INIS)

    Objective: To observe the characteristics of virtual histology-intravascular ultrasound (VH-IVUS) in 70 patients with acute ST segment elevated type myocardial infarction (AMI), the findings were compared with that in 70 patients with stable angina (control group), and to analyze the correlation between VH-IVUS characteristics and pregnancy-associated plasma protein A (PAPPA) level. Methods: Seventy patients with ST segment elevated AMI and 70 patients with stable angina, who received percutaneous coronary artery intervention and were encountered from Jan. 2008 to Dec. 2009, were involved in this study. After coronary angiography was completed,the plasma was aspirated from culprit coronary artery with ZEEK catheter. Then, IVUS examination to culprit lesion was carried out and grayscale and VH data were stored. The characteristics of VH-IVUS of culprit atheromatous plaque were observed and its correlation with PAPPA was analyzed. Results: The difference in age,gender, hypertension, smoking, diabetes mellitus and hyperlipidemia between two groups was of no statistical significance, but statistically significant difference in VH-IVUS characteristics of the atheromatous plaque existed between two groups, more fibro-fatty tissue and necrotic tissue with less dense calcium were seen in AMI group. The ratio of necrotic tissue area to calcified tissue area was (3.62±1.46) in AMI group and(7.18±2.53) in control group (P<0.01). PAPPA in AMI group was significantly higher than that in control group (P<0.01). Parameters of VH-IVUS in AMI group were highly correlated with PAPPA (P<0.05 or P<0.01). Conclusion: The characteristics of virtual histology-intravascular ultrasound of infarction-related artery atheromatous plaque include more necrotic tissue, higher ratio of necrotic tissue area to calcified tissue area and a closer correlation with PAPPA. (authors)

  6. MRI of the transplanted endothelial progenitor cells for prevent atherosclerotic plaque formation

    International Nuclear Information System (INIS)

    Objective: To evaluate the 1.5 T magnetic resonance imaging system to depict and track in vivo of magnetically labeled endothelial progenitor cells (EPCs), and to study the possibility for preventing the atherosclerotic plaque formation in New Zealand rabbit model of carotid arterial injury after transplantation. Methods: New Zealand rabbit EPCs were isolated, confirmed, expanded and then incubated with home synthesized Fe2O3-PLL, Prussian blue stain was performed for showing intracellular irons. The model of carotid arterial injury was performed by 2.5F balloons, the group A of 8 rabbits received magnetically labeled EPCs, group B of 3 rabbits received fluorescent-labeled EPCs and the group C of 5 rabbits were given same volume saline injection after endothelial injury of the carotid artery. MR imaging and histology were performed and compared 4 days later for randomly chosen three rabbit, each from one of the three group; all the other rabbits were fed with high lipid diet and examed using MR imaging and histology after 15 weeks. Results: Epcs labeling efficiency was more than 95% by Prussian blue stain, 4 days after transplantation of EPCs, only in group A, the injured endothelium of carotid artery had signal intensity loss in T2*WI, which were correlated well with the area where the most Prussian blue staining positive cells were found in histopathology analyses. The rabbits of group A and B which received EPCs transplantation exhibited fewer plaques formation than those of the group C (P2O3-PLL. The 1.5 T magnetic resonance imaging system could depict and monitor the magnetically labeled endothelial progenitor cells homing to the injured endothelium of the artery, and EPCs contribute to preventing atherosclerotic plaque formation in New Zealand rabbit model of atherosclerosis. (authors)

  7. Atherosclerotic Plaque Inflammation Varies Between Vascular Sites and Correlates With Response to Inhibition of Lipoprotein‐Associated Phospholipase A2

    OpenAIRE

    Fenning, Robert S.; Burgert, Mark E.; Hamamdzic, Damir; Peyster, Eliot G.; Mohler, Emile R; Kangovi, Shreya; Jucker, Beat M.; Lenhard, Stephen C.; Macphee, Colin H.; Wilensky, Robert L.

    2015-01-01

    Background Despite systemic exposure to risk factors, the circulatory system develops varying patterns of atherosclerosis for unclear reasons. In a porcine model, we investigated the relationship between site‐specific lesion development and inflammatory pathways involved in the coronary arteries (CORs) and distal abdominal aortas (AAs). Methods and Results Diabetes mellitus (DM) and hypercholesterolemia (HC) were induced in 37 pigs with 3 healthy controls. Site‐specific plaque development was...

  8. Carotid Artery Screening

    Science.gov (United States)

    ... Resources Professions Site Index A-Z Carotid Artery Screening What is carotid artery screening? Who should consider ... about carotid artery screening? What is carotid artery screening? Screening examinations are tests performed to find disease ...

  9. Carotid artery phantom designment and simulation using field II

    Science.gov (United States)

    Lin, Yuan; Yang, Xin; Ding, Mingyue

    2013-10-01

    Carotid atherosclerosis is the major cause of ischemic stroke, a leading cause of mortality and disability. Morphology and structure features of carotid plaques are the keys to identify plaques and monitoring the disease. Manually segmentation on the ultrasonic images to get the best-fitted actual size of the carotid plaques based on physicians personal experience, namely "gold standard", is a important step in the study of plaque size. However, it is difficult to qualitatively measure the segmentation error caused by the operator's subjective factors. In order to reduce the subjective factors, and the uncertainty factors of quantification, the experiments in this paper were carried out. In this study, we firstly designed a carotid artery phantom, and then use three different beam-forming algorithms of medical ultrasound to simulate the phantom. Finally obtained plaques areas were analyzed through manual segmentation on simulation images. We could (1) directly evaluate the different beam-forming algorithms for the ultrasound imaging simulation on the effect of carotid artery; (2) also analyze the sensitivity of detection on different size of plaques; (3) indirectly reflect the accuracy of the manual segmentation base on segmentation results the evaluation.

  10. Estimation of Plaque Contents With Multi-Angle 3D Compound Imaging

    DEFF Research Database (Denmark)

    Wilhjelm, Jens E.; Grønholdt, Marie Louise; Rasmussen, Steen Tofthøj;

    1996-01-01

    varies much more with angle for fibrous tissues. An experimental multi-angle 3D pulse-echo recording system has been established with a 10 MHz focused single element transducer mounted on a high precision rotational device. The received signal was processed in order to match axial resolution size to...... lateral resolution size (1.4 mm @ -3 dB) to obtain an omnidirectional range cell. After scanning, the plaques underwent histological analysis in order to estimate the amount of calcification, fibrous tissues, lipid, blood and thrombus. So far, 13 plaques surgically removed during carotid endarterectomy...... have been scanned in 3D from five different angles. Based on the angle-dependence of the signal energy for each range cell, six features could be extracted and correlated to the histological results. From the limited amount of data presented here, correlation was found between one feature and the...

  11. The efficacy of carotid ultrasonography in estimating coronary artery stenosis in patients receiving hemodialysis

    International Nuclear Information System (INIS)

    In patients with dialysis therapy, cardiovascular diseases have a great impact on morbidity and mortality. Because physicians have recently been encountering more patients with diabetes mellitus as well as more elderly patients, the importance of evaluating atherosclerosis has continuously increased. It has been reported that ischemic heart diseases or cerebrovascular diseases can be estimated using non-invasive ultrasonography. In addition, we can also diagnose coronary stenosis using computed tomography more easily than before. In this study, we in vestigated the efficacy of carotid ultrasonography in estimating coronary artery stenosis in patients with hemodialysis. One hundred and eight patients (58 men and 50 women with a mean age of 69±12 years, and a mean dialysis duration of 6.7±6.2 years) were enrolled in this study. We measured the maximum intima-media thickness (max-IMT), the distribution and the properties of plaque and plaque scores at carotid arteries using ultrasonography, and examined the degree of stenosis and the number of stenotic coronary arteries using computed tomography. As the max-IMT or plaque scores increased, the degree of stenosis became significantly more severe and multi-vessel disease was observed with significantly greater frequency. End stage renal disease is one of most significant cardiovascular risk factors. However, it is difficult to diagnose ischemic heart disease correctly in these patients because they sometimes have few symptoms due to diabetes and often show atypical electrocardiograms due to ventricular hypertrophy or electrolyte disorders. In this study, we clearly showed the correlation between atherosclerosis in the carotid arteries and stenosis in the coronary arteries. It is suggested that carotid ultrasonography is useful to estimate coronary artery stenosis, and effective for evaluating the risk of ischemic heart diseases non-invasively in patients with hemodialysis. (author)

  12. Correlation study of plaque and gingival indexes of mothers and their children Estudo da correlação dos índices de placa e gengival em mães e filhos

    OpenAIRE

    Ana Cláudia Durante Ramires-Romito; Luciana Butini Oliveira; Giuseppe Alexandre Romito; Márcia Pinto Alves Mayer; Célia Regina Martins Delgado Rodrigues

    2005-01-01

    This study aimed to compare the periodontal condition between plaque and gingival indexes in 30 pairs of mother and child with mixed dentition, as well as to correlate the findings with some of their social and oral hygiene habits. Mother's and child's plaque and gingival indexes were recorded during clinical examination. Periapical and bitewing radiographs were taken in order to assess the presence of any pathologic bone loss. Questionnaires answered by the mothers were used to collect infor...

  13. Phage Display Identification of CD100 in Human Atherosclerotic Plaque Macrophages and Foam Cells

    OpenAIRE

    Luque, Maria Carolina Aquino; Gutierrez, Paulo Sampaio; Debbas, Victor; Martins, Waleska Kerllen; Puech-Leao, Pedro; Porto, Georgia; Coelho, Verônica; Boumsell, Laurence; Kalil, Jorge; Stolf, Beatriz

    2013-01-01

    Atherosclerosis is a complex disease in which vessels develop plaques comprising dysfunctional endothelium, monocyte derived lipid laden foam cells and activated lymphocytes. Considering that humans and animal models of the disease develop quite distinct plaques, we used human plaques to search for proteins that could be used as markers of human atheromas. Phage display peptide libraries were probed to fresh human carotid plaques, and a bound phage homologous to plexin B1, a high affinity rec...

  14. A comparison of ultrasound measurements to assess carotid atherosclerosis development in subjects with and without type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Zinman Bernard

    2005-06-01

    Full Text Available Abstract Background Subjects with type 2 diabetes are at an increased risk of vascular complications. The use of carotid ultrasound remains an attractive, non-invasive method to monitor atherosclerotic disease progression and/or response to treatment in patients with type 2 diabetes, with intima-media thickness routinely used as the gold standard to detect pathology. However, alternative measurements, such as plaque area or volume, may represent a potentially more powerful approach. Thus, the objective of this study was to compare the traditional intima-media thickness measurement against the novel total plaque volume measurement in analyzing carotid atherosclerosis development in individuals with type 2 diabetes. Methods The case-control study included 49 Oji-Cree adults with diabetes or impaired glucose tolerance, aged 21–69, and 49 sex- and age-matched normoglycemic subjects. At baseline, metabolic variables were measured, including body mass index, waist circumference, total cholesterol:high density lipoprotein ratio, plasma triglycerides, plasma glucose, and serum insulin. Carotid ultrasound measurements, 7 years later, assessed carotid arterial intima-media thickness and total plaque volume. Results At baseline, the two groups were well matched for smoking habits, hypertension, body mass index, and waist circumference. Differences were noted in baseline measurements of total cholesterol:high density lipoprotein (P = 0.0006, plasma triglycerides (P P P = 0.037, but not intima-media thickness measurements, were higher in subjects with diabetes/impaired glucose tolerance compared to the normoglycemic controls. Correlation between intima-media thickness and total plaque volume was moderate. Based on our study findings, to achieve power levels >0.70 when comparing intima-media thickness measurements for diabetics versus non-diabetics, thousands of study subjects are required. For comparing total plaque volume measurements, only hundreds of

  15. Long-term effects on carotid intima-media thickness after radiotherapy in patients with nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Vascular abnormalities are the predominant histologic changes associated with radiation in nasopharyngeal carcinoma (NPC). This study examined if the duration after radiotherapy correlates with the progression of carotid intima-media thickness (IMT) and investigated its relationship with inflammatory markers. One hundred and five NPC patients post-radiotherapy for more than one year and 25 healthy control subjects were examined by B-mode ultrasound for IMT measurement at the far wall of the common carotid artery (CCA). Surrogate markers including lipid profile, HbA1c, and high sensitive C-reactive protein (hs-CRP) were assessed. The IMT of CCA was significantly increased in NPC patients and carotid plaque was detected in 38 NPC patients (38/105, 36.2%). Significant risk factors for carotid plaques included age, duration after radiotherapy, and HbA1c levels. Age, duration after radiotherapy, hs-CRP, HbA1c, and platelet count positively correlated with IMT. The cut-off value of age and duration after radiotherapy for the presence of plaque was 52.5 years and 42.5 months, respectively. In NPC subjects, multiple linear regression analysis revealed that age, gender, duration after radiotherapy and platelet counts were independently associated with CCA IMT. After adjustments for age, gender and platelet counts, IMT increased in a linear manner with duration after radiotherapy. Radiation-induced vasculopathy is a dynamic and progressive process due to late radiation effects. Extra-cranial color-coded duplex sonography can be part of routine follow-up in NPC patients aged ≥50 years at 40 months post-radiotherapy

  16. Recent concepts in the management of extracranial carotid stenosis: Carotid endarterectomy versus carotid artery stenting

    Directory of Open Access Journals (Sweden)

    Jeyaraj D Pandian

    2011-01-01

    Full Text Available Carotid stenosis is seen in 10% of patients with ischemic stroke, and carotid endarterectomy (CEA and carotid artery stenting (CAS are the two invasive treatments options available. Pooled analysis of the three largest randomized trials of CEA involving more than 3000 symptomatic patients estimated 30-day stroke and death rate at 7.1% after CEA. Some subgroups among the symptomatic patients appeared to have more benefit from CEA. These include patients aged 75 years or more, patients with ulcerated plaques, and patients with recent transient ischemic attacks within 2 weeks of randomization. Selection of asymptomatic patients for carotid revascularization should be guided by an assessment of comorbid conditions, life expectancy, and other individual factors, and should include a thorough discussion of the risks and benefits of the procedure with an understanding of patient preferences. The recent trials comparing CEA with CAS has not established its superiority over CEA. The carotid revascularization endarterectomy versus stenting (CREST study showed that CAS is still associated with a higher periprocedural risk of stroke or death than CEA. In patients over 70 years of age, CEA is clearly superior to CAS. The increased risk of nonfatal myocardial infarction in the CREST group subjected to CEA clearly suggests that patients being considered for CEA or CAS require a careful preliminary cardiac evaluation. CAS can be justified for patients whose medical comorbidities or cervical anatomy make them questionable candidates for CEA. The benefit of revascularization by either method versus modern aggressive medical therapy has not been established for patients with asymptomatic carotid stenosis.

  17. Association between genetic polymorphisms and carotid atherosclerosis in patients treated with radiotherapy for nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Radiotherapy (RT) of the neck is commonly given to nasopharyngeal carcinoma (NPC) patients for preventing cervical lymph node metastasis. However, neck RT may induce the development of carotid atherosclerosis. The mechanisms of radiation-induced carotid atherosclerosis are still unclear and no previous study has investigated the genetic involvement of radiation-induced carotid atherosclerosis. The present study aims to determine the association between genetic polymorphisms and carotid atherosclerosis in patients treated with RT for nasopharyngeal carcinoma. The present study recruited 128 post-RT NPC patients. Carotid plaque score was assessed using ultrasonography. Thirteen single nucleotide polymorphisms (SNPs) that affect the function of anti-atherosclerotic genes, including SOD2, SOD3, CAT, PON1, PPARG, ADIPOQ, IL10, TGFB1 and NOS3, were genotyped. Association between the 13 SNPs and carotid atherosclerosis was evaluated using multiple regression after adjustment for covariates (PLINK). Multiple testing was corrected using Benjamini-Hochberg step-up false discovery rate controlling procedure. rs662 and rs705379 of PON1 were close to be significantly associated with carotid plaque score (Corrected P value, Pcor = 0.0528 and Pcor = 0.0842). When the two SNPs were combined together, TC haplotype in rs662-rs705379 of PON1 was significantly associated with higher carotid plaque score (Pcor < 0.05). None of the other SNPs showed significant association with carotid plaque score. TC haplotype in rs662-rs705379 of PON1 is likely to be a genetic risk factor of carotid plaque score. Post-RT NPC patients with the TC haplotype may need earlier and more frequent carotid ultrasound examinations for early detection of carotid atherosclerosis

  18. Genotype-phenotype correlations in a prospective cohort study of paediatric plaque psoriasis: lack of correlation between HLA-C*06 and family history of psoriasis

    OpenAIRE

    Oostveen, A.M.; Bergboer, J.G.M.; van de Kerkhof, P C M; Zeeuwen, P.L.J.M.; Jong, E.M.G.J. de; Schalkwijk, J; Seyger, M.M.B.

    2014-01-01

    This study aims to investigate associations between observed clinical parameters and known genetic risk factors of psoriasis in a well-defined prospective cohort of paediatric patients with plaque psoriasis (n = 151). Significant associations were found for paediatric-onset psoriasis with ERAP1 (p = 0.002), IL23R (p = 0.01), LCE3C_LCE3B-del (p = 0.00049) and HLA-C*06 (p = 3.15 x 10(-30)). Psoriasis severity was associated with the single nucleotide polymorphisms tagging IFIH1 and ERAP1 (p <...

  19. Correlation between coronary artery disease severity, left ventricular mass index and carotid intima media thickness, assessed by radio-frequency

    Directory of Open Access Journals (Sweden)

    Ciccone Marco M

    2011-11-01

    Full Text Available Abstract Background Intima-media thickness of the common carotid artery (CCA-IMT is a validated marker of systemic atherosclerosis process. The aim of this study was to evaluate the association between coronary artery disease (CAD, left ventricular hypertrophy (LVH and CCA-IMT, assessed by Radio Frequency-Quality Intima Media Thickness (RFQIMT method, the next generation of IMT real-time measurement, based on the direct analysis of the radiofrequency signal and endowed with high accuracy and reproducibility in early detection of arterial wall thickness. Methods 115 patients (76 men, mean age: 65.1 ± 12 years referred to our department and shown significant (≥ 70% luminal obstruction stenosis at least in one major epicardial coronary artery were studied. Coronary angiograms were divided for severity and extent of the disease: 79 patients (69% had one, 24 patients (21% two, 12 patients (10% three major epicardial coronary arteries with ≥ 70% stenosis. All patients underwent echocardiography and carotid ultrasound examination, assessed by RF. Results Dividing RFQIMT data in tertiles, dyslipidaemia (31 patients with IMT ≥ 1.20 mm vs 16 with IMT = 0.91-1.19 vs 25 with IMT ≤ 0.9, p = 0.004, LVMI (153.5 ± 20.6 g/m2 in IMT ≥ 1.20 mm vs 131.2 ± 8.4 g/m2 in IMT = 0.91-1.19 mm vs 114.3 ± 11.1 g/m2 in IMT ≤ 0.9 mm, P 2 = 0.88, RFQIMT remained significantly associated with the dyslipidemia (regression coefficient ± standard error [SE]: 0.057 ± 0.023; p = 0.017, LVMI (regression coefficient ± SE: 0.01 ± 0.001; P Conclusions RFQIMT is a sophisticated method for carotid ultrasound evaluation. Its evaluation in patients with at least one important major epicardial coronary vessel stenosis would help the accuracy in the general assessment of the number of coronary lesions in these patients.

  20. Heart-Carotid Pulse Wave Velocity a Useful Index of Atherosclerosis in Chinese Hypertensive Patients.

    Science.gov (United States)

    Li, Chunyue; Xiong, Huahua; Pirbhulal, Sandeep; Wu, Dan; Li, Zhenzhou; Huang, Wenhua; Zhang, Heye; Wu, Wanqing

    2015-12-01

    This study was designed to investigate the relationship between heart-carotid pulse wave velocity (hcPWV) and carotid intima-media thickness (CIMT) in hypertensive patients, and also to examine the effect of pre-ejection period (PEP) on it. Doppler ultrasound device was used to measure CIMT in left common carotid artery. Hypertensive patients were divided into normal (n = 36, CIMT ≤0.8 mm) and thickened (n = 31, CIMT > 0.8 mm) group. Electrocardiogram R-wave-based carotid pulse wave velocity (rcPWV) and aortic valve-carotid pulse wave velocity (acPWV) were calculated as the ratio of the travel length to the pulse transit time with or without PEP, respectively. CIMT has significant relations with rcPWV (r = 0.611, P < 0.0001) and acPWV (r = 0.384, P = 0.033) in thickened group. Moreover, CIMT showed stronger correlation with rcPWV than with acPWV in thickened group. Furthermore, both acPWV and rcPWV were determinant factors of CIMT in thickened group, independent of clinical confounders including age, gender, smoking behavior, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, high-density lipoprotein cholesterol, antihypertensive medication, and plaque occurrence. However, similar results were not found in normal group. Since CIMT has been considered as an index of atherosclerosis, our results suggested that both rcPWV and acPWV could be useful indexes of atherosclerosis in thickened CIMT hypertensive patients. Additionally, if hcPWV is computed with heart-carotid pulse transit time, including PEP could improve the accuracy of atherosclerosis assessment in hypertensive patients. PMID:26705228

  1. Radiation-induced carotid artery disease

    International Nuclear Information System (INIS)

    Nine patients with atherosclerotic carotid artery disease associated with neck radiation were compared to 40 control patients. The data suggest that significant differences in age, incidence of coronary and peripheral vascular disease, elevated lipids and serum cholesterol, and the angiographic incidence of disseminated atherosclerosis justify the description of radiation-induced carotid disease as a clinical entity. Elevated serum cholesterol and hyperlipidemia may contribute to the development of radiation-induced vascular disease. Successful surgical reconstruction does not appear to be influenced by the prior radiotherapy, although periarterial fibrosis and increased difficulty in separating the plaques from the vascular media was encountered

  2. The role of contrast-enhanced ultrasound in risk assessment of carotid atheroma

    Directory of Open Access Journals (Sweden)

    Silviu Stanciu

    2016-07-01

    Full Text Available Background and objective: Contrast-enhanced ultrasound, used to assess atherosclerotic carotid plaques, improves visualization of vessel wall irregularities and depicts intraplaque neovascularization. This article illustrates the use of contrast-enhanced ultrasound in the risk assessment of carotid atherosclerotic lesions, especially in challenging plaques evaluation. Materials and methods: For 23 patients with difficult duplex ultrasound examination due to carotid tortuosity or calcifications we assessed plaque morphology (contour, echogenicity and stenosis degree using contrast substance (Sonovue, Braco with dedicated vascular low mechanical index CPC software. Conclusion: Contrast-enhanced ultrasound is a new, noninvasive, and safe procedure for imaging carotid atherosclerotic lesions. It is a valuable tool for evaluating the vulnerable plaque at risk for rupture and for the diagnostic of the development and severity of systemic atherosclerotic disease

  3. An Integrated Backscatter Ultrasound Technique for the Detection of Coronary and Carotid Atherosclerotic Lesions

    OpenAIRE

    Masanori Kawasaki

    2015-01-01

    The instability of carotid and coronary plaques has been reported to be associated with acute coronary syndrome, strokes and other cerebrovascular events. Therefore, recognition of the tissue characteristics of carotid and coronary plaques is important to understand and prevent coronary and cerebral artery disease. Recently, an ultrasound integrated backscatter (IB) technique has been developed. The ultrasound IB power ratio is a function of the difference in acoustic characteristic impedance...

  4. The Use of Carotid Artery Ultrasonography in Different Clinical Conditions

    OpenAIRE

    Gasparyan, Armen Yuri

    2009-01-01

    B-mode ultrasonography of the carotid artery is a non-invasive, informative and reproducible technique used for the assessment of prevalence and course of atherosclerosis in a variety of clinical conditions. Visualization of intima-media complex, atherosclerotic plaques, rough arterial wall and calcifications of the carotid artery may be useful for the assessment of atherosclerotic burden. The latter was confirmed in a recent consensus statement of the American Society of Echocardiography. De...

  5. Effect of atorvastatin on expression of macrophage and smooth muscle actin in carotid atherosclerotic plaques in rabbits%阿托伐他汀对家兔颈动脉粥样硬化斑块内巨噬细胞浸润和平滑肌肌动蛋白表达的影响

    Institute of Scientific and Technical Information of China (English)

    于熙滢; 曹海利; 刘雅君; 刘洋; 李晓光; 班翔; 魏林

    2011-01-01

    目的:研究阿托伐他汀对家兔颈动脉粥样硬化(AS)斑块内巨噬细胞及平滑肌肌动蛋白(SMA)表达的影响,并探讨他汀类药物稳定AS斑块的机制.方法:24只健康雄性新西兰大耳白兔随机分为对照组(n=8)和高胆固醇血症组(n=16).16只高胆固血症组的家兔喂饲高胆固醇饲料2周后,进行颈总动脉内膜球囊拉伤术,术后再随机等分为AS模型组和阿托伐他汀组[给予阿托伐他汀5 mg/(kg·d)],两组均继续喂饲高胆固醇饲料10周.喂养第12周时处死动物,取颈总动脉进行石蜡切片,用酶标法检测不同时间点血清脂质和脂蛋白;应用光学显微镜观察AS的进程;采用免疫组化染色法检测巨噬细胞浸润和SMA在斑块处的表达.结果:阿托伐他汀组的血清总胆固醇(TC)及低密度脂蛋白-胆固醇(LDL-C)的浓度明显低于AS模型组(P<0.01),颈总动脉内膜的厚度较AS模型组显著变薄[(0.49±0.072)vs.(0.66±0.08)mm,P<0.05].免疫组化染色法检测结果示,阿托伐他汀组血管壁中巨噬细胞的数量显著较模型组减少(P<0.05)而SMA的表达较AS模型组显著增多(P<0.01).结论:阿托伐他汀可能通过抑制AS斑块内巨噬细胞的浸润并增强SMA的表达,而发挥稳定斑块的作用.%AIM: To observe inflammatory macrophages and smooth muscle actin in carotid atherosclerotic plaques in rabbits and the effects of atorvastatin on them and to explore whether statins could stabilize carotid plaques and its possible mechanism.METHODS: Twenty-four rabbits were randomly divided into three groups: control group (n = 8 ) and hypercholesterolemia group (n = 16).The hypercholesterolemia group was fed a hypercholesterol diet for 2 weeks and then catheter-induced arterial wall injury was made.Rabbits in hypercholesterolemia and aortic injury group were randomized into model group (n = 8 ) and atorvastatin group 5 mg/( kg· day) for 10 weeks (n = 8 ).Carotid arteries were isolated and paraffinembedded

  6. Correlation of common carotid intima media thickness with atherosclerotic cardiovascular events in patients with type 2 diabetes mellitus

    International Nuclear Information System (INIS)

    Vascular complications are a major cause of morbidity and mortality in patients with diabetes mellitus and affect the quality of life. Atherosclerosis, which is the major underlying risk factor, is accelerated in diabetes. To reduce morbidity and mortality, identification of patients with a high risk for development of vascular events is necessary. Apart from other risk prediction models, detection of subclinical atherosclerosis at common carotid site by B-mode ultrasonography which is a noninvasive and reliable method, can add to the benefit and improve risk prediction. Population based studies have revealed that increased Common Carotid Intima Media Thickness (CCIMT) is associated with prevalent coronary artery disease and is a surrogate marker of cardiovascular events. Aim was to evaluate whether increased CCIMT is associated with increased risk of cardiovascular events in patients with type 2 diabetes. A total of 90 patients with type 2 diabetes who were included in the study, were divided in two groups. Group 1: without vascular events and group 2: with vascular events. Apart from patient's demographics, detailed history of events physical examination, through blood analysis for fasting, post postprandial blood sugar, serum cholesterol, TG, renal function test glycosylated Hb, chest x-ray, ECG were recoded. CCIMT was measured by B-mode ultrasonography using high frequency linear transducer, by a specialist radiologist (blind to all clinical and laboratory findings) by standard protocol as described in literature. Mean of the three readings in each side were used for statistical analysis. Our results showed that of the 90 patients studied, 45 diabetes mellitus (DM) patients had atherosclerotic events and significantly higher CCIMT value (mean value of 1.005 +- 0.17 mm) whereas as 45 comparable DM patients without sclerotic events and lower CCIMT values (0.798 +- 0.12 mm) (p0.99 mm) had a statistically significant association with high odds ratios for

  7. Common Carotid Intima Media Thickness and Ankle-Brachial Pressure Index Correlate with Local but Not Global Atheroma Burden: A Cross Sectional Study Using Whole Body Magnetic Resonance Angiography

    OpenAIRE

    Weir-McCall, Jonathan R.; Khan, Faisel; Lambert, Matthew A.; Carly L Adamson; Gardner, Michael; Gandy, Stephen J.; Ramkumar, Prasad Guntur; Belch, Jill J. F.; Struthers, Allan D.; Rauchhaus, Petra; Andrew D Morris; Houston, J. Graeme

    2014-01-01

    Background Common carotid intima media thickness (CIMT) and ankle brachial pressure index (ABPI) are used as surrogate marker of atherosclerosis, and have been shown to correlate with arterial stiffness, however their correlation with global atherosclerotic burden has not been previously assessed. We compare CIMT and ABPI with atheroma burden as measured by whole body magnetic resonance angiography (WB-MRA). Methods 50 patients with symptomatic peripheral arterial disease were recruited. CIMT...

  8. Common carotid intima media thickness and ankle-brachial pressure index correlate with local but not global atheroma burden:A cross sectional study using whole body magnetic resonance angiography

    OpenAIRE

    Weir-McCall, Jonathan R.; Khan, Faisel; Lambert, Matthew A.; Carly L Adamson; Gardner, Michael; Gandy, Stephen J.; Ramkumar, Prasad Guntur; Belch, Jill J. F.; Struthers, Allan D.; Rauchhaus, Petra; Andrew D Morris; Houston, J. Graeme

    2014-01-01

    Background: Common carotid intima media thickness (CIMT) and ankle brachial pressure index (ABPI) are used as surrogate marker of atherosclerosis, and have been shown to correlate with arterial stiffness, however their correlation with global atherosclerotic burden has not been previously assessed. We compare CIMT and ABPI with atheroma burden as measured by whole body magnetic resonance angiography (WB-MRA). Methods: 50 patients with symptomatic peripheral arterial disease were recruited. CI...

  9. Combination of Agatston Calcium Score and CTA: quantification and characterization of carotid calcium

    International Nuclear Information System (INIS)

    Objective: To quantify and characterize carotid calcification with combined Agatston Calcium Score and multidetector CT angiography (MDCTA) and to determine whether the combination could he applied as a useful decision- making tool for treatment. Methods: A total of 136 carotid arteries were examined with MDCTA (67.6±10.2 years; age range from 37-86 years; 11 women, 57 men). The calcium scores were determined using Agatston method from pre-contrast data. The stenosis was assessed based on North American Symptomatic Carotid Endarterectomy Trial criteria from post-contrast data. Results: Symptomatic patients had higher total calcium volume (TCV), total equiv mass (TEM) and total calcium score (TCS) than asymptomatic patients, but the differences did not reach statistical significance with or without taking the interactive effect of age and stenosis into account. TCV, TEM, and TCS differed significantly between high-grade and mild- grade stenotic vessels (P<0.001), and moderate-grade and mild-grade stenotic vessels (P<0.001); and they also differed statistically between age groups of 51-69 years and of ≥70 years (P<0.001). Pearson's correlation test showed a mild but significant correlation between stenotic grade of carotid bifurcation and ipsilateral ICA and total calcium volume (rbifurcation=0.322 and rICA=0.418 respectively, P<0.01). Conclusion: Combination of Agatston Calcium Score and CTA is likely to emerge as a noninvasive choice to accurately assess calcification and quantification of the burden in the carotid arteries. It can provide valuable insights into plaque characterization and stability, which is especially important for clinical decision-making. (authors)

  10. Automatic Active Contour-Based Segmentation and Classification of Carotid Artery Ultrasound Images

    OpenAIRE

    Chaudhry, Asmatullah; Hassan, Mehdi; Khan, Asifullah; Kim, Jin Young

    2013-01-01

    In this paper, we present automatic image segmentation and classification technique for carotid artery ultrasound images based on active contour approach. For early detection of the plaque in carotid artery to avoid serious brain strokes, active contour-based techniques have been applied successfully to segment out the carotid artery ultrasound images. Further, ultrasound images might be affected due to rotation, scaling, or translational factors during acquisition process. Keeping in view th...

  11. Carotid angioplasty with cerebral protection

    International Nuclear Information System (INIS)

    Background. Carotid endarterectomy (CEA) is widely used in the management of high-grade carotid stenosis. It is a surgical procedure requiring general anaesthesia and is suitable only for lesions located at or close to the carotid bifurcation. It may develop complications, such as stroke, death, cranial nerve palsies, wound haematoma and cardiac complications. The risk of complications is increased in patients with recurrent carotid artery stenosis following CEA, in subjects undergoing radiotherapy to the neck, and in patients with cardiopulmonary disease. The drawbacks of CEA have led physicians to search for alternative treatment options. Carotid angioplasty and stenting (CAS) is less invasive than CEA. The method is particularly suitable for the treatment of recurrent stenosis after previous CEA and distal internal artery stenosis, which is inaccessible for CEA. CAS does not cause cranial nerve palsies. Moreover, it does not require general anaesthesia and causes lower morbidity and mortality in patients with severe cardiopulmonary disease. The complications of CAS include stroke due to distal immobilisation of a plaque or thrombus dislodged during the procedure, abrupt vessel occlusion due to thrombosis, dissection or vasospasm, and restenosis due to intimal hyperplasia. CAS is a relatively new procedure; therefore, it is essential to establish its efficacy and safety before it is introduced widely into clinical practice. Patients and methods. In Slovenia, we have also started with carotid angioplasty by the study: Slovenian Carotid Angioplasty Study (SCAS). We performed CAS in 17 patients (12 males and 5 females) aged from 69 to 82 years. All patients were symptomatic with stenosis greater than 70 %. 10 patients suffered transient ischemic attacks, 4 patients minor strokes and 3 patients amaurosis fugax. Results. Technical success (< 30 % residual stenosis) was achieved in all cases. In 14 patients, no residual stenosis was found, in 2 patients a 15 % residual

  12. Direct association between diet and the stability of human atherosclerotic plaque

    OpenAIRE

    Isabel Gonçalves; Elisavet Andersson Georgiadou; Sören Mattsson; Göran Skog; Luís Pedro; José Fernandes e Fernandes; Nuno Dias; Gunnar Engström; Jan Nilsson; Kristina Stenström

    2015-01-01

    Mediterranean diet has been suggested to explain why coronary heart disease mortality is lower in southern than northern Europe. Dietary habits can be revealed by isotope ratio mass spectrometry (IRMS) measurement of carbon (δ(13)C) and nitrogen (δ(15)N) in biological tissues. To study if diet is associated with human plaque stability, atherosclerotic plaques from carotid endarterectomy on 56 patients (21 Portuguese and 35 Swedish) were analysed by IRMS and histology. Plaque components affect...

  13. Periodontal pathogens in atheromatous plaque

    Directory of Open Access Journals (Sweden)

    Saroj K. Rath

    2014-01-01

    Full Text Available Background: There has been increasing attention paid in recent years to the possibility that oral bacterial infection, particularly periodontal disease may influence the initiation and or progression of systemic diseases. These studies confirm the observation that heart disease is the most commonly found systemic condition in patients with periodontal disease. Moreover, the literature has also highlighted substantial evidence indicating the presence of Gram-negative periodontal pathogens in atheromatous plaques. Aim: This study intends to investigate the possible association between periodontal health and coronary artery disease by evaluating periodontal status, association between the periodontal plaque and coronary atheromatous plaques for presence of micro-organisms such as, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, and Tannerella forsythia. Materials and methods: A case-control study was designed with seven patients who had undergone coronary endarterectomy for cardiovascular disease and 28 controls. The periodontal examination for cases was performed 1 day before vascular surgery and the controls were clinically examined. The atheromatous plaque sample collected during endarterectomy and the intraoral plaque samples were subjected to polymerase chain reaction for identification of A. actinomycetemcomitans, P. gingivalis, P. intermedia and T. forsythia. Results: The presence of periodontal bacteria DNA in coronary atheromatous plaques and sub-gingival plaque samples of the same patients was confirmed by this study. CONCLUSION A correlation was established between putative bacteria contributing to atheromatous plaques and species associated with periodontal disease. One particularly important study to be carried out is the investigation of a possible clinically meaningful reduction in coronary heart disease resulting from the prevention or treatment of periodontal disease.

  14. Daily Psychological Demands Are Associated with Six-Year Progression of Carotid Artery Atherosclerosis: The Pittsburgh Healthy Heart Project

    Science.gov (United States)

    Kamarck, Thomas W.; Shiffman, Saul; Sutton-Tyrrell, Kim; Muldoon, Matthew F.; Tepper, Ping

    2016-01-01

    Objective We examine associations between the perception of ongoing psychological demands by ecological momentary assessment (EMA) and 6-year changes in carotid artery atherosclerosis by ultrasonography. Methods 270 initially healthy participants collected ambulatory blood pressure (ABP) and recorded their daily experiences, using electronic diaries, over two 3-day periods. Mean intima-medial thickness (IMT) and plaque were assessed in the carotid arteries using B-mode ultrasound at baseline and again during a 6-year follow-up (average follow-up duration 73 months). Results Among those who had no exposure to antihypertensive medications over the course of follow-up (n = 192), daily psychological demands were associated with greater progression of IMT as well as plaque, after adjustment for demographic and risk factor covariates. Associations between demands and plaque change were partially accounted for by ABP differences among those reporting high demands. Among those who were employed at baseline (n=117), six-year IMT changes were more strongly associated with ratings of daily demands than with traditional measures of occupational stress. Conclusion These data support the role of psychological demands as a correlate of subclinical atherosclerotic progression, they point to ABP as a potential mechanism facilitating these effects, and they highlight the utility of EMA measures for capturing daily psychological demands with potential effects on health. PMID:22582340

  15. Comparison between Carotid Intima-Media Thickness and Coronary Artery Calcification in the Prediction of Atherosclerosis in Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Rusli Muljadi

    2014-04-01

    Full Text Available BACKGROUND: Cardiovascular disease is one of the atherosclerosis etiologies that can lead to death. Diabetes mellitus increases the risk of atherosclerosis. Screening tool is very beneficial for detecting atherosclerotic plaque, especially in subclinical atherosclerotic cases. Carotid intima-media thickness (CIMT and coronary artery calcification score (CACS are two kinds of tools that are widely used, and each of these tools has its own superiority. This study was aimed to investigate the sensitivity and specificity of both of these tools as screening tools. METHODS: The study was conducted with a cross sectional design involving 43 diabetic and 68 non-diabetic male subjects aged above 45 years old. All subjects fulfilled inclusion criteria. Carotid artery ultrasonography and CACS measurement were performed. RESULTS: Fischer exact test was used to show a significant correlation between CIMT and CACS (p<0.05. Diagnostic test was used to assess the sensitivity of CIMT toward CACS in above 75 percentile. The left common carotid artery (LCCA showed the highest sensitivity either in diabetic (76.4% or non-diabetic male subjects (90%. CONCLUSIONS: CIMT has the same sensitivity with CACS. CIMT can be used as the preferred screening tool for high risk patients and as a substitution tool to CACS for low risk patients in subclinical atherosclerosis detection. KEYWORDS: atherosclerosis, diabetes mellitus, carotid intima-media thickness, coronary artery calciication score.

  16. Carotid Artery Doppler Assessment In Patients Accussed Of Strokes

    OpenAIRE

    H. Mazaher; S. Sharif Kashani

    2005-01-01

    Carotid Doppler ultrasound assessment mostly indicated in patients accussed of TIAs or in younger patients with nonpersistant neurologic deficits. This assessment should be consisted of gray scale sonography, color Doppler Sonography, spectral Doppler sonography and power Doppler sonography. By gray scale sonography atherosclerotic plaques assessed from the point of Homogenousity, degree of echogenicity, surface regularity, calcification, length, Thichkness and sites of involvement. In color ...

  17. Increased YKL-40 expression in patients with carotid atherosclerosis

    DEFF Research Database (Denmark)

    Michelsen, Axel Gottlieb; Rathcke, C.N.; Skjelland, M.; Holm, S.; Ranheim, T.; Krohg-Sorensen, K.; Klingvall, M.F.; Brosstad, F.; Oie, E.; Vestergaard, H.; Aukrust, P.; Halvorsen, Esben Bistrup

    2010-01-01

    atherosclerosis, with particularly high levels in those with symptomatic disease; (2) patients with recent ischemic symptoms (within 2 months) had higher YKL-40 mRNA levels in carotid plaque than other patients; (3) in vitro, the beta-adrenergic receptor agonist isoproterenol, toll-like receptor (TLR) 2 and TLR4...

  18. Risk Analysis on Uric Acid Resulting in Carotid Atherosclerosis

    Institute of Scientific and Technical Information of China (English)

    肖敏; 李河; 郭兰; 石美铃; 麦劲壮

    2004-01-01

    Objectives To explore the risk of uric acid (UA) resulting in carotid atherosclerosis. Methods With a cross sectional study, 643 subjects (aged 41-83 yrs, male 552 and female 91)were surveyed in 1999 in Guangdong Province, China.The main research variables were uric acid (UA), occurrence and the size of carotid artery plaque. Results There was no statistical significance between the UA means of plaque occurrence and no-occurrence groups (t=0.60, df=242, P=0.5495). It seemed UA was not a possible risk factor of carotid atherosclerosis (OR=1.060, P=-0.8448>0.05, n=244) based on the logistic regression analysis. Conclusions Our results are not consistent with serum UA being an independent risk factor for atherosclerosis and coronary heart disease (CHD). It is necessary to do more research to learn the risk degree of UA during the progress of atherosclerosis/CHD.

  19. Carotid Artery Doppler Assessment In Patients Accussed Of Strokes

    Directory of Open Access Journals (Sweden)

    H. Mazaher

    2005-08-01

    Full Text Available Carotid Doppler ultrasound assessment mostly indicated in patients accussed of TIAs or in younger patients with nonpersistant neurologic deficits. This assessment should be consisted of gray scale sonography, color Doppler Sonography, spectral Doppler sonography and power Doppler sonography. By gray scale sonography atherosclerotic plaques assessed from the point of Homogenousity, degree of echogenicity, surface regularity, calcification, length, Thichkness and sites of involvement. In color Doppler sonography hypoechoic Plaques which could not be identified in gray scale sonogarphy, arterial tortusity, Better and faster detection of Dis-turbed flow for flow spectrum analysis are assessed. Flow spectrum analysis and degree of stenosis in carotid arteries are assessed by Spectral Doppler sonography. Finally the main indication of carotid power Doppler sonography is differentiation Of high grade stenosis from occlusion.

  20. Visfatin Destabilizes Atherosclerotic Plaques in Apolipoprotein E-Deficient Mice.

    Directory of Open Access Journals (Sweden)

    Bo Li

    Full Text Available Although there is evidence that visfatin is associated with atherogenesis, the effect of visfatin on plaque stability has not yet been explored.In vivo, vulnerable plaques were established by carotid collar placement in apolipoprotein E-deficient (ApoE-/- mice, and lentivirus expressing visfatin (lenti-visfatin was locally infused in the carotid artery. The lipid, macrophage, smooth muscle cell (SMC and collagen levels were evaluated, and the vulnerability index was calculated. In vitro, RAW264.7 cells were stimulated with visfatin, and the MMPs expressions were assessed by western blot and immunofluorescence. And the mechanism that involved in visfatin-induced MMP-8 production was investigated.Transfection with lenti-visfatin significantly promoted the expression of visfatin which mainly expressed in macrophages in the plaque. Lenti-visfatin transfection significantly promoted the accumulation of lipids and macrophages, modulated the phenotypes of smooth muscle cells and decreased the collagen levels in the plaques, which significantly decreased the plaque stability. Simultaneously, transfection with lenti-visfatin significantly up-regulated the expression of MMP-8 in vivo, as well as MMP-1, MMP-2 and MMP-9. Recombinant visfatin dose- and time-dependently up-regulated the in vitro expression of MMP-8 in macrophages. Visfatin promoted the translocation of NF-κB, and inhibition of NF-κB significantly reduced visfatin-induced MMP-8 production.Visfatin increased MMP-8 expression, promoted collagen degradation and increased the plaques vulnerability index.

  1. Longitudinal assessment of carotid atherosclerosis after Radiation Therapy using Computed Tomography: A case control Study

    Energy Technology Data Exchange (ETDEWEB)

    Anzidei, Michele [Rome Univ. ' ' La Sapienza' ' (Italy). Dept. of Radiology; Suri, Jasjit S.; Piga, Mario [AtheroPoint TM LLC, Roseville, CA (United States). Monitoring and Diagnostic Div.; Global Biomedical Technologies, Inc., CA (United States). Point of Care Devices; Idaho Univ., Moscow, ID (United States). Electrical Engineering Dept.; Saba, Luca [Azienda Ospedaliero Universitaria (A.O.U.), Cagliari (Italy). Dept. of Radiology; Sanfilippo, Roberto; Montisci, Roberto [Azienda Ospedaliero Universitaria (A.O.U.), Cagliari (Italy). Dept. of Vascular Surgery; Laddeo, Giancarlo [New York Univ. Langone Medical Center, New York, NY (United States). Dept. of Radiology; Argiolas, Giovanni Maria [Azienda Ospedaliera Brotzu, Cagliari (Italy). Dept. of Radiology; Raz, Eytan [Rome Univ. ' ' La Sapienza' ' (Italy). Dept. of Radiology; New York Univ. Langone Medical Center, New York, NY (United States). Dept. of Radiology

    2016-01-15

    To study the carotid artery plaque composition and its volume changes in a group of patients at baseline and 2 years after head and neck radiation therapy treatment (HNXRT). In this retrospective study, 62 patients (41 males; mean age 63 years; range 52-81) who underwent HNXRT and 40 patients (24 males; mean age 65) who underwent surgical resection of neoplasm and did not undergo HNXRT were assessed, with 2-year follow-up. The carotid artery plaque volumes, as well as the volume of the sub-components (fatty-mixed-calcified), were semiautomatically quantified. Mann-Whitney and Wilcoxon tests were used to test the hypothesis. In the HNXRT group, there was a statistically significant increase in the total volume of the carotid artery plaques (from 533 to 746 mm{sup 3}; p = 0.001), in the fatty plaques (103 vs. 202 mm{sup 3}; p = 0.001) and mixed plaque component volume (328 vs. 419 mm{sup 3}; p = 0.034). A statistically significant variation (from 21.8 % to 27.6 %) in the percentage of the fatty tissue was found. of this preliminary study suggest that HNXRT promotes increased carotid artery plaque volume, particularly the fatty plaque component. (orig.)

  2. Diagnosis of carotid artery disease by CT scan. Intravenous CT carotid-angiography

    Energy Technology Data Exchange (ETDEWEB)

    Kuriyama, Y.; Sawada, T.; Naito, H.; Karasawa, J. (National Cardiovascular Center, Osaka (Japan))

    1981-09-01

    Non-invasive methods, such as radioisotope angiography, oculoplethsmography, and ultrasonic Doppler flowmetry, are used for the detection of caroid artery lesion. However, these methods are qualitative, and diagnostic accuracies are inferior to arteriography. On the other hand arterography needs catheterization. So we tried to use CT scan and intravenous contrast enhancement for the diagnosis of carotid artery disease. A CT/T scanner (X-2) was used, which enabled to produce computer reconstruction image of the carotid artery by use of the arrange program. 12 sequential axial images of the neck (between heights of C2 and C5) were obtained before and during infusion of contrast material. Analysis of sequential axial images and reformatted images were obtained in patients with cerebrovascular disease. Carotid arteriography were made in 53 arteries, lesions with stenosis and/or occlusion were demonstrated in 26/53 arteries. Intravenous CT carotid-angiography revealed lesions with stenosis and/or occlusion in 25/53 arteries. Results of statistical analysis were as follows; overall diagnostic accuracy 52/53 (98%), diagnostic sensitivity 25/26 (96%) and diagnostic specificity 27/27 (100%), respectively. Moreover, intravenous CT carotid-angiography provided following benefits beyond arteriography. 1) Minimal calcification of the carotid wall and precise localisation of atheromatous plaque could be detected. 2) Patent arterial lumen above the occluded lesion could be found out. 3) CT carotid-angiography would be suitable for the follow-up study after carotid endoarterectomy because of the unneccessity of catheterization. 4) Thrombus formation in the internal jugular vein could be grasped.

  3. Carotid Artery Disease

    Science.gov (United States)

    ... brain with blood. If you have carotid artery disease, the arteries become narrow, usually because of atherosclerosis. ... one of the causes of stroke. Carotid artery disease often does not cause symptoms, but there are ...

  4. Carotid artery disease

    Science.gov (United States)

    ... you have had a stroke or TIA, a nervous system (neurological) exam will show other problems. You may also have the following tests: Blood cholesterol and triglycerides test Blood sugar (glucose) test Ultrasound of the carotid arteries ( carotid ...

  5. Gene expression levels of matrix metalloproteinases in human atherosclerotic plaques and evaluation of radiolabeled inhibitors as imaging agents for plaque vulnerability

    International Nuclear Information System (INIS)

    Introduction: Atherosclerotic plaque rupture is the primary cause for myocardial infarction and stroke. During plaque progression macrophages and mast cells secrete matrix-degrading proteolytic enzymes, such as matrix metalloproteinases (MMPs). We studied levels of MMPs and tissue inhibitor of metalloproteinases-3 (TIMP-3) in relation to the characteristics of carotid plaques. We evaluated in vitro two radiolabeled probes targeting active MMPs towards non-invasive imaging of rupture-prone plaques. Methods: Human carotid plaques obtained from endarterectomy were classified into stable and vulnerable by visual and histological analysis. MMP-1, MMP-2, MMP-8, MMP-9, MMP-10, MMP-12, MMP-14, TIMP-3, and CD68 levels were investigated by quantitative polymerase chain reaction. Immunohistochemistry was used to localize MMP-2 and MMP-9 with respect to CD68-expressing macrophages. Western blotting was applied to detect their active forms. A fluorine-18-labeled MMP-2/MMP-9 inhibitor and a tritiated selective MMP-9 inhibitor were evaluated by in vitro autoradiography as potential lead structures for non-invasive imaging. Results: Gene expression levels of all MMPs and CD68 were elevated in plaques. MMP-1, MMP-9, MMP-12 and MMP-14 were significantly higher in vulnerable than stable plaques. TIMP-3 expression was highest in stable and low in vulnerable plaques. Immunohistochemistry revealed intensive staining of MMP-9 in vulnerable plaques. Western blotting confirmed presence of the active form in plaque lysates. In vitro autoradiography showed binding of both inhibitors to stable and vulnerable plaques. Conclusions: MMPs differed in their expression patterns among plaque phenotypes, providing possible imaging targets. The two tested MMP-2/MMP-9 and MMP-9 inhibitors may be useful to detect atherosclerotic plaques, but not the vulnerable lesions selectively

  6. Development of 3D ultrasound techniques for carotid artery disease assessment and monitoring

    International Nuclear Information System (INIS)

    Quantitative measurements of carotid plaque burden are used to monitor patients and evaluate established interventions as well as new treatment options. Three-dimensional ultrasound (3D US) techniques were developed to noninvasively monitor the progression of carotid artery disease in both symptomatic and asymptomatic patients. Three-dimensional carotid US images were acquired and reconstructed, and methods for quantitative assessment were developed. The measurement of intima-media thickness (IMT) based on two-dimensional ultrasound (2D US) images was extended to a 3D vessel-wall-plus- plaque thickness (VWT), obtained by computing the distance between the carotid wall and lumen surfaces on a point-by-point basis. VWT measurements were superimposed on the arterial wall to produce 3D VWT maps. VWT changes were determined by comparing the 3D VWT maps obtained at two different time points. To facilitate the visualization and interpretation of the VWT and VWT-Change maps, a technique to flatten these maps was developed. Carotid remodeling involving changes in both arterial wall and plaque thickness was assessed with VWT maps obtained from in vivo 3D ultrasound images. 3D carotid ultrasound image evaluation with VWT mapping provides a feasible means for the analysis of plaque burden volumes and changes. (orig.)

  7. Correlations between nuclear data and integral slab experiments: the case of hafnium; Correlations entre donnees nucleaires et experiences integrales a plaques: le cas du hafnium

    Energy Technology Data Exchange (ETDEWEB)

    Palau, J.M

    1999-07-01

    The aim of this work was to evaluate how much integral slab experiments can both reduce discrepancies between experimental results and calculations, and improve the knowledge of hafnium isotopes neutronic parameters by an adapted sensitivity and uncertainty method. A statistical approach, based on the generalized least squares method and perturbation theory, has been incorporated into our calculation system in order to deduce microscopic cross-section adjustments from observed integral measurements on this particular 'mock-up' reactor.In this study it has been established that the correlations between integral parameters and hafnium capture cross-sections enable specific variations in the region of resolved resonances at the level of multigroup and punctual cross-sections recommended data (JEF-2.2 evaluation) to be highlighted. The use of determinist methods together with Monte Carlo- type simulations enabled a depth analysis of the modelling approximations to be carried out. Furthermore, the sensitivity coefficient validation technique employed leads to a reliable assessment of the quality of the new basic nuclear data. In this instance, the adjustments proposed for certain isotope {sup 177}Hf resonance parameters reduce, after error propagation, by 3 to 5 per cent the difference between experimental results and calculations related to this absorbent's efficiency. Beyond this particular application, the qualification methodology integrated in our calculation system should enable other basic sizing parameters to be treated (chemical / geometric data or other unexplored nuclear data) to make technological requirements less stringent. (author)

  8. Increased tissue factor, MMP-8, and D-dimer expression in diabetic patients with unstable advanced carotid atherosclerosis

    Directory of Open Access Journals (Sweden)

    Jerzy Krupinski

    2007-09-01

    Full Text Available Jerzy Krupinski1,2, Marta M Turu1,2, M Angels Font1, Nesser Ahmed3, Matthew Sullivan3, Ana Luque1,2, Francisco Rubio1, Lina Badimon2, Mark Slevin31Department of Neurology, Stroke Unit, University Hospital of Bellvitge (HUB, Fundacio IDIBELL, Barcelona, Spain; 2Cardiovascular Research Centre, IIBB/CSIC-HSCSP-UAB, Barcelona, Spain; 3School of Biology, Chemistry and Health Science, Manchester Metropolitan University, Manchester, United KingdomAbstract: Advanced atherogenesis is characterized by the presence of markers of enhanced prothrombotic capacity, attenuated fibrinolysis, and by clinical conditions associated with defective coagulation. Diabetes may be associated with enhanced lesion instability and atherosclerotic plaque rupture. Plaques obtained from 206 patients undergoing carotid endarterectomy were divided into diabetic (type 2 and nondiabetic and analyzed by Western blotting and immunohistochemistry to detect tissue factor (TF, metalloproteinases (MMP-2, -8, -9, and fibrin/fibrinogen related antigens, and in situ zymography to detect MMP activity. Plasma samples were quantified for TF procoagulant activity, C-reactive protein, fibrinogen and D-dimer. Diabetic and symptomatic patients with hypoechogenic plaques had increased plasma TF activity and D-dimer, compared with those with hyperechogenic plaques (p = 0.03, p = 0.007, respectively. Diabetic, symptomatic patients had higher plasma D-dimer levels than asymptomatic patients (p = 0.03. There was a significant correlation between intramural TF levels and D-dimer in diabetic patients with symptomatic disease (p = 0.001, r2 = 0.4. In diabetic patients, plasma fibrinogen levels were higher in patients with hypoechogenic plaques (p = 0.007. Diabetic patients with ulcerated plaques had higher plasma D-dimer and MMP-8 levels than those with fibrous plaques (p = 0.02, p = 0.01, respectively. This data suggests that currently available circulating markers may be clinically useful to select

  9. 18F-FDG accumulation in atherosclerosis: use of CT and MR co-registration of thoracic and carotid arteries

    International Nuclear Information System (INIS)

    The purpose of this study was to depict18F-fluoro-2-deoxy-D-glucose (FDG) accumulation in atherosclerotic lesions of the thoracic and carotid arteries on CT and MR images by means of automatic co-registration software. Fifteen hospitalised men suffering cerebral infarction or severe carotid stenosis requiring surgical treatment participated in this study. Automatic co-registration of neck MR images and FDG-PET images and of contrast-enhanced CT images and FDG-PET images was achieved with co-registration software. We calculated the count ratio, which was standardised to the blood pool count of the superior vena cava, for three arteries that branch from the aorta, i.e. the brachial artery, the left common carotid artery and the subclavian artery (n=15), for atherosclerotic plaques in the thoracic aorta (n=10) and for internal carotid arteries with and without plaque (n=13). FDG accumulated to a significantly higher level in the brachial artery, left common carotid artery and left subclavian artery at their sites of origin than in the superior vena cava (p=0.000, p=0.000 and p=0.002, respectively). Chest CT showed no atherosclerotic plaque at these sites. Furthermore, the average count ratio of thoracic aortic atherosclerotic plaques was not higher than that of the superior vena cava. The maximum count ratio of carotid atherosclerotic plaques was significantly higher than that of the superior vena cava but was not significantly different from that of the carotid artery without plaque. The results of our study suggest that not all atherosclerotic plaques show high FDG accumulation. FDG-PET studies of plaques with the use of fused images can potentially provide detailed information about atherosclerosis. (orig.)

  10. Carotid thin fluttering bands: A new element of arterial wall remodelling? An ultrasound study.

    Science.gov (United States)

    Costanzo, Luca; Sole, Andrea; Tamburino, Corrado; Di Pino, Luigi

    2015-10-01

    Carotid artery ultrasound is a non-invasive and reproducible technique used for early atherosclerotic assessment. Intimal flap has been described in the presence of dissection or mobile plaque rupture, however presence of carotid thin fluttering bands (TFBs) have not been described yet. To investigate frequency, characteristics and impact of TFBs in carotid lumen of patients who underwent carotid ultrasound scan (CUS). 3341 patients were admitted from January 2009 to January 2014. Patients with history of cerebral ischemia (CI) were excluded. In the cases in which TFBs were observed, a 3-months clinical and CUS follow-up (FU) was performed. TFBs were found in 71 patients (2.1%). The mean age was 63.41 ± 11.20 years (range 42-89). All patients showed a mean increase in intima-media thickness. We identified two subgroups: in 22 patients the TFB was related to a carotid plaque while in 49 no carotid plaque was found. TFB mostly originated in the carotid bulb (88.7%) and was similarly located in carotid arteries (49.3% left-side and 50.7% right-side). CUS and clinical FU were available for all patients (mean duration 25.34 months, median 19). CI occurred in none of the patients. TFB disappeared in 13 patients (18.3%) with no sign or symptoms of CI. In 3 of 49 patients without carotid plaque (6.1%), progressive thickening beneath TFB was observed. TFB is a rare finding. Longer FU is needed to evaluate its prognosis. To date, the pathophysiology is unknown, however it could be related to vascular remodeling. PMID:26179862

  11. Combination probe for optically assisted ultrasonic velocity-change imaging aimed at detecting unstable blood vessel plaque

    Science.gov (United States)

    Tanigawa, Shohei; Mano, Kazune; Wada, Kenji; Matsunaka, Toshiyuki; Horinaka, Hiromichi

    2016-04-01

    Blood vessel plaque with a large lipid core is at risk of becoming thrombus and is likely to induce acute heart disease. To prevent this, it is necessary to determine not only the plaque's size but also its chemical composition. We, therefore, made the prototype of a combination probe to diagnose carotid artery plaque. It is used to differentiate propagation characteristics between light spectra and ultrasonic images. By propagating light and ultrasound along a common direction, it is possible to effectively warm the diagnosis domain. Moreover, the probe is thought to be compact and be easy to use for diagnosing human carotid artery plaque. We applied the combination probe to a carotid artery phantom with a lipid area and obtained an image of the ultrasonic velocity change in the fatty area.

  12. Cardiovascular magnetic resonance parameters of atherosclerotic plaque burden improve discrimination of prior major adverse cardiovascular events

    Directory of Open Access Journals (Sweden)

    Bansilal Sameer

    2009-04-01

    Full Text Available Abstract Aims Patients with prior major cardiovascular or cerebrovascular events (MACE are more likely to have future recurrent events independent of traditional cardiovascular disease risk factors. The purpose of this study was to determine if patients with traditional risk factors and prior MACE had increased cardiovascular magnetic resonance (CMR plaque burden measures compared to patients with risk factors but no prior events. Methods and Results Black blood carotid and thoracic aorta images were obtained from 195 patients using a rapid extended coverage turbo spin echo sequence. CMR measures of plaque burden were obtained by tracing lumen and outer vessel wall contours. Patients with prior MACE had significantly higher MR plaque burden (wall thickness, wall area and normalized wall index in carotids and thoracic aorta compared to those without prior MACE (Wall thickness carotids: 1.03 ± 0.03 vs. 0.93± 0.03, p = 0.001; SD wall thickness carotids: 0.137 ± 0.0008 vs. 0.102 ± 0.0004, p Conclusion A greater plaque burden and plaque eccentricity is prevalent among patients with prior MACE.

  13. Calcium deposits in the common carotid artery

    International Nuclear Information System (INIS)

    Complete text of publication follows. Arterial calcification consists mainly of calcium apatite and takes place at two sites in the vessel wall: the intima and the media. Intimal calcification occurs exclusively within atherosclerotic plaques, while medial calcification may develop independently [1]. Ultrasound examination of the carotid arteries is performed routinely to assess pathological alterations. Large calcified plaques in the carotid arteries can be detected by B-mode ultrasonography easily as high frequency ultrasound does not penetrate calcium and have been investigated extensively. In this study our aim was to determine the calcium distribution in the vessel wall itself, excluding large plaques, and to make the first step towards investigating the relationship between the calcium distributional maps and the respective ultrasonic images. The carotid arteries of five elderly (age 71±9 years) and one young (age 27 years) deceased patients were excised at autopsy and were investigated with a medical ultrasound equipment in a tank containing saline solution. Scan sequences were videotaped and images of previously marked cross-sections were transferred to a computer. Small pieces of the arteries were cut and quench frozen. Sections of 60μm from the middle of the scanned segments (30mm proximal to the bifurcation) were cut in a cryostat. The cryosections were transferred to microprobe target holders. The elemental distribution of the samples were determined by particle induced X-ray emission (PIXE) at the Debrecen microprobe [2]. True elemental maps and absolute concentration values were evaluated with a new software (True Pixe Imaging) [3]. The average calcium content of the scanned areas varied between 1000 and 9000μg/g in the slices of the common carotid arteries of the elderly patients. In contrast, scanned areas in the slices from the young subject contained only 600-800μg/g calcium. The concentration of calcium could reach even 3.75% along the wide

  14. The Complementary Roles of Dynamic Contrast Enhanced MRI and 18F-Fluorodeoxyglucose PET/CT for Imaging of Carotid Atherosclerosis

    Science.gov (United States)

    Calcagno, Claudia; Ramachandran, Sarayu; Izquierdo-Garcia, David; Mani, Venkatesh; Millon, Antoine; Rosenbaum, David; Tawakol, Ahmed; Woodward, Mark; Bucerius, Jan; Moshier, Erin; Godbold, James; Kallend, David; Farkouh, Michael E; Fuster, Valentin; Rudd, James HF; Fayad, Zahi A

    2013-01-01

    Background Inflammation and neovascularization in vulnerable atherosclerotic plaques are key risk factors for severe clinical events. Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) are two non-invasive imaging techniques capable of quantifying plaque neovascularization and inflammatory infiltrate respectively. However, their mutual role in defining plaque vulnerability and their possible overlap has not been thoroughly investigated. Here, we study the relationship between DCE-MRI and 18F-FDG PET in the carotid arteries of 40 subjects with coronary heart disease (CHD) or CHD equivalent, recruited as a substudy of the dal-PLAQUE trial (NCT00655473). Methods The dal-PLAQUE trial was a multicenter study that evaluated dalcetrapib, a cholesteryl ester transfer protein modulator. Subjects underwent anatomical MRI, DCE-MRI and 18F-FDG PET. Only baseline imaging and biomarkers data (before randomization) from dal-PLAQUE were used as part of this substudy. Our primary goal was to evaluate the relationship between DCE-MRI and 18F-FDG PET data. As secondary endpoints, we evaluated the relationship between a) PET data and whole vessel anatomical MRI data, and b) DCE-MRI and matching anatomical MRI data. All correlations were estimated using a mixed linear model. Results We found a significant inverse relationship between several perfusion indices by DCE-MRI and 18F-FDG uptake by PET. Regarding our secondary endpoints, there was a significant relationship between plaque burden measured by anatomical MRI with several perfusion indices by DCE-MRI and 18F-FDG uptake by PET. No relationship was found between plaque composition by anatomical MRI with DCEMRI or 18F-FDG PET metrics. Conclusions In this study we observed a significant, weak inverse relationship between inflammation measured as 18F-FDG uptake by PET and plaque perfusion by DCE-MRI. Our findings suggest that there may be a complex

  15. The complementary roles of dynamic contrast-enhanced MRI and {sup 18}F-fluorodeoxyglucose PET/CT for imaging of carotid atherosclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Calcagno, Claudia; Ramachandran, Sarayu; Mani, Venkatesh; Millon, Antoine [Mount Sinai School of Medicine, Translational and Molecular Imaging Institute, One Gustave L. Levy Place, Box 1234, New York, NY (United States); Mount Sinai School of Medicine, Department of Radiology, New York, NY (United States); Izquierdo-Garcia, David [Harvard University - MIT - Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA (United States); Rosenbaum, David [Hopital Pitie Salpetriere, Paris (France); Tawakol, Ahmed [Harvard Medical School and Massachusetts General Hospital, Boston, MA (United States); Woodward, Mark [University of Sydney, George Institute, Sydney (Australia); Bucerius, Jan [Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands); Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); Rheinisch-Westfaelische Technische Hochschule Aachen, Department of Nuclear Medicine, Aachen (Germany); Moshier, Erin; Godbold, James [Mount Sinai School of Medicine, Biostatistics Shared Research Facility, New York, NY (United States); Kallend, David [F. Hoffmann-La Roche Ltd, Basel (Switzerland); Farkouh, Michael E. [Mount Sinai School of Medicine, Cardiovascular Institute, New York, NY (United States); Peter Munk Cardiac Centre and Li Ka Shing Knowledge Institute, Toronto (Canada); Fuster, Valentin [Mount Sinai School of Medicine, Cardiovascular Institute, New York, NY (United States); The Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid (Spain); Rudd, James H.F. [University of Cambridge, Division of Cardiovascular Medicine, Cambridge (United Kingdom); Fayad, Zahi A. [Mount Sinai School of Medicine, Translational and Molecular Imaging Institute, One Gustave L. Levy Place, Box 1234, New York, NY (United States); Mount Sinai School of Medicine, Department of Radiology, New York, NY (United States); Mount Sinai School of Medicine, Cardiovascular Institute, New York, NY (United States)

    2013-12-15

    Inflammation and neovascularization in vulnerable atherosclerotic plaques are key features for severe clinical events. Dynamic contrast-enhanced (DCE) MRI and FDG PET are two noninvasive imaging techniques capable of quantifying plaque neovascularization and inflammatory infiltrate, respectively. However, their mutual role in defining plaque vulnerability and their possible overlap has not been thoroughly investigated. We studied the relationship between DCE-MRI and {sup 18}F-FDG PET data from the carotid arteries of 40 subjects with coronary heart disease (CHD) or CHD risk equivalent, as a substudy of the dal-PLAQUE trial (NCT00655473). The dal-PLAQUE trial was a multicenter study that evaluated dalcetrapib, a cholesteryl ester transfer protein modulator. Subjects underwent anatomical MRI, DCE-MRI and {sup 18}F-FDG PET. Only baseline imaging and biomarker data (before randomization) from dal-PLAQUE were used as part of this substudy. Our primary goal was to evaluate the relationship between DCE-MRI and {sup 18}F-FDG PET data. As secondary endpoints, we evaluated the relationship between (a) PET data and whole-vessel anatomical MRI data, and (b) DCE-MRI and matching anatomical MRI data. All correlations were estimated using a mixed linear model. We found a significant inverse relationship between several perfusion indices by DCE-MRI and {sup 18}F-FDG uptake by PET. Regarding our secondary endpoints, there was a significant relationship between plaque burden measured by anatomical MRI with several perfusion indices by DCE-MRI and {sup 18}F-FDG uptake by PET. No relationship was found between plaque composition by anatomical MRI and DCE-MRI or {sup 18}F-FDG PET metrics. In this study we observed a significant, weak inverse relationship between inflammation measured as {sup 18}F-FDG uptake by PET and plaque perfusion by DCE-MRI. Our findings suggest that there may be a complex relationship between plaque inflammation and microvascularization during the different

  16. The complementary roles of dynamic contrast-enhanced MRI and 18F-fluorodeoxyglucose PET/CT for imaging of carotid atherosclerosis

    International Nuclear Information System (INIS)

    Inflammation and neovascularization in vulnerable atherosclerotic plaques are key features for severe clinical events. Dynamic contrast-enhanced (DCE) MRI and FDG PET are two noninvasive imaging techniques capable of quantifying plaque neovascularization and inflammatory infiltrate, respectively. However, their mutual role in defining plaque vulnerability and their possible overlap has not been thoroughly investigated. We studied the relationship between DCE-MRI and 18F-FDG PET data from the carotid arteries of 40 subjects with coronary heart disease (CHD) or CHD risk equivalent, as a substudy of the dal-PLAQUE trial (NCT00655473). The dal-PLAQUE trial was a multicenter study that evaluated dalcetrapib, a cholesteryl ester transfer protein modulator. Subjects underwent anatomical MRI, DCE-MRI and 18F-FDG PET. Only baseline imaging and biomarker data (before randomization) from dal-PLAQUE were used as part of this substudy. Our primary goal was to evaluate the relationship between DCE-MRI and 18F-FDG PET data. As secondary endpoints, we evaluated the relationship between (a) PET data and whole-vessel anatomical MRI data, and (b) DCE-MRI and matching anatomical MRI data. All correlations were estimated using a mixed linear model. We found a significant inverse relationship between several perfusion indices by DCE-MRI and 18F-FDG uptake by PET. Regarding our secondary endpoints, there was a significant relationship between plaque burden measured by anatomical MRI with several perfusion indices by DCE-MRI and 18F-FDG uptake by PET. No relationship was found between plaque composition by anatomical MRI and DCE-MRI or 18F-FDG PET metrics. In this study we observed a significant, weak inverse relationship between inflammation measured as 18F-FDG uptake by PET and plaque perfusion by DCE-MRI. Our findings suggest that there may be a complex relationship between plaque inflammation and microvascularization during the different stages of plaque development. 18F-FDG PET and

  17. Human-like atherosclerosis in minipigs: a new model for detection and treatment of vulnerable plaques.

    Science.gov (United States)

    Thim, Troels

    2010-07-01

    Advanced atherosclerosis, through thrombosis, leads to ischemic heart disease and ischemic stroke, the leading causes of death and disability worldwide. Advanced atherosclerosis and imaging of atherosclerosis are the focus of this dissertation with particular emphasis on the vulnerable plaque and vulnerable plaque detection. Aspects of advanced atherosclerosis and the vulnerable plaque in humans are described along with the basis for the selected minipig models and methods for atherosclerosis acceleration used. The overall aims of the studies were to develop an animal model of advanced atherosclerosis with human like vulnerable plaque morphology and use this animal model to test an imaging modality aimed at vulnerable plaque detection. The first aim is addressed in 3 papers, where accelerated plaque development in the coronary and carotid arteries is investigated in down sized Rapacz pigs. Down-sized Rapacz pigs are minipigs with familial hypercholesterolemia caused by a mutation in the low density lipoprotein receptor. Paper 1 describes the lipid profile in the down-sized Rapacz on chow and atherogenic diets and spontaneously developed and balloon accelerated coronary plaque with a morphology that resembles the morphology of human vulnerable plaque. Paper 2 describes vein graft disease in internal jugular vein grafts inserted into the common carotid artery. Plaques with necrotic cores were found in oversized vein grafts only indicating an effect of flow and shear stress on plaque development. Paper 3 describes the effects of wall shear stress on local plaque development in surgically stenosed common carotid arteries in the down-sized Rapacz pigs. This study indicated that the combination of low and oscillatory wall shear stress was needed for development of advanced plaque. In paper 4, we interrogated coronary lesions in the down-sized Rapacz with a commercially available diagnostic tool VH IVUS. It is claimed that VH IVUS can characterize the tissue components

  18. Continuous Ambulatory Peritoneal Dialysis Patients Show High Prevalence of Carotid Artery Calcification which is Associated with a Higher Left Ventricular Mass Index

    OpenAIRE

    Oh, Dong-Jin

    2005-01-01

    This study examined intima-media thickness and arterial plaque occurrence in the carotid and brachial arteries in continuous ambulatory peritoneal dialysis (CAPD) patients. The study compared 25 CAPD patients with 25 normotensive age- and sex-matched controls. Intima-media thickness and presence of plaque in carotid and brachial artery were measured three times using high-resolution B-mode echocardiography. Left ventricular mass was calculated using the Penn Convection equation. Blood samples...

  19. Carotid artery stenting

    International Nuclear Information System (INIS)

    An ipsilateral stenosis of the internal carotid artery is found in 10 - 15 % of all ischemic strokes and indicates an increased risk of a second stroke. Carotid artery stenting (CAS) is a therapy that is established for many years. CAS reveals complication rates and long-term efficacy comparable to carotid endarterectomy (TEA). Especially younger patients seem to benefit from CAS. Abilities and experiences of the therapist and the choice of the techniques used are critical for patient safety. The efficacy of CAS for treatment of asymptomatic carotid stenosis is probable but still unproven in prospective-randomized trial. (orig.)

  20. Carotid artery stenting; Karotisangioplastie

    Energy Technology Data Exchange (ETDEWEB)

    Fiehler, Jens [Universitaetsklinikum Eppendorf, Hamburg (Germany). Klinik und Poliklinik fuer Neuroradiologische Diagnostik und Intervention, Diagnostikzentrum

    2009-09-15

    An ipsilateral stenosis of the internal carotid artery is found in 10 - 15 % of all ischemic strokes and indicates an increased risk of a second stroke. Carotid artery stenting (CAS) is a therapy that is established for many years. CAS reveals complication rates and long-term efficacy comparable to carotid endarterectomy (TEA). Especially younger patients seem to benefit from CAS. Abilities and experiences of the therapist and the choice of the techniques used are critical for patient safety. The efficacy of CAS for treatment of asymptomatic carotid stenosis is probable but still unproven in prospective-randomized trial. (orig.)

  1. A comparison between NASCET and ECST methods in the study of carotids

    International Nuclear Information System (INIS)

    Purpose: NASCET and ECST systems to quantify carotid artery stenosis use percent diameter ratios from conventional angiography. With the use of Multi-Detector-Row CT scanners it is possible to easily measure plaque area and residual lumen in order to calculate carotid stenosis degree. Our purpose was to compare NASCET and ECST techniques in the measurement of carotid stenosis degree by using MDCTA. Methods and material: From February 2007 to October 2007, 83 non-consecutive patients (68 males; 15 females) were studied using Multi-Detector-Row CT. Each patient was assessed by two experienced radiologists for stenosis degree by using both NASCET and ECST methods. Statistic analysis was performed to determine the entity of correlation (method of Pearson) between NASCET and ECST. The Cohen kappa test and Bland-Altman analysis were applied to assess the level of inter- and intra-observer agreement. Results: The correlation Pearson coefficient between NASCET and ECST was 0.962 (p < 0.01). Intra-observer agreement in the NASCET evaluation, by using Cohen statistic was 0.844 and 0.825. Intra-observer agreement in the ECST evaluation was 0.871 and 0.836. Inter-observer agreement in the NASCET and ECTS were 0.822 and 0.834, respectively. Agreement analysis by using Bland-Altman plots showed a good intra-/inter-observer agreement for the NASCET and an optimal intra-/inter-observer agreement for the ECST. Conclusions: Results of our study suggest that NASCET and ECST methods show a strength correlation according to quadratic regression. Intra-observer agreement results high for both NASCET and ECST.

  2. Atherosclerotic Calcification Detection: A Comparative Study of Carotid Ultrasound and Cone Beam CT

    OpenAIRE

    Fisnik Jashari; Pranvera Ibrahimi; Elias Johansson; Jan Ahlqvist; Conny Arnerlöv; Maria Garoff; Eva Levring Jäghagen; Per Wester; Michael Y. Henein

    2015-01-01

    BACKGROUND AND AIM: Arterial calcification is often detected on ultrasound examination but its diagnostic accuracy is not well validated. The aim of this study was to determine the accuracy of carotid ultrasound B mode findings in detecting atherosclerotic calcification quantified by cone beam computed tomography (CBCT). METHODS: We analyzed 94 carotid arteries, from 88 patients (mean age 70 ± 7 years, 33% females), who underwent pre-endarterectomy ultrasound examination. Plaques with high ec...

  3. Independent association between serum sclerostin levels and carotid artery atherosclerosis in prevalent haemodialysis patients

    OpenAIRE

    Alper KIRKPANTUR; BALCI, Mustafa; Turkvatan, Aysel; Afsar, Baris

    2015-01-01

    Background Sclerostin is a soluble inhibitor of the Wnt signalling pathway and has been shown to be associated with decreased bone turnover and vascular and/or valvular calcification in patients with chronic kidney disease. Common carotid artery intima-media thickness (CIMT) assessment and common carotid artery (CCA) plaque identification with ultrasound imaging are well-recognized tools for the identification and monitoring of atherosclerosis. The aim of the present study was to investigate ...

  4. CAROTID ATHEROSCLEROTIC LESION IN YOUNG PATIENTS

    Directory of Open Access Journals (Sweden)

    N. V. Pizova

    2014-01-01

    Full Text Available Objective: to determine the incidence of atherosclerotic lesions in the carotid and vertebral arteries of young patients from Doppler ultrasound data and to compare the quantitatively assessed traditional risk factors of coronary heart disease (CHD with severe extracranial artery atherosclerotic lesion.Subjects and methods. Doppler ultrasound was carried out evaluating structural changes in the aortic arch branches in 1563 railway transport workers less than 45 years of age. A separate sample consisted of 68 young people with carotid atherosclerotic changes, in whom traditional risk factors for CHD were studied, so were in a control group of individuals without atherosclerotic changes (n = 38.Results. Among the examinees, carotid atherosclerotic lesion was detected in 112 (7.1 % cases, the increase in the rate of atherosclerotic plaques in patients aged 35–45 years being 9.08 %; that in the rate of local intima-media thickness in those aged 31–40 years being 5.1 %. Smoking (particularly that along with hypercholesterolemia and a family history of cardiovascular diseases, obesity (along with low activity, and emotional overstrain were defined as important risk factors in the young patients. Moreover, factor analysis has shown that smoking,hypertension, and early cardiovascular pathology in the next of kin makes the greatest contribution to the development of carotid atherosclerotic lesion.Conclusion. Among the patients less than 45 years of age, carotid and vertebral artery atherosclerotic changes were found in 112 (7.1 % cases, which were more pronounced in male patients. Smoking, particularly along with hypercholesterolemia and genetic predisposition to cardiovascular diseases, was a risk factor that had the highest impact on the degree of atherosclerotic lesion in the aortic arch branches of the young patients.

  5. Mitral and aortic valve sclerosis/calcification and carotid atherosclerosis: results from 1065 patients.

    Science.gov (United States)

    Rossi, Andrea; Faggiano, Pompilio; Amado, Alexandra E; Cicoira, Mariantonietta; Bonapace, Stefano; Franceschini, Lorenzo; Dini, Frank L; Ghio, Stefano; Agricola, Eustachio; Temporelli, Pier Luigi; Vassanelli, Corrado

    2014-11-01

    This study assesses whether aortic valve sclerosis (AVS) and mitral annulus calcification (MAC) are associated with carotid artery atherosclerosis, independently of traditional cardiovascular risk factors. A total of 1065 patients underwent both echocardiography and carotid artery ultrasound scanning. AVS and MAC were defined as focal areas of increased echogenicity and thickening of the aortic leaflets or mitral valve annulus. Carotid artery atherosclerosis was defined as presence/absence of any atherosclerotic plaque or presence/absence of plaque >50 %. Of 1065 patients (65 ± 9 years; 38 % female) who comprised the study population, 642 (60 %) had at least one atherosclerotic plaque. AVS, but not mitral valve sclerosis; was associated with the presence of carotid atherosclerosis (odds ratio (OR) 1.9, 95 % confidence interval (CI) 1.2-3.9; P = 0.005) and the degree of carotid atherosclerosis (OR 2.1, 95 % CI 1.2-3.9; P = 0.01) in a multivariate model including age, gender, previous ischemic heart disease, hypertension, dyslipidemia, smoking, diabetes, family cardiovascular history, left ventricular size, mass, and ejection fraction, and left atrial size. AVS is a significant predictor of carotid atherosclerosis, independently of other cardiovascular clinical and echocardiographic risk factors. PMID:24196525

  6. Automatic active contour-based segmentation and classification of carotid artery ultrasound images.

    Science.gov (United States)

    Chaudhry, Asmatullah; Hassan, Mehdi; Khan, Asifullah; Kim, Jin Young

    2013-12-01

    In this paper, we present automatic image segmentation and classification technique for carotid artery ultrasound images based on active contour approach. For early detection of the plaque in carotid artery to avoid serious brain strokes, active contour-based techniques have been applied successfully to segment out the carotid artery ultrasound images. Further, ultrasound images might be affected due to rotation, scaling, or translational factors during acquisition process. Keeping in view these facts, image alignment is used as a preprocessing step to align the carotid artery ultrasound images. In our experimental study, we exploit intima-media thickness (IMT) measurement to detect the presence of plaque in the artery. Support vector machine (SVM) classification is employed using these segmented images to distinguish the normal and diseased artery images. IMT measurement is used to form the feature vector. Our proposed approach segments the carotid artery images in an automatic way and further classifies them using SVM. Experimental results show the learning capability of SVM classifier and validate the usefulness of our proposed approach. Further, the proposed approach needs minimum interaction from a user for an early detection of plaque in carotid artery. Regarding the usefulness of the proposed approach in healthcare, it can be effectively used in remote areas as a preliminary clinical step even in the absence of highly skilled radiologists. PMID:23417308

  7. Correlação da composição de placas à histologia virtual com proteína C-reativa Correlation between plaque composition as assessed by virtual histology and C-reactive protein

    Directory of Open Access Journals (Sweden)

    Dimytri Alexandre de Alvim Siqueira

    2013-01-01

    vulnerable plaque. Virtual histology IVUS (VH-IVUS characterizes plaque components as calcified, fibrotic, fibrofatty, or necrotic core. C-reactive protein (hsCRP is an independent risk factor and a powerful predictor of future coronary events. However, a relationship between inflammatory response indicated by CRP and plaque characteristics in ACS patients remains not well established. OBJECTIVE: To determine, by using VH-IVUS, the relation between coronary plaque components and plasma high-sensitivity CRP levels in patients with acute coronary syndromes (ACS. METHODS: 52 patients with ACS were enrolled in this prospective study. Electrocardiographically-gated VH-IVUS were performed in the culprit lesion before PCI. Blood sample was drawn from all patients before the procedure and after 24 hours, and hs-CRP levels were determined. RESULTS: Mean age was 55.3±4.9 years, 76.9% were men and 30.9% had diabetes. Mean MLA was 3.9±1.3 mm², and plaque burden was 69±11.3%, as assessed by IVUS. VH-IVUS analysis at the minimum luminal site identified plaque components: fibrotic (59.6±15.8%, fibrofatty (7.6±8.2%, dense calcium (12.1±9.2% and necrotic core (20.7±12.7%. Plasma hs-CRP (mean 16.02±18.07 mg/L did not correlate with necrotic core (r=-0.089, p = 0.53 and other plaque components. CONCLUSIONS: In this prospective study with patients with ACS, the predominant components of the culprit plaque were fibrotic and necrotic core. Serum hs C-reactive protein levels did not correlate with plaque composition.

  8. AN INVESTIGATION OF RELATIONSHIP BETWEEN TONSILLOLITH AND CAROTID ARTERY CALCIFICATION ON PANORAMIC RADIOGRAPHY

    OpenAIRE

    Cakur, Binali; Yıldırım, Eren; Demirtaş, Ömer

    2015-01-01

    Aim: Carotid artery calcification can results in important vascular obstruction. It is reported that the combination of risk factors such as periodontitis, pulp stones contribute to carotid artery calcification. However in the literature, no study has yet investigated carotid artery calcification with respect to tonsillolith. The objective of this study was to investigate whether carotid artery calcification correlate with tonsillolith using dental panoramic radiography.Material and method: P...

  9. Semi-automatic 3D segmentation of carotid lumen in contrast-enhanced computed tomography angiography images.

    Science.gov (United States)

    Hemmati, Hamidreza; Kamli-Asl, Alireza; Talebpour, Alireza; Shirani, Shapour

    2015-12-01

    The atherosclerosis disease is one of the major causes of the death in the world. Atherosclerosis refers to the hardening and narrowing of the arteries by plaques. Carotid stenosis is a narrowing or constriction of carotid artery lumen usually caused by atherosclerosis. Carotid artery stenosis can increase risk of brain stroke. Contrast-enhanced Computed Tomography Angiography (CTA) is a minimally invasive method for imaging and quantification of the carotid plaques. Manual segmentation of carotid lumen in CTA images is a tedious and time consuming procedure which is subjected to observer variability. As a result, there is a strong and growing demand for developing computer-aided carotid segmentation procedures. In this study, a novel method is presented for carotid artery lumen segmentation in CTA data. First, the mean shift smoothing is used for uniformity enhancement of gray levels. Then with the help of three seed points, the centerlines of the arteries are extracted by a 3D Hessian based fast marching shortest path algorithm. Finally, a 3D Level set function is performed for segmentation. Results on 14 CTA volumes data show 85% of Dice similarity and 0.42 mm of mean absolute surface distance measures. Evaluation shows that the proposed method requires minimal user intervention, low dependence to gray levels changes in artery path, resistance to extreme changes in carotid diameter and carotid branch locations. The proposed method has high accuracy and can be used in qualitative and quantitative evaluation. PMID:26429385

  10. IEEM Programming Procedure For Detecting Boundary Of Carotid Artery

    OpenAIRE

    V.Savithri; Purushothaman, S.(GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, 64291, Germany)

    2010-01-01

    This paper presents an IEEM programming procedure for use on noisy B-mode ultrasound images of the carotid artery. This programming procedure is based on Image Enhancement, Edge detection and Morphological operations in Boundary detection. This procedure may simplify the job of the practitioner for analyzing accuracy and variability of segmentation results. Possible plaque regions are also highlighted. A thorough evaluation of the method in the clinical environment shows that inter observer v...

  11. Development of a near infrared fluorescence catheter: operating characteristics and feasibility for atherosclerotic plaque detection

    International Nuclear Information System (INIS)

    We present a one-dimensional optical fibre-based imaging catheter specifically developed for the atherosclerotic plaque detection of emerging novel near infrared fluorescence imaging agents. We show that femtomole amounts of fluorochromes can be detected, especially in the presence of a blood-free medium. We further studied the catheter responses for a wide range of laser powers and biologically relevant concentrations of fluorochrome. In vitro tissue-like phantoms and human carotid plaque specimen measurements further demonstrate the feasibility of atherosclerotic plaque detection

  12. Low prevalence of significant carotid artery disease in Iranian patients undergoing elective coronary artery bypass

    Directory of Open Access Journals (Sweden)

    Karimi Fatemeh

    2007-01-01

    Full Text Available Abstract Background Coronary artery bypass grafting ranks as one of the most frequent operations worldwide. The presence of carotid artery stenosis may increase the stroke rate in the perioperative period. Routine preoperative noninvasive assessment of the carotid arteries are recommended in many institutions to reduce the stroke rate. Methods 271 consecutive patients undergoing coronary artery bypass grafting at Shaheed Madani hospital of Tabriz, Iran (age, 58.5 Y; 73.1% male underwent preoperative ultrasonography for assessment of carotid artery wall thickness. Results Plaque in right common, left common, right internal and left internal carotid arteries was detected in 4.8%, 7.4%, 43.2% and 42.1% of patients respectively. 5 patients (1.8% had significant ( Conclusion Consecutive Iranian patients undergoing elective coronary artery bypass surgery show a very low prevalence of significant carotid artery disease.

  13. PET/SPECT imaging: From carotid vulnerability to brain viability

    Energy Technology Data Exchange (ETDEWEB)

    Meerwaldt, Robbert [Department of Surgery, Isala Clinics, Zwolle (Netherlands); Slart, Riemer H.J.A. [Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen (Netherlands); Dam, Gooitzen M. van [Department of Surgery, University Medical Center Groningen, Groningen (Netherlands); Luijckx, Gert-Jan [Department of Neurology, University Medical Center Groningen, Groningen (Netherlands); Tio, Rene A. [Department of Cardiology, University Medical Center Groningen, Groningen (Netherlands); Zeebregts, Clark J. [Department of Surgery, University Medical Center Groningen, Groningen (Netherlands)], E-mail: czeebregts@hotmail.com

    2010-04-15

    Background: Current key issues in ischemic stroke are related to carotid plaque vulnerability, brain viability, and timing of intervention. The treatment of ischemic stroke has evolved into urgent active interventions, as 'time is brain'. Functional imaging such as positron emission tomography (PET)/single photon emission computed tomography (SPECT) could improve selection of patients with a vulnerable plaque and evaluation of brain viability in ischemic stroke. Objective: To describe the current applications of PET and SPECT as a diagnostic tool in relation to ischemic stroke. Methods: A literature search using PubMed identified articles. Manual cross-referencing was also performed. Results: Several papers, all observational studies, identified PET/SPECT to be used as a tool to monitor systemic atheroma modifying treatment and to select high-risk patients for surgery regardless of the degree of luminal stenosis in carotid lesions. Furthermore, PET/SPECT is able to quantify the penumbra region during ischemic stroke and in this way may identify those patients who may benefit from timely intervention. Discussion: Functional imaging modalities such as PET/SPECT may become important tools for risk-assessment and evaluation of treatment strategies in carotid plaque vulnerability and brain viability. Prospective clinical studies are needed to evaluate the diagnostic accuracy of PET/SPECT.

  14. PET/SPECT imaging: From carotid vulnerability to brain viability

    International Nuclear Information System (INIS)

    Background: Current key issues in ischemic stroke are related to carotid plaque vulnerability, brain viability, and timing of intervention. The treatment of ischemic stroke has evolved into urgent active interventions, as 'time is brain'. Functional imaging such as positron emission tomography (PET)/single photon emission computed tomography (SPECT) could improve selection of patients with a vulnerable plaque and evaluation of brain viability in ischemic stroke. Objective: To describe the current applications of PET and SPECT as a diagnostic tool in relation to ischemic stroke. Methods: A literature search using PubMed identified articles. Manual cross-referencing was also performed. Results: Several papers, all observational studies, identified PET/SPECT to be used as a tool to monitor systemic atheroma modifying treatment and to select high-risk patients for surgery regardless of the degree of luminal stenosis in carotid lesions. Furthermore, PET/SPECT is able to quantify the penumbra region during ischemic stroke and in this way may identify those patients who may benefit from timely intervention. Discussion: Functional imaging modalities such as PET/SPECT may become important tools for risk-assessment and evaluation of treatment strategies in carotid plaque vulnerability and brain viability. Prospective clinical studies are needed to evaluate the diagnostic accuracy of PET/SPECT.

  15. Diagnosis of atherosclerosis in human carotid artery by FT-Raman spectroscopy: Principal Components Analysis algorithm

    Science.gov (United States)

    Nogueira, Grazielle V.; Silveira, Landulfo, Jr.; Martin, Airton A.; Zangaro, Renato A.; Pacheco, Marcos T.; Chavantes, Maria C.; Zampieri, Marcelo; Pasqualucci, Carlos A. G.

    2004-07-01

    FT- Raman Spectroscopy (FT-Raman) could allow identification and evaluation of human atherosclerotic lesions. A Raman spectrum can provide biochemical information of arteries which can help identifying the disease status and evolution. In this study, it is shown the results of FT-Raman for identification of human carotid arteries in vitro. Fragments of human carotid arteries were analyzed using a FT-Raman spectrometer with a Nd:YAG laser at 1064nm operating at an excitation power of 300mW. Spectra were obtained with 250 scans and spectral resolution of 4 cm-1. Each collection time was approximately 8 min. A total of 75 carotid fragments were spectroscopically scanned and FT-Raman results were compared with histopathology. Principal Components Analysis (PCA) was used to model an algorithm for tissue classification into three categories: normal, atherosclerotic plaque without calcification and atherosclerotic plaque with calcification. Non-atherosclerotic (normal) artery, atherosclerotic plaque and calcified plaque exhibit different spectral signatures related to biochemicals presented in each tissue type, such as, bands of collagen and elastin (proteins), cholesterol and its esters and calcium hydroxyapatite and carbonate apatite respectively. Results show that there is 96% match between classifications based on PCA algorithm and histopathology. The diagnostic applied over all 75 samples had sensitivity and specificity of about 89% and 100%, respectively, for atherosclerotic plaque and 100% and 98% for calcified plaque.

  16. CT angiography in carotid stenosis

    International Nuclear Information System (INIS)

    Purpose: Prospective evaluation of the accuracy CT angiography (CTA) with different postprocessing for extracranial carotid artery in comparison with DSA. Method: one hundred patients were studied with standarized CTA. For postprocessing, MPR, MIP, and 3D reconstruction based on segmentation with upper and lower threshold were used. Intravascular density profiles were considered. All CTA studies were correlated with intra-arterial angiography. The degree and classification of stenoses was determined using the guidelines established by the NASCET collaborators. Results: Measurement of stenosis was possible by MPR in 82.5%, by MIP in 85%, and 3D in 100%. Correct classification was found in 65.5% for MPR, 66% for MIP and 88.5% for 3D. The sensitivity for severe stenoses was 74% for MPR, 82% for MIP, and 93% for 3D. The specificity of these methods was 98%, 96%, and 97%, respectively. All carotid occlusions were correctly identified, no carotid artery was wrongly classified as occluded. (orig./AJ)

  17. Nontraditional Cardiovascular Biomarkers and Estimation of Cardiovascular Risk in Predialysis Chronic Kidney Disease Patients and Their Correlations With Carotid Intima Media Thickness

    OpenAIRE

    Sathi, Satyanand; Mahapatra, Himanshu; Sunder, Sham; Jayaraman, Rajesh; Sharma, Neera; Verma, Himanshu; Krishnamoorthy, Venkataramanan; Gupta, Anurag; Kanchi, Prabhu; Daksh, Sunil; Pursnani, Lalit; Shadab, Faisal; Singh, Manveer

    2014-01-01

    Background: Cardiovascular biomarkers such as N-terminal pro-B-type natriuretic peptide (NT-proBNP), cardiac troponin T (cTnT), hs-CRP (high sensitivity C-reactive protein), and albuminuria predict underlying heart disease in the general population as well as CKD patients. Objectives: We aimed to study the association of NT-proBNP, cTnT, hs-CRP, and spot urine albumin creatinine ratio with carotid intima media thickness (CIMT) for cardiovascular risk estimation in predialysis CKD (chronic kid...

  18. {sup 18}F-FDG accumulation in atherosclerosis: use of CT and MR co-registration of thoracic and carotid arteries

    Energy Technology Data Exchange (ETDEWEB)

    Okane, Kumiko; Ibaraki, Masanobu; Toyoshima, Hideto; Sugawara, Shigeki; Takahashi, Kazuhiro; Miura, Shuichi; Shimosegawa, Eku [Research Institute for Brain and Blood Vessels-Akita, Department of Radiology and Nuclear Medicine, Akita (Japan); Satomi, Junichiro [Research Institute for Brain and Blood Vessels-Akita, Department of Neurosurgery, Akita (Japan); Kitamura, Keishi; Satoh, Tomohiko [Shimadzu Corporation, Research and Development Department, Medical Systems Division, Kyoto (Japan)

    2006-05-15

    The purpose of this study was to depict{sup 18}F-fluoro-2-deoxy-D-glucose (FDG) accumulation in atherosclerotic lesions of the thoracic and carotid arteries on CT and MR images by means of automatic co-registration software. Fifteen hospitalised men suffering cerebral infarction or severe carotid stenosis requiring surgical treatment participated in this study. Automatic co-registration of neck MR images and FDG-PET images and of contrast-enhanced CT images and FDG-PET images was achieved with co-registration software. We calculated the count ratio, which was standardised to the blood pool count of the superior vena cava, for three arteries that branch from the aorta, i.e. the brachial artery, the left common carotid artery and the subclavian artery (n=15), for atherosclerotic plaques in the thoracic aorta (n=10) and for internal carotid arteries with and without plaque (n=13). FDG accumulated to a significantly higher level in the brachial artery, left common carotid artery and left subclavian artery at their sites of origin than in the superior vena cava (p=0.000, p=0.000 and p=0.002, respectively). Chest CT showed no atherosclerotic plaque at these sites. Furthermore, the average count ratio of thoracic aortic atherosclerotic plaques was not higher than that of the superior vena cava. The maximum count ratio of carotid atherosclerotic plaques was significantly higher than that of the superior vena cava but was not significantly different from that of the carotid artery without plaque. The results of our study suggest that not all atherosclerotic plaques show high FDG accumulation. FDG-PET studies of plaques with the use of fused images can potentially provide detailed information about atherosclerosis. (orig.)

  19. A framework for the co-registration of hemodynamic forces and atherosclerotic plaque components

    International Nuclear Information System (INIS)

    Local hemodynamic forces, such as wall shear stress (WSS), are thought to trigger cellular and molecular mechanisms that determine atherosclerotic plaque vulnerability to rupture. Magnetic resonance imaging has emerged as a powerful tool to characterize human carotid atherosclerotic plaque composition and morphology, and to identify plaque features shown to be key determinants of plaque vulnerability. Image-based computational fluid dynamics has allowed researchers to obtain time-resolved WSS information of atherosclerotic carotid arteries. A deeper understanding of the mechanisms of initiation and progression of atherosclerosis can be obtained through the comparison of WSS and plaque composition and morphology. To date, however, advance in knowledge has been limited greatly due to the lack of a reliable infrastructure to perform such analysis. The aim of this study is to establish a framework that will allow for the co-registration and analysis of the three-dimensional distribution of WSS and plaque components and morphology. The use of this framework will lead to future studies targeted to determining the role of WSS in atherosclerotic plaque progression and vulnerability. (paper)

  20. Current Approaches for Carotid Endarterectomy

    Directory of Open Access Journals (Sweden)

    Cengiz Köksal

    2010-12-01

    Full Text Available Permanent neurologic injuries and death following stroke, necessitates more vigorous treatment of carotid disease. Carotid stenting and carotid endarterectomy are treatment options in many centers besides medical treatment. Whether the patient is symptomatic or asymtomatic, indications and management strategies for treatment remain controversial. Despite the debate, carotid endarterectomy is still accepted to be the most efficientintervention to decrease risk of stroke due to carotid artery stenosis.

  1. The application of MR and CT angiography in the evaluation of carotid artery stenosis and follow-up of carotid endarterectomy

    International Nuclear Information System (INIS)

    Objective: To estimate the accuracy of MR angiography (MRA) and CT angiography (CTA) in the evaluation of the carotid artery stenosis. Methods: Eleven patients were studied with MRA and CTA. The results were compared with DSA, CT virtual endoscopy (CTVE), and Doppler ultrasound (DUS). MRA was performed with 2D and 3D TOF sequences. CTA was post processed using MIP and SSD. CTVE was performed using navigator function. Three patients with severe stenosis received carotid endarterectomy. Results: There was a total of 22 carotid arteries studied, with 8 mild, 3 moderate, 5 severe stenosis, 1 occlusion, and 5 normal. Agreement on stenosis between CTA and DSA was found in 11 of 12 carotid arteries. Agreement on stenosis between MRA and DSA was found in 9. Plaques were delineated in CTA, CTVE, and confirmed by pathology in 3 cases. Postoperative MRA and CTA proved the release of stenosis. Conclusion: MRA and DUS can be used as a screening technique to evaluate carotid artery stenosis and as a convenient follow-up modality for post-endarterectomy. CTA has a high degree of accuracy for the assessment of carotid artery stenosis compared with DSA, and it could provide information on calcified plaque

  2. Imaging unstable plaque.

    Science.gov (United States)

    Sriranjan, Rouchelle S; Tarkin, Jason M; Evans, Nicholas R; Chowdhury, Mohammed M; Rudd, James H

    2016-09-01

    Recent advances in imaging technology have enabled us to utilise a range of diagnostic approaches to better characterise high-risk atherosclerotic plaque. The aim of this article is to review current and emerging techniques used to detect and quantify unstable plaque in the context of large and small arterial systems and will focus on both invasive and non-invasive imaging techniques. While the diagnosis of clinically relevant atherosclerosis still relies heavily on anatomical assessment of arterial luminal stenosis, evolving multimodal cross-sectional imaging techniques that encompass novel molecular probes can provide added information with regard to plaque composition and overall disease burden. Novel molecular probes currently being developed to track precursors of plaque rupture such as inflammation, micro-calcification, hypoxia and neoangiogenesis are likely to have translational applications beyond diagnostics and have the potential to play a part in quantifying early responses to therapeutic interventions and more accurate cardiovascular risk stratification. PMID:27273430

  3. Carotid stenting and endarterectomy.

    Science.gov (United States)

    Yip, Hon-Kan; Sung, Pei-Hsun; Wu, Chiung-Jen; Yu, Cheuk-Man

    2016-07-01

    Stroke, either ischemic or hemorrhagic, remains the second commonest cause of death worldwide in the last decade. Etiologies for ischemic stroke (IS) vary widely. Atherothrombotic occlusion is an essential cause to which carotid artery stenosis (CAS) is a major contributor. Administration of anti-platelet agent to patients with CAS has been shown to reduce incidence of long-term IS. In additional, in patients with symptomatic CAS, clinical trials have demonstrated that carotid endarterectomy (CEA) is superior to medical therapy for prevention of future CAS-related IS. However, CEA is not suitable for CAS post-radiotherapy or those located at higher level of the internal carotid artery; and major complications of this procedure including cranial nerve injuries have stimulated the interest of using percutaneous transfemoral carotid stenting as an alternative approach. Although transfemoral arterial approach of carotid stenting is not inferior to CEA in improving clinical outcomes, it has been reported to be associated with vascular complication and has its limitations in patients with athero-occlusive disease of abdominal aorta or bilateral iliac arteries, level II or III aortic arch, or bovine type carotid arterial anatomy. Therefore, transradial/transbrachial arterial approach has emerged as a novel method for carotid stenting. This article provides a critical review on interventional approaches for the treatment of CAS. PMID:27061654

  4. Comparison of semi-automated and manual measurements of carotid intima-media thickening.

    LENUS (Irish Health Repository)

    Mac Ananey, Oscar

    2014-01-01

    Carotid intima-media thickening (CIMT) is a marker of both arteriosclerotic and atherosclerotic risks. Technological advances have semiautomated CIMT image acquisition and quantification. Studies comparing manual and automated methods have yielded conflicting results possibly due to plaque inclusion in measurements. Low atherosclerotic risk subjects (n = 126) were recruited to minimise the effect of focal atherosclerotic lesions on CIMT variability. CIMT was assessed by high-resolution B-mode ultrasound (Philips HDX7E, Phillips, UK) images of the common carotid artery using both manual and semiautomated methods (QLAB, Phillips, UK). Intraclass correlation coefficient (ICC) and the mean differences of paired measurements (Bland-Altman method) were used to compare both methodologies. The ICC of manual (0.547 ± 0.095 mm) and automated (0.524 ± 0.068 mm) methods was R = 0.74 and an absolute mean bias ± SD of 0.023 ± 0.052 mm was observed. Interobserver and intraobserver ICC were greater for automated (R = 0.94 and 0.99) compared to manual (R = 0.72 and 0.88) methods. Although not considered to be clinically significant, manual measurements yielded higher values compared to automated measurements. Automated measurements were more reproducible and showed lower interobserver variation compared to manual measurements. These results offer important considerations for large epidemiological studies.

  5. Breast arterial calcification and risk of carotid atherosclerosis: Focusing on the preferentially affected layer of the vessel wall

    Energy Technology Data Exchange (ETDEWEB)

    Sedighi, Nahid, E-mail: nsedighi@sina.tums.ac.ir [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Radmard, Amir Reza, E-mail: radmard@ams.ac.ir [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Radmehr, Ali, E-mail: radmehr@sina.tums.ac.ir [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Hashemi, Pari, E-mail: phtums@yahoo.com [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Hajizadeh, Abdolmahmoud, E-mail: mroomezi@yahoo.com [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Taheri, Amir Pejman Hashemi, E-mail: hashemip@sina.tums.ac.ir [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of)

    2011-08-15

    Objective: To assess the relationship between breast arterial calcification (BAC) detected on screening mammography and atherosclerosis of carotid arteries considering the most likely involved layer of the arterial wall. Materials and methods: A total of 537 consecutive women who underwent screening mammography were enrolled in this study. Seventy-nine subjects having BAC, aged 46-75 years, and 125 age-matched controls from those without BAC were selected for ultrasound examination of carotid arteries assessing intima-media thickness (IMT) and plaque presence. Participants were divided into three groups of risk including, low-risk: IMT < 0.6 mm without plaque, medium-risk: 0.6 mm {<=} IMT {<=} 0.8 mm without plaque and high-risk: IMT > 0.8 mm and/or plaque. Risk factors for atherosclerosis were obtained from medical records for independent effects. Results: BAC was present in 14.7% of mammograms. According to multivariable logistic regression analyses, significant association was identified between the carotid atherosclerosis risk and presence of BAC. Compared to women with IMT < 0.6 mm, those with 0.6 mm {<=} IMT{<=} 0.8 mm and IMT > 0.8 mm had OR (95% CI) of 4.88 (1.47-16.16) and 23.36 (4.54-120.14), respectively. The OR (95% CI) for carotid plaque was 3.13 (1.3-7.57). There was no interaction between IMT category and plaque. Significant associations were also detected with postmenopausal duration (P = 0.02) and hypertension (P = 0.004). Conclusion: The risk of carotid atherosclerosis increases with the presence of BAC. Women with BAC are more likely to have thicker IMT than plaque, which could be attributed to the preferentially similar affected layer of media causing thick IMT rather than plaque.

  6. Inverse association of serum vitamin D in relation to carotid intima-media thickness in Chinese postmenopausal women.

    Directory of Open Access Journals (Sweden)

    Yaping Hao

    Full Text Available This study aimed to investigate the relationship between serum vitamin D level and carotid intima-media thickness (C-IMT in Chinese postmenopausal women.Nine hundred and twenty six Chinese postmenopausal women without carotid artery plaque or history of cardiovascular disease were selected for analysis. Measurements of serum 25 hydroxyvitamin D3 (25(OHD3 concentration and C-IMT were made by electrochemiluminescence immunoassay and B-mode ultrasound, respectively. Trend analysis was conducted according to tertiles of C-IMT.The median serum 25(OHD3 level was 11.03 ng/mL, with an interquartile range of 8.22-14.70. A decreasing trend of serum 25(OHD3 level was accompanied by increased C-IMT tertiles (P for trend = 0.001. Correlation analysis found an inverse relationship between serum 25(OHD3 level and C-IMT (r = -0.113, P = 0.001. After adjustment for confounding factors, multiple regression analysis showed that serum 25(OHD3 level independently and negatively associated with C-IMT (Standard β = -0.112, P < 0.001. Moreover, the inverse correlation of serum 25(OHD3 with C-IMT was also found in a subgroup of women with normal glucose tolerance, blood pressure and body mass index, and without undergoing lipid-lowering therapy (standard β = -0.140, P = 0.018.Serum 25(OHD3 level was inversely correlated with C-IMT in Chinese postmenopausal women.

  7. Correlation of atherosclerotic changes in peripheral arteries with pathological involvement of aortic arch in coronary bypass patients

    Directory of Open Access Journals (Sweden)

    Eshraghi N

    2010-10-01

    Full Text Available "nBackground: A correlation between coronary artery disease (CAD and atherosclerosis of peripheral arteries and the determination of noninvasive indexes for its existence and extent have been sought by many researchers. Some studies report that the intima-media thickness (IMT of peripheral arteries could play this role. This study evaluated the correlation between the IMTs of common carotid and common femoral arteries and the degree of atherosclerosis in aortic arch and to evaluate the severity of CAD in candidates of coronary artery bypass grafting (CABG."n "nMethods: In a cross-sectional analytic-descriptive study, The severity of CAD, the grade of atherosclerosis of the aortic arch, and the IMTs of the common carotid and common femoral arteries were determined."n "nResults: There was a significant weak positive correlation between the IMT of common carotid artery (ρ = 0.193, p = 0.039 and common femoral artery (ρ = 0.206, p = 0.028 with the number of involved carotid vessels; the mean of these two parameters was not significantly different between the three CAD groups. There was not any significant relation between the IMTs of common carotid and common femoral arteries with the severity of atherosclerosis in the aortic arch too. There was not any significant relation between the presences of atherosclerotic plaque in the common carotid or the common femoral arteries with the severity of CAD. The severe atherosclerosis of the aortic arch was significantly higher in patients with three vessel disease."n "nConclusion: According to our results, the IMTs of common carotid and/or common femoral arteries may increase with the severity of CAD; however, these parameters are not a surrogate for predicting the CAD severity.

  8. Correlation study of plaque and gingival indexes of mothers and their children Estudo da correlação dos índices de placa e gengival em mães e filhos

    Directory of Open Access Journals (Sweden)

    Ana Cláudia Durante Ramires-Romito

    2005-09-01

    Full Text Available This study aimed to compare the periodontal condition between plaque and gingival indexes in 30 pairs of mother and child with mixed dentition, as well as to correlate the findings with some of their social and oral hygiene habits. Mother's and child's plaque and gingival indexes were recorded during clinical examination. Periapical and bitewing radiographs were taken in order to assess the presence of any pathologic bone loss. Questionnaires answered by the mothers were used to collect information regarding the mother's and the child's habits of tooth hygiene and the mother's job, instruction level and family income. The data collected from the mothers' group and from the children's group were statistically analyzed both separately and with the two groups together. From the statistical analyses (Pearson correlation test, student test and Covariance analysis, it was possible to conclude that there was a greater correlation between the plaque and gingival indexes in the mothers' group than in the children's group. No significant correlation between plaque and gingival indexes could be found between the pairs. Also, bone loss and plaque and gingival indexes in the children did not show any correlation. The mothers' plaque indexes increased with age and decreased when they flossed everyday and when they had a job. The children's plaque indexes were lower when they had their tooth hygiene done by their mothers, when the latter had declared that they flossed their children's teeth everyday, and also when the mothers had a job. Children's gingival indexes increased with age and decreased when they brushed their teeth more often, when their mothers had a job and when their mothers declared they are used to flossing every day.O objetivo deste estudo foi comparar a condição periodontal em 30 pares de mães e crianças com dentição mista, através dos índices de placa e gengival, bem como verificar sua correlação com alguns aspectos sociais e h

  9. Carotid Artery Disease

    Science.gov (United States)

    ... org Diagnosis Proteins in the wall of the aorta, called elastin and collagen The diagnosis of carotid ... a higher risk after age 75) • Smoking • Hypertension • Diabetes • High cholesterol, and especially high amounts of “low ...

  10. Astrocytosis precedes amyloid plaque deposition in Alzheimer APPswe transgenic mouse brain: a correlative positron emission tomography and in vitro imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez-Vieitez, Elena; Ni, Ruiqing; Voytenko, Larysa; Marutle, Amelia [Karolinska Institutet, Division of Translational Alzheimer Neurobiology, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Stockholm (Sweden); Gulyas, Balazs; Halldin, Christer [Karolinska Institutet, Centre for Psychiatric Research, Department of Clinical Neuroscience, Stockholm (Sweden); Nanyang Technological University, NTU - Imperial College, Lee Kong Chian School of Medicine, Singapore (Singapore); Toth, Miklos; Haeggkvist, Jenny [Karolinska Institutet, Centre for Psychiatric Research, Department of Clinical Neuroscience, Stockholm (Sweden); Nordberg, Agneta [Karolinska Institutet, Division of Translational Alzheimer Neurobiology, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Stockholm (Sweden); Karolinska University Hospital Huddinge, Department of Geriatric Medicine, Stockholm (Sweden)

    2015-04-17

    Pathological studies suggest that neuroinflammation is exacerbated by increased beta-amyloid (Aβ) levels in the brain early in Alzheimer's disease (AD). The time course and relationships between astrocytosis and Aβ deposition were examined using multitracer in vivo positron emission tomography (PET) imaging in an AD transgenic mouse model, followed by postmortem autoradiography and immunohistochemistry analysis. PET imaging with the amyloid plaque tracer {sup 11}C-AZD2184 and the astroglial tracer {sup 11}C-deuterium-L-deprenyl ({sup 11}C-DED) was carried out in APPswe mice aged 6, 8-15 and 18-24 months (4-6 animals/group) and in wild-type (wt) mice aged 8-15 and 18-24 months (3-6 animals/group). Tracer uptake was quantified by region of interest analysis using PMOD software and a 3-D digital mouse brain atlas. Postmortem brain tissues from the same APPswe and wt mice in all age groups were analysed for Aβ deposition and astrocytosis by in vitro autoradiography using {sup 3}H-AZD2184, {sup 3}H-Pittsburgh compound B (PIB) and {sup 3}H-L-deprenyl and immunostaining performed with antibodies for Aβ{sub 42} and glial fibrillary acidic protein (GFAP) in sagittal brain sections. {sup 11}C-AZD2184 PET retention in the cerebral cortices of APPswe mice was significantly higher at 18-24 months than in age-matched wt mice. Cortical and hippocampal {sup 11}C-DED PET binding was significantly higher at 6 months than at 8-15 months or 18-24 months in APPswe mice, and it was also higher than at 8-15 months in wt mice. In vitro autoradiography {sup 3}H-AZD2184 and {sup 3}H-PIB binding confirmed the in vivo findings with {sup 11}C-AZD2184 and demonstrated age-dependent increases in Aβ deposition in APPswe cortex and hippocampus. There were no significant differences between APPswe and wt mice in {sup 3}H-L-deprenyl autoradiography binding across age groups. Immunohistochemical quantification demonstrated more Aβ{sub 42} deposits in the cortex and hippocampus and more

  11. Astrocytosis precedes amyloid plaque deposition in Alzheimer APPswe transgenic mouse brain: a correlative positron emission tomography and in vitro imaging study

    International Nuclear Information System (INIS)

    Pathological studies suggest that neuroinflammation is exacerbated by increased beta-amyloid (Aβ) levels in the brain early in Alzheimer's disease (AD). The time course and relationships between astrocytosis and Aβ deposition were examined using multitracer in vivo positron emission tomography (PET) imaging in an AD transgenic mouse model, followed by postmortem autoradiography and immunohistochemistry analysis. PET imaging with the amyloid plaque tracer 11C-AZD2184 and the astroglial tracer 11C-deuterium-L-deprenyl (11C-DED) was carried out in APPswe mice aged 6, 8-15 and 18-24 months (4-6 animals/group) and in wild-type (wt) mice aged 8-15 and 18-24 months (3-6 animals/group). Tracer uptake was quantified by region of interest analysis using PMOD software and a 3-D digital mouse brain atlas. Postmortem brain tissues from the same APPswe and wt mice in all age groups were analysed for Aβ deposition and astrocytosis by in vitro autoradiography using 3H-AZD2184, 3H-Pittsburgh compound B (PIB) and 3H-L-deprenyl and immunostaining performed with antibodies for Aβ42 and glial fibrillary acidic protein (GFAP) in sagittal brain sections. 11C-AZD2184 PET retention in the cerebral cortices of APPswe mice was significantly higher at 18-24 months than in age-matched wt mice. Cortical and hippocampal 11C-DED PET binding was significantly higher at 6 months than at 8-15 months or 18-24 months in APPswe mice, and it was also higher than at 8-15 months in wt mice. In vitro autoradiography 3H-AZD2184 and 3H-PIB binding confirmed the in vivo findings with 11C-AZD2184 and demonstrated age-dependent increases in Aβ deposition in APPswe cortex and hippocampus. There were no significant differences between APPswe and wt mice in 3H-L-deprenyl autoradiography binding across age groups. Immunohistochemical quantification demonstrated more Aβ42 deposits in the cortex and hippocampus and more GFAP+ reactive astrocytes in the hippocampus at 18-24 months than at 6 months in APPswe

  12. Plaque regression and plaque stabilisation in cardiovascular diseases

    Directory of Open Access Journals (Sweden)

    Tarun Dave

    2013-01-01

    Full Text Available Atherosclerosis is characterized by formation of plaques on the inner walls of arteries that threatens to become the leading cause of death worldwide via its sequelae of myocardial infarction and stroke. Endothelial dysfunction leads to cholesterol uptake and accumulation of infl ammatory markers within the plaque. The stability of a plaque eventually depends on the balance between vascular smooth muscle cells that stabilize it and the infl ammatory cells like macrophages and T lymphocytes that make it prone to rupture. The current approach to manage atherosclerosis focuses on the treatment of a ruptured plaque and efforts have been made to reduce the risk of plaque rupture by identifying vulnerable plaques and treating them before they precipitate into clinical events. New diagnostic approaches such as IVUS and CIMT ultrasound are now being preferred over traditional coronary angiography because of their better accuracy in measuring plaque volume rather than the level of stenosis caused. The present review highlights the literature available on two prevalent approaches to manage a vulnerable plaque, namely, plaque stabilization and plaque regression, and their validation through various treatment modalities in recent plaque management studies. Plaque stabilization focuses on stabilizing the content of plaque and strengthening the overlying endothelium, while plaque regression focuses on the overall reduction in plaque volume and to reverse the arterial endothelium to its normal functional state. Although earlier studies contemplated the practicality of plaque regression and focused greatly on stabilization of a vulnerable plaque, our review indicated that, aided by the use of superior diagnostics tools, more intensive lipid modifying therapies have resulted in actual plaque regression.

  13. Robust information gain based fuzzy c-means clustering and classification of carotid artery ultrasound images.

    Science.gov (United States)

    Hassan, Mehdi; Chaudhry, Asmatullah; Khan, Asifullah; Iftikhar, M Aksam

    2014-02-01

    In this paper, a robust method is proposed for segmentation of medical images by exploiting the concept of information gain. Medical images contain inherent noise due to imaging equipment, operating environment and patient movement during image acquisition. A robust medical image segmentation technique is thus inevitable for accurate results in subsequent stages. The clustering technique proposed in this work updates fuzzy membership values and cluster centroids based on information gain computed from the local neighborhood of a pixel. The proposed approach is less sensitive to noise and produces homogeneous clustering. Experiments are performed on medical and non-medical images and results are compared with state of the art segmentation approaches. Analysis of visual and quantitative results verifies that the proposed approach outperforms other techniques both on noisy and noise free images. Furthermore, the proposed technique is used to segment a dataset of 300 real carotid artery ultrasound images. A decision system for plaque detection in the carotid artery is then proposed. Intima media thickness (IMT) is measured from the segmented images produced by the proposed approach. A feature vector based on IMT values is constructed for making decision about the presence of plaque in carotid artery using probabilistic neural network (PNN). The proposed decision system detects plaque in carotid artery images with high accuracy. Finally, effect of the proposed segmentation technique has also been investigated on classification of carotid artery ultrasound images. PMID:24239296

  14. Association between the surfactant protein D (SFTPD) gene and subclinical carotid artery atherosclerosis

    DEFF Research Database (Denmark)

    Sorensen, Grith L; Bladbjerg, Else Marie; Steffensen, Rudi; Tan, Qihua; Madsen, Jens; Drivsholm, Thomas; Holmskov, Uffe

    2016-01-01

    intima-media thickness (IMT) and protruding plaques in the right carotid artery. Associations between cardiovascular traits and the levels of pSP-D (n = 687) or two coding SFTPD SNPs rs3088308 and rs721917 (n = 396) were investigated using multiple linear regressions and logistic regressions. RESULTS...

  15. An Integrated Backscatter Ultrasound Technique for the Detection of Coronary and Carotid Atherosclerotic Lesions

    Directory of Open Access Journals (Sweden)

    Masanori Kawasaki

    2015-01-01

    Full Text Available The instability of carotid and coronary plaques has been reported to be associated with acute coronary syndrome, strokes and other cerebrovascular events. Therefore, recognition of the tissue characteristics of carotid and coronary plaques is important to understand and prevent coronary and cerebral artery disease. Recently, an ultrasound integrated backscatter (IB technique has been developed. The ultrasound IB power ratio is a function of the difference in acoustic characteristic impedance between the medium and target tissue, and the acoustic characteristic impedance is determined by the density of tissue multiplied by the speed of sound. This concept allows for tissue characterization of carotid and coronary plaques for risk stratification of patients with coronary and cerebral artery disease. Two- and three-dimensional IB color-coded maps for the evaluation of tissue components consist of four major components: fibrous, dense fibrosis, lipid pool and calcification. Although several ultrasound techniques using special mathematical algorithms have been reported, a growing body of literature has shown the reliability and usefulness of the IB technique for the tissue characterization of carotid and coronary plaques. This review summarizes concepts, experimental procedures, image reliability and the application of the IB technique. Furthermore, the IB technique is compared with other techniques.

  16. Hepatic steatosis is associated with an increased risk of carotid atherosclerosis

    Institute of Scientific and Technical Information of China (English)

    Henry V(o)lzke; Daniel M. Robinson; Volker Kleine; Roland Deutscher; Wolfgang Hoffmann; Jan Lüdemann; Ulf Schminke; Christof Kessler; Ulrich John

    2005-01-01

    AIM: Although an association between helatic steatosis and vascular risk factors has been described, direct relationships between fatty liver and atherosclerosis have not yet been investigated. The aim of the present study has been to investigate those relationships.METHODS: The Study of Health in Pomerania examined a random population sample aged between 20 and 79 years.A study population of 4 222 subjects without hepatitis B and C infections and without liver cirrhosis was available for the present analysis. Hepatic steatosis was defined sonographically and intima-media thickness (IMT) as well as plaque prevalence were estimated by carotid ultrasound.RESULTS: The prevalence rate of hepatic steatosis was 29.9%. Among subjects aged ≥45 years, an association between hepatic steatosis and IMT of the carotid arteries was found in bivariate analysis, but not after adjustment for atherosclerotic risk factors. Individuals with fatty liver had more often carotid plaques than persons without fatty liver (plaque prevalence rate 76.8% vs 66.6%; P<0.001).This association persisted after adjustment for confounding factors and was predominantly present in subjects with no to mild alcohol consumption.CONCLUSION: There is an independent association between hepatic steatosis and carotid atherosclerotic plaques. Metabolic changes due to nonalcoholic fatty liver disease may explain this relationship.

  17. Serum soluble RAGE levels and carotid atherosclerosis: the Northern Manhattan Study (NOMAS)

    Science.gov (United States)

    Hudson, Barry I; Gardener, Hannah; Liu-Mares, Wen; Dong, Chuanhui; Cheung, Ken; Elkind, Mitchell SV; Wright, Clinton B; Sacco, Ralph L; Rundek, Tatjana

    2016-01-01

    Background Recent cohort studies suggested that serum levels of soluble Receptor for Advanced Glycation End-products (sRAGE) are associated with the risk of cardiovascular disease. We hypothesized that sRAGE levels are associated with subclinical atherosclerosis in a racially and ethnically diverse population. Methods and results 828 stroke-free participants from the Northern Manhattan Study (mean age 71.1±8.7yrs; 64% Hispanic, 19% black, and 17% white) underwent high-resolution carotid B-mode ultrasound to measure carotid plaque (present in 62% of subjects) and intima-media thickness (IMT) (mean Total= 0.96±0.10 mm). Serum sRAGE was measured by ELISA and associations tested between sRAGE with IMT and plaque presence. Soluble RAGE levels were not associated with plaque presence or IMT after adjusting for sociodemographic, vascular risk factors and medication use. Stratification by race-ethnicity did not reveal any associations with carotid IMT or plaque. Conclusion In the present study, sRAGE levels were not associated with carotid atherosclerosis. PMID:25744702

  18. Potential application of nonstructural protein NS1 serotype-specific immunoglobulin G enzyme-linked immunosorbent assay in the seroepidemiologic study of dengue virus infection: correlation of results with those of the plaque reduction neutralization test.

    Science.gov (United States)

    Shu, Pei-Yun; Chen, Li-Kuang; Chang, Shu-Fen; Yueh, Yi-Yun; Chow, Ling; Chien, Li-Jung; Chin, Chuan; Yang, Hui-Hua; Lin, Ting-Hsiang; Huang, Jyh-Hsiung

    2002-05-01

    An NS1 serotype-specific indirect enzyme-linked immunosorbent assay (ELISA) was developed to differentiate primary and secondary dengue virus infections and serotypes of primary dengue virus infection. For this report, we carried out retrospective seroepidemiologic studies on serum samples collected from residents of Liuchiu Hsiang, Pingtung County, an isolated island in southern Taiwan during 1997-1998. The results demonstrated that good correlation existed between dengue virus NS1 serotype-specific immunoglobulin G (IgG) ELISA and dengue virus plaque reduction neutralization test (PRNT). Our data suggested that NS1 serotype-specific IgG ELISA could replace PRNT for seroepidemiologic studies to differentiate Japanese encephalitis and dengue virus infections and for dengue virus serotyping. PMID:11980973

  19. Investigation of the composition of arterial plaques based on arterial waveforms and material properties.

    Science.gov (United States)

    Feng, J; Rajeswaran, T; He, S; Wilkinson, F L; Serracino-Inglott, F; Azzawi, M; Parikh, V; Miraftab, M; Alexander, M Y

    2015-08-01

    Stroke is mainly caused by a narrowing of the carotid artery from a build-up of plaque. The risk of plaque rupture and subsequent stroke is dependent on plaque composition. Advances in imaging modalities offer a non-invasive means to assess the health of blood vessels and detect damage. However, the current diagnosis fails to identify patients with soft lipid plaque that are more susceptible to fissure, resulting in stroke. The aim of this study was to use waveform analysis to identify plaque composition and the risk of rupture. We have investigated pressure and flow by combining an artificial blood flow circuit with tubing containing different materials, to simulate plaques in a blood vessel. We used fat and bone to model lipid and calcification respectively to determine if the composition of plaques can be identified by arterial waveforms. We demonstrate that the arterial plaque models with different percentages of calcification and fat, results in significantly different arterial waveforms. These findings imply that arterial waveform analysis has the potential for further development to identify the vulnerable plaques prone to rupture. These findings could have implications for improved patient prognosis by speed of detection and a more appropriate treatment strategy. PMID:26736431

  20. 心脏瓣膜钙化与颈动脉内膜中层厚度的相关性研究%Relationship of Heart Valve Calcification and Carotid Intima Media Thickness

    Institute of Scientific and Technical Information of China (English)

    贾彦青; 党群; 姚民强; 李永健

    2012-01-01

    目的:研究心脏瓣膜钙化程度与颈动脉内膜中层厚度、斑块积分的相关性.方法:用经胸多普勒超声显像仪评估426例患者心脏瓣膜钙化情况,根据瓣膜钙化诊断标准将所有患者分为无钙化组、轻度钙化组、中度钙化组和重度钙化组.比较4组间的一般资料、病史、血压、血脂,同时测量4组患者颈动脉内膜中层厚度、软斑块积分、硬斑块积分及总斑块积分.结果:4组间的年龄、性别、体质量指数、吸烟情况、总胆固醇、三酰甘油、高密度脂蛋白胆固醇,低密度脂蛋白胆固醇差异无统计学意义;瓣膜钙化程度与冠心病患病率、收缩压、脉压、颈动脉内膜中层厚度、总斑块积分、硬斑块积分呈正相关(r.分别为0.546、0.628、0.512、0.802、0.628、0.544,均P<0.001),与舒张压、软斑块积分无相关性.结论:心脏瓣膜钙化程度可作为推测颈动脉内膜中层厚度、总斑块积分、硬斑块积分的一个重要指标.%Objective:To investigate the relationship between the degree of heart valve calcification and carotid intima media thickness and plaque integral. Methods: The valve calcification was assessed using transthoracic Doppler ultrasound imaging in 426 patients. All patients were divided into four groups according to the diagnostic criteria, including no calcification group, mild calcification group, moderate and severe calcification group. The general information, medical history, blood pressure, blood lipids were compared between four groups. The intima media thickness, suft plaque score, hard plaque score and the total plaque score of carotid artery were also measured in patients of four groups. Results: There were no significant differences in age, gender, body mass index, smoking status, total cholesterol, triglycerides, high density lipoprotein and low density lipoprotein between four groups. The degree of valve calcification was positively correlated with

  1. Gamma mixture classifier for plaque detection in intravascular ultrasonic images.

    Science.gov (United States)

    Vegas-Sánchez-Ferrero, Gonzalo; Seabra, José; Rodriguez-Leor, Oriol; Serrano-Vida, Angel; Aja-Fernández, Santiago; Palencia, César; Martín-Fernández, Marcos; Sanches, Joao

    2014-01-01

    Carotid and coronary vascular incidents are mostly caused by vulnerable plaques. Detection and characterization of vulnerable plaques are important for early disease diagnosis and treatment. For this purpose, the echomorphology and composition have been studied. Several distributions have been used to describe ultrasonic data depending on tissues, acquisition conditions, and equipment. Among them, the Rayleigh distribution is a one-parameter model used to describe the raw envelope RF ultrasound signal for its simplicity, whereas the Nakagami distribution (a generalization of the Rayleigh distribution) is the two-parameter model which is commonly accepted. However, it fails to describe B-mode images or Cartesian interpolated or subsampled RF images because linear filtering changes the statistics of the signal. In this work, a gamma mixture model (GMM) is proposed to describe the subsampled/interpolated RF images and it is shown that the parameters and coefficients of the mixture are useful descriptors of speckle pattern for different types of plaque tissues. This new model outperforms recently proposed probabilistic and textural methods with respect to plaque description and characterization of echogenic contents. Classification results provide an overall accuracy of 86.56% for four classes and 95.16% for three classes. These results evidence the classifier usefulness for plaque characterization. Additionally, the classifier provides probability maps according to each tissue type, which can be displayed for inspecting local tissue composition, or used for automatic filtering and segmentation. PMID:24402895

  2. Ex vivo identification of atherosclerotic plaque calcification by a 31P solid-state magnetic resonance imaging technique.

    Science.gov (United States)

    Hallock, Kevin J; Hamilton, James A

    2006-12-01

    Calcified tissue is a common component of atherosclerotic plaques, and occurs most often in mature plaques. The process of calcification is a poorly understood risk factor that may contribute to a plaque's vulnerability to sudden rupture. In this study a solid-state imaging sequence, termed single-point imaging (SPI), was used to observe calcification directly in ex vivo atherosclerotic plaques. Standards were used to validate the ability of (31)P SPI to detect and differentiate calcification from crystalline cholesterol, phospholipids, and other plaque components. After suitable experimental parameters were found, human carotid specimens obtained by endarterectomy were imaged ex vivo by (31)P solid-state imaging and standard (1)H methods. In contrast to (1)H imaging methods, (31)P imaging detected only the calcification in the plaque. PMID:17089379

  3. Diagnosis of carotid artery disease by CT scan

    International Nuclear Information System (INIS)

    Non-invasive methods, such as radioisotope angiography, oculoplethsmography, and ultrasonic Doppler flowmetry, are used for the detection of caroid artery lesion. However, these methods are qualitative, and diagnostic accuracies are inferior to arteriography. On the other hand arterography needs catheterization. So we tried to use CT scan and intravenous contrast enhancement for the diagnosis of carotid artery disease. A CT/T scanner (X-2) was used, which enabled to produce computer reconstruction image of the carotid artery by use of the arrange program. 12 sequential axial images of the neck (between heights of C2 and C5) were obtained before and during infusion of contrast material. Analysis of sequential axial images and reformatted images were obtaned in patients with cerebrovascular disease. Carotid arteriography were made in 53 arteries, lesions with stenosis and/or occlusion were demonstrated in 26/53 arteries. Intravenous CT cartid-angiography revealed lesions with stenosis and/or occlusion in 25/53 arteries. Results of statistical analysis were as follows; overall diagnostic accuracy 52/53 (98%), diag nostic sensitivity 25/26 (96%) and diagnostic specificity 27/27 (100%), respectively. Moreover, intravenous CT carotid-angiography provided following benefits beyond arteriography. 1) Minimal calcification of the carotid wall and precise localisation of atheromatous plaque could be detected. 2) Patent arterial lumen above the occluded lesion could be found out. 3) CT carotid-angiography would be suitable for the follow-up study after carotid endoarterectomy because of the unneccessity of catheterization. 4) Thrombus formation in the internal jugular vein could be grasped. (author)

  4. Quantitative estimation of AgNORs in inflammatory gingival overgrowth in pediatric patients and its correlation with the dental plaque status

    Directory of Open Access Journals (Sweden)

    Mukhopadhyay S

    2009-01-01

    Full Text Available Background and Objectives: Nucleolar organizer Regions (NORs are situated within the nucleolus of a cell. The proteins are selectively stained by the silver colloid technique that is known as the AgNOR technique. AgNOR stain can be visualized as a black dot under the optical microscope. The present study aimed to evaluate the cases for quantitative estimation of AgNORs in the epithelial cells in various grades of gingival overgrowth to that of normal gingival tissues. Materials and Methods: Only preadolescent and adolescent groups aged up to 14 years were selected. Twenty normal and 31 disease cases of gingival overgrowth were selected. The tissue sections were stained by the hematoxylin and eosin (HandE technique for the routine histological evaluation, while the AgNOR counts were performed through the improved one-step method of Ploton et al. Results: HandE staining revealed five different types of gingival overgrowth. The plaque index (PI, gingival index (GI, and AgNOR count were not significantly (P> 0.05 higher than that of control cases in pyogenic granuloma, puberty gingivitis, and in drug-induced gingival overgrowth cases. In gingival fibromatosis cases, for comparison of different indices t-tests were done. The PI when compared with AgNOR count was found significant at 5% level and 0.1% level for mixed and permanent dentition, respectively. The GI when compared with AgNOR count was found significant at 1% level and 0.1% level in mixed and permanent dentitions, respectively.

  5. Nonrigid registration of carotid ultrasound and MR images using a "twisting and bending" model

    Science.gov (United States)

    Nanayakkara, Nuwan D.; Chiu, Bernard; Samani, Abbas; Spence, J. David; Parraga, Grace; Samarabandu, Jagath; Fenster, Aaron

    2008-03-01

    Atherosclerosis at the carotid bifurcation resulting in cerebral emboli is a major cause of ischemic stroke. Most strokes associated with carotid atherosclerosis can be prevented by lifestyle/dietary changes and pharmacological treatments if identified early by monitoring carotid plaque changes. Plaque composition information from magnetic resonance (MR) carotid images and dynamic characteristics information from 3D ultrasound (US) are necessary for developing and validating US imaging tools to identify vulnerable carotid plaques. Combining these images requires nonrigid registration to correct the non-linear miss-alignments caused by relative twisting and bending in the neck due to different head positions during the two image acquisitions sessions. The high degree of freedom and large number of parameters associated with existing nonrigid image registration methods causes several problems including unnatural plaque morphology alteration, computational complexity, and low reliability. Our approach was to model the normal movement of the neck using a "twisting and bending model" with only six parameters for nonrigid registration. We evaluated our registration technique using intra-subject in-vivo 3D US and 3D MR carotid images acquired on the same day. We calculated the Mean Registration Error (MRE) between the segmented vessel surfaces in the target image and the registered image using a distance-based error metric after applying our "twisting bending model" based nonrigid registration algorithm. We achieved an average registration error of 1.33+/-0.41mm using our nonrigid registration technique. Visual inspection of segmented vessel surfaces also showed a substantial improvement of alignment with our non-rigid registration technique.

  6. Study on the Prevalence and Corelation of Carotid Atherosclerosis in Stroke Patients

    Institute of Scientific and Technical Information of China (English)

    Wei Hua; Wang Yongjun; Yah Zhenying

    2000-01-01

    Objective To assess the prevalence and severity of carotid atherosclerosis in stroke patients and the risk factors of carotid atherosclerosis. Methods Two hundred fifty-one ischemic stroke patients,46 ccrcbral hemorrhagc patients and 96 control subjects were entercd into this study. Sonographic assessment of the extracranial carotid arteries was performed in all patients. Diametcr. IMT, plaques and percentage ratio of lumen stenosis were observcd. Results (1)The prevalence of carotid plaqucs was prominent in stroke patients than the control subjects(63.0%vs 36.5%). (2)The prevalencc of lumen stenosis>50% in ischemic stroke patients was higher than the cerebral hemorrhage patients and control subjects (15.6% vs 4.3%. 2.1%).(3) The prevalence of severe carotid artery stcnosis(>75%) was promincnt in aged 61~70 years old patients.(4)Our data revealed 30% of the cortical infarction subgroup, 17.5%of the subcortical infarction subgroup, 17% of the lacunar infarction subgroup,8% of the vcrtibral-basilar artery infarction subgroup.2.8% of thc CT normal subgroup possessed carotid stcnosis >50%. (5)Age, diabetes mellitus and ApoAl(inversely) were independent predictors of the extracranial carotid atherosclcrosis. Discusssion (Ⅰ)There is close relation between extracraniai carotid atherosclerosis and ischemic cerebrovascular disease.(2)The extent of serious carotid artery stcnosis in aged patients was lower.(3)Thc severity of extracranial carotid artery atherosclerosis was prominent in patients with conical infarction. Conclusion There is a high prevalence of extracranial carotid atherosclerosis in Chinese stroke patients.

  7. Clinical and Imaging Features Associated with an Increased Risk of Early and Late Stroke in Patients with Symptomatic Carotid Disease

    DEFF Research Database (Denmark)

    Naylor, A R; Sillesen, H; Schroeder, T V

    2015-01-01

    OBJECTIVE: The aim of this review was to identify clinical and/or imaging parameters that are associated with an increased (decreased) risk of early/late stroke in patients with symptomatic carotid disease. IN THE FIRST 14 DAYS: Natural history studies suggest that 8-15% of patients with 50...... intracranial disease; (v) a failure to recruit intracranial collaterals; (vi) low GSM; (vii) MR diagnosis of intra-plaque haemorrhage; (vii) spontaneous embolisation on TCD; and (viii) increased FDG uptake in the carotid plaque on PET. Clinical/imaging parameters associated with a lower risk of stroke include...

  8. 9p21 locus rs10757278 is associated with advanced carotid atherosclerosis in a gender-specific manner.

    Science.gov (United States)

    Zivotić, Ivan; Djurić, Tamara; Stanković, Aleksandra; Djordjević, Ana; Končar, Igor; Davidović, Lazar; Alavantić, Dragan; Zivković, Maja

    2016-06-01

    Single nucleotide polymorphisms from the chromosome locus 9p21 are reported to carry a risk for various cardiovascular diseases. One of the lead single nucleotide polymorphisms, rs10757278, was mostly investigated in association with coronary artery disease but rarely with carotid atherosclerosis. In this study, we aimed to analyze the association of rs10757278 A/G polymorphism with carotid plaque presence in advanced carotid atherosclerosis. The study included 803 participants, 486 patients with high-grade stenosis (>70%) who were undergoing carotid endarterectomy and 317 controls from Serbian population. Genotypes were determined using the real-time polymerase chain reaction. According to the recessive model of inheritance, GG genotype was significantly and independently associated with carotid plaque in females only (odds ratio 2.42, CI = 1.20-4.90, P = 0.013). Odds ratio was adjusted for age, body mass index, hypertension, TC, LDLC, HDLC and TG, and P value was corrected for multiple comparisons. Our preliminary findings suggest a gender-specific association of rs10757278 polymorphism with carotid plaque. Further studies on larger sample and in genetically and environmentally similar populations are needed. PMID:26941057

  9. Functional Expression of Dental Plaque Microbiota

    Directory of Open Access Journals (Sweden)

    Scott Norman Peterson

    2014-08-01

    Full Text Available Dental caries remains a significant public health problem and is considered pandemic worldwide. The prediction of dental caries based on profiling of microbial species involved in disease and equally important, the identification of species conferring dental health has proven more difficult than anticipated due to high interpersonal and geographical variability of dental plaque microbiota. We have used RNA-Seq to perform global gene expression analysis of dental plaque microbiota derived from 19 twin pairs that were either concordant (caries-active or caries-free or discordant for dental caries. The transcription profiling allowed us to define a functional core microbiota consisting of nearly 60 species. Similarities in gene expression patterns allowed a preliminary assessment of the relative contribution of human genetics, environmental factors and caries phenotype on the microbiota’s transcriptome. Correlation analysis of transcription allowed the identification of numerous functional networks, suggesting that inter-personal environmental variables may co-select for groups of genera and species. Analysis of functional role categories allowed the identification of dominant functions expressed by dental plaque biofilm communities, that highlight the biochemical priorities of dental plaque microbes to metabolize diverse sugars and cope with the acid and oxidative stress resulting from sugar fermentation. The wealth of data generated by deep sequencing of expressed transcripts enables a greatly expanded perspective concerning the functional expression of dental plaque microbiota.

  10. Dental plaque identification at home

    Science.gov (United States)

    ... your teeth. Plaque is the major cause of tooth decay and gum disease ( gingivitis ). It is hard to ... the plaque is not removed, it can cause tooth decay or cause the gums to bleed easily (gingivitis) ...

  11. [Effect of Root Iron Plaque on Norfloxacin Uptake by Rice].

    Science.gov (United States)

    Ma, Wei; Bao, Yan-yu

    2015-06-01

    In anaerobic condition, release of oxygen by roots to rhyzosphere caused the formation of red plaque of iron oxides or hydroxides on the root surface of rice. The effect of iron plaque on norfloxacin uptake was investigated with solution culture in greenhouse, and the results are showed in the following. The content of iron plaque increased with the increase of Fe2+ concentration in medium. After the addition of norfloxacin in nutrient solution, the content of iron plaques on the root surface decreased to different degree, and the reduction of iron plaques was increasing with the increase of norfloxacin mass concentration. Significant relationships were found between the iron plaques and norfloxacin on the root surface, and the correlation coefficients were 0.959 (norfloxacin mass concentration was 10 mg x L(-1)) and 0.987 (norfloxacin mass concentration was 50 mg x L(-1)), respectively, however, the norfloxacin contents in roots and shoots had no significant correlation with the iron plaques. After addition of different mass concentrations of norfloxacin, the quality distribution percentages of norfloxacin on the root surface and in roots and shoots were 87.7%-97.6%, 0.8%-4.8%, 1.5%-7.5%, respectively, the norfloxacin content on the root surface was far greater than those in roots and shoots. It was therefore concluded that iron plaque on roots was a norfloxacin reservoir for rice plant but had no significant effect on the transfer of norfloxacin to roots and shoots of the rice plant. PMID:26387334

  12. Common carotid intima media thickness and ankle-brachial pressure index correlate with local but not global atheroma burden: a cross sectional study using whole body magnetic resonance angiography.

    Directory of Open Access Journals (Sweden)

    Jonathan R Weir-McCall

    Full Text Available Common carotid intima media thickness (CIMT and ankle brachial pressure index (ABPI are used as surrogate marker of atherosclerosis, and have been shown to correlate with arterial stiffness, however their correlation with global atherosclerotic burden has not been previously assessed. We compare CIMT and ABPI with atheroma burden as measured by whole body magnetic resonance angiography (WB-MRA.50 patients with symptomatic peripheral arterial disease were recruited. CIMT was measured using ultrasound while rest and exercise ABPI were performed. WB-MRA was performed in a 1.5T MRI scanner using 4 volume acquisitions with a divided dose of intravenous gadolinium gadoterate meglumine (Dotarem, Guerbet, FR. The WB-MRA data was divided into 31 anatomical arterial segments with each scored according to degree of luminal narrowing: 0 = normal, 1 = <50%, 2 = 50-70%, 3 = 70-99%, 4 = vessel occlusion. The segment scores were summed and from this a standardized atheroma score was calculated.The atherosclerotic burden was high with a standardised atheroma score of 39.5±11. Common CIMT showed a positive correlation with the whole body atheroma score (β 0.32, p = 0.045, however this was due to its strong correlation with the neck and thoracic segments (β 0.42 p = 0.01 with no correlation with the rest of the body. ABPI correlated with the whole body atheroma score (β -0.39, p = 0.012, which was due to a strong correlation with the ilio-femoral vessels with no correlation with the thoracic or neck vessels. On multiple linear regression, no correlation between CIMT and global atheroma burden was present (β 0.13 p = 0.45, while the correlation between ABPI and atheroma burden persisted (β -0.45 p = 0.005.ABPI but not CIMT correlates with global atheroma burden as measured by whole body contrast enhanced magnetic resonance angiography in a population with symptomatic peripheral arterial disease. However this is

  13. Segmentation of carotid arteries by graph-cuts using centerline models

    Science.gov (United States)

    Gülsün, Mehmet A.; Tek, Hüseyin

    2010-02-01

    This document presents a semi-automatic method for segmenting carotid arteries in contrast enhanced (CE)- CT angiography (CTA) scans. The segmentation algorithm extracts the lumen of carotid arteries between user specified locations. Specifically, the algorithm first detects the centerline representations between the user placed seed points. This centerline extraction algorithm is based on a minimal path detection method which operates on a medialness map. The lumen of carotid arteries is then extracted by graph-cuts optimization technique using the detected centerlines as input. The distance from the centerline representation is used to normalize the gradient based edge weights of the graph. It is shown that this algorithm can successfully segment the carotid arteries without including calcified and non-calcified plaques in the segmentation results.

  14. Systemic Glucocorticoids Are Associated With Mortality After Carotid Endarterectomy.

    Science.gov (United States)

    Siemelink, Marten; den Ruijter, Hester; van der Valk, Fleur; de Vries, Jean-Paul; de Borst, Gert Jan; Moll, Frans; Stroes, Erik; Pasterkamp, Gerard

    2015-10-01

    Glucocorticoids (GCs) are widely used anti-inflammatory drugs well known to cause many adverse effects. Still, there is a dearth of data on the long-term cardiovascular effects of GCs in patients with established cardiovascular disease and the effect on atherosclerotic plaque composition. A total of 1894 patients who underwent carotid endarterectomy (CEA), of whom 40 patients received systemic GCs, were included in the Athero-Express Biobank. Atherosclerotic plaque samples and peripheral blood samples were obtained during CEA. Cardiovascular events during 3 years of follow-up were investigated using Cox regression modeling to adjust for possible confounding. Atherosclerotic plaque composition was examined using immunohistochemical staining. Use of GCs at inclusion was associated with markedly increased incidences of ischemic stroke (15.2% vs. 5.9%), composite events (48.5% vs. 26.9%), and cardiovascular death (21.2% vs. 5.7%), as well as an increased risk of cardiovascular death (hazards ratio 2.7, 95% confidence interval, 1.1-6.7) and all-cause death (hazards ratio 2.3, 95% confidence interval, 1.1-4.8) after 2.6 years of follow-up. None of the histological features of atherosclerotic plaques were significantly different in patients using GCs. After CEA, the use of systemic GCs is independently associated with an increased incidence of cardiovascular events and an increased risk of cardiovascular and all-cause death, but not atherosclerotic plaque composition. PMID:26191970

  15. Plaque characterization in ex vivo MRI evaluated by dense 3D correspondence with histology

    DEFF Research Database (Denmark)

    Engelen, A. van; de Bruijne, Marleen; Klein, S.;

    2011-01-01

    . Histological slices of human atherosclerotic plaques were manually segmented into necrotic core, fibrous tissue and calcification. Classification of these three components was voxelwise evaluated. As features the intensity, gradient magnitude and Laplacian in four MRI sequences after different degrees of......Automatic quantification of carotid artery plaque composition is important in the development of methods that distinguish vulnerable from stable plaques. MRI has shown to be capable of imaging different components noninvasively. We present a new plaque classification method which uses 3D...... registration of histology data with ex vivo MRI data, using non-rigid registration, both for training and evaluation. This is more objective than previously presented methods, as it eliminates selection bias that is introduced when 2D MRI slices are manually matched to histological slices before evaluation...

  16. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study) : an interim analysis of a randomised controlled trial

    NARCIS (Netherlands)

    Ederle, Joerg; Dobson, Joanna; Featherstone, Roland L.; Bonati, Leo H.; van der Worp, H. Bart; de Borst, Gert J.; Lo, T. Hauw; Gaines, Peter; Dorman, Paul J.; Macdonald, Sumaira; Lyrer, Philippe A.; Hendriks, Johanna M.; McCollum, Charles; Nederkoorn, Paul J.; Brown, Martin M.; Algra, A.; Bamford, J.; Beard, J.; Bland, M.; Bradbury, A. W.; Brown, M. M.; Clifton, A.; Gaines, P.; Hacke, W.; Halliday, A.; Malik, I.; Mas, J. L.; McGuire, A. J.; Sidhu, P.; Venables, G.; Bradbury, A.; Brown, M. M.; Clifton, A.; Gaines, P.; Collins, R.; Molynewc, A.; Naylor, R.; Warlow, C.; Ferro, J. M.; Thomas, D.; Bonati, L. H.; Coward, L.; Dobson, J.; Ederle, J.; Featherstone, R. F.; Tindall, H.; McCabe, D. J. H.; Wallis, A.; Brooks, M.; Chambers, B.; Chan, A.; Chu, P.; Clark, D.; Dewey, H.; Donnan, G.; Fell, G.; Hoare, M.; Molan, M.; Roberts, A.; Roberts, N.; Beiles, B.; Bladin, C.; Clifford, C.; Fell, G.; Grigg, M.; New, G.; Bell, R.; Bower, S.; Chong, W.; Holt, M.; Saunder, A.; Than, P. G.; Gett, S.; Leggett, D.; McGahan, T.; Quinn, J.; Ray, M.; Wong, A.; Woodruff, P.; Foreman, R.; Schultz, D.; Scroop, R.; Stanley, B.; Allard, B.; Atkinson, N.; Cambell, W.; Davies, S.; Field, P.; Milne, P.; Mitchell, P.; Tress, B.; Yan, B.; Beasley, A.; Dunbabin, D.; Stary, D.; Walker, S.; Cras, P.; d'Archambeau, O.; Hendriks, J. M. H.; Van Schil, P.; Bosiers, M.; Deloose, K.; van Buggenhout, E.; De Letter, J.; Devos, V.; Ghekiere, J.; Vanhooren, G.; Astarci, P.; Hammer, F.; Lacroix, V.; Peeters, A.; Verhelst, R.; DeJaegher, L.; Peeters, A.; Verbist, J.; Blair, J-F; Caron, J. L.; Daneault, N.; Giroux, M-F; Guilbert, F.; Lanthier, S.; Lebrun, L-H; Oliva, V.; Raymond, J.; Roy, D.; Soulez, G.; Weill, A.; Hill, M.; Hu, W.; Hudion, M.; Morrish, W.; Sutherland, G.; Wong, J.; Alback, A.; Harno, H.; Ijas, P.; Kaste, M.; Lepantalo, M.; Mustanoja, S.; Paananen, T.; Porras, M.; Putaala, J.; Railo, M.; Sairanen, T.; Soinne, L.; Vehmas, A.; Vikatmaa, P.; Goertler, M.; Halloul, Z.; Skalej, M.; Brennan, P.; Kelly, C.; Leahy, A.; Moroney, J.; Thornton, J.; Koelemay, M. J. W.; Nederkoorn, P. J.; Reekers, J. A. A.; Roos, Y. B. W. E. M.; Hendriks, J. M.; Koudstaal, P. J.; Pattynama, P. M. T.; van der Lugt, A.; van Dijk, L. C.; van Sambeek, M. R. H. M.; van Urk, H.; Verhagen, H. J. M.; Bruininckx, C. M. A.; de Bruijn, S. F.; Keunen, R.; Knippenberg, B.; Mosch, A.; Treurniet, F.; van Dijk, L.; van Overhagen, H.; Wever, J.; de Beer, F. C.; van den Berg, J. S. P.; van Hasselt, B. A. A. M.; Zeilstra, D. J.; Boiten, J.; van Otterloo, J. C. A. de Mol; de Vries, A. C.; Nieholt, G. J. Lycklama A.; van der Kallen, B. F. W.; Blankensteijn, J. D.; De Leeuw, F. E.; Kool, L. J. Schultze; van der Vliet, J. A.; de Borst, G. J.; de Kort, G. A. P.; Kapelle, L. J.; Lo, T. H.; Mali, W. P. Th M.; Moll, F.; van der Worp, H. Bart; Verhagen, H.; Barber, P. A.; Bourchier, R.; Hill, A.; Holden, A.; Stewart, J.; Bakke, S. J.; Krohg-Sorensen, K.; Skjelland, M.; Tennoe, B.; Bialek, P.; Biejat, Z.; Czepiel, W.; Czlonkowska, A.; Dowzenko, A.; Jedrzejewska, J.; Kobayashi, A.; Lelek, M.; Polanski, J.; Kirbis, J.; Milosevic, Z.; Zvan, B.; Blasco, J.; Chamorro, A.; Macho, J.; Obach, V.; Riambau, V.; San Roman, L.; Branera, J.; Canovas, D.; Estela, Jordi; Gimenez Gaibar, A.; Perendreu, J.; Bjorses, K.; Gottsater, A.; Ivancev, K.; Maetzsch, T.; Sonesson, B.; Berg, B.; Delle, M.; Formgren, J.; Gillgren, P.; Kall, T-B; Konrad, P.; Nyman, N.; Takolander, R.; Andersson, T.; Malmstedt, J.; Soderman, M.; Wahlgren, C.; Wahlgren, N.; Binaghi, S.; Hirt, L.; Michel, P.; Ruchat, P.; Bonati, L. H.; Engelter, S. T.; Fluri, F.; Guerke, L.; Jacob, A. L.; Kirsch, E.; Lyrer, P. A.; Radue, E-W; Stierli, P.; Wasner, M.; Wetzel, S.; Bonvin, C.; Kalangos, A.; Lovblad, K.; Murith, N.; Ruefenacht, D.; Sztajzel, R.; Higgins, N.; Kirkpatrick, P. J.; Martin, P.; Adam, D.; Bell, J.; Bradbury, A. W.; Crowe, P.; Gannon, M.; Henderson, M. J.; Sandler, D.; Shinton, R. A.; Scriven, J. M.; Wilmink, T.; D'Souza, S.; Egun, A.; Guta, R.; Punekar, S.; Seriki, D. M.; Thomson, G.; Brennan, A.; Enevoldson, T. P.; Gilling-Smith, G.; Gould, D. A.; Harris, P. L.; McWilliams, R. G.; Nasser, H-C; White, R.; Prakash, K. G.; Serracino-Inglott, F.; Subramanian, G.; Symth, J. V.; Walker, M. G.; Clarke, M.; Davis, M.; Dixit, S. A.; Dolman, P.; Dyker, A.; Ford, G.; Golkar, A.; Jackson, R.; Jayakrishnan, V.; Lambert, D.; Lees, T.; Louw, S.; Macdonald, S.; Mendelow, A. D.; Rodgers, H.; Rose, J.; Stansby, G.; Wyatt, M.; Baker, T.; Baldwin, N.; Jones, L.; Mitchell, D.; Munro, E.; Thornton, M.; Baker, D.; Davis, N.; Hamilton, G.; McCabe, D.; Platts, A.; Tibballs, J.; Beard, J.; Cleveland, T.; Dodd, D.; Gaines, P.; Lonsdale, R.; Nair, R.; Nassef, A.; Nawaz, S.; Venables, G.; Belli, A.; Clifton, A.; Cloud, G.; Halliday, A.; Markus, H.; McFarland, R.; Morgan, R.; Pereira, A.; Thompson, A.; Chataway, J.; Cheshire, N.; Gibbs, R.; Hammady, M.; Jenkins, M.; Malik, I.; Wolfe, J.; Adiseshiah, M.; Bishop, C.; Brew, S.; Brookes, J.; Brown, M. M.; Jaeger, R.; Kitchen, N.; Ashleigh, R.; Butterfield, S.; Gamble, G. E.; McCollum, C.; Nasim, A.; O'Neill, P.; Wong, J.; Edwards, R. D.; Lees, K. R.; MacKay, A. J.; Moss, J.; Rogers, P.

    2010-01-01

    Background Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. Methods The International Carotid

  17. Intracranial Carotid Calcification on Cranial Computed Tomography

    Science.gov (United States)

    Subedi, Deepak; Zishan, Umme Sara; Chappell, Francesca; Gregoriades, Maria-Lena; Sudlow, Cathie; Sellar, Robin

    2015-01-01

    Background and Purpose— Intracranial internal carotid artery calcification is associated with cerebrovascular risk factors and stroke, but few quantification methods are available. We tested the reliability of visual scoring, semiautomated Agatston score, and calcium volume measurement in patients with recent stroke. Methods— We used scans from a prospective hospital stroke registry and included patients with anterior circulation ischemic stroke or transient ischemic stroke whose noncontrast cranial computed tomographic scans were available electronically. Two raters measured semiautomatic quantitative Agatston score, and calcium volume, and performed qualitative visual scoring using the original 4-point Woodcock score and a modified Woodcock score, where each image on which the internal carotid arteries appeared was scored and the slice scores summed. Results— Intra- and interobserver coefficient of variations were 8.8% and 16.5% for Agatston, 8.8% and 15.5% for calcium volume, and 5.7% and 5.4% for the modified Woodcock visual score, respectively. The modified Woodcock visual score correlated strongly with both Agatston and calcium volume quantitative measures (both R2=0.84; P<0.0001); calcium volume increased by 0.47-mm/point increase in modified Woodcock visual score. Intracranial internal carotid artery calcification increased with age by all measures (eg, visual score, Spearman ρ=0.4; P=0.005). Conclusions— Visual scores correlate highly with quantitative intracranial internal carotid artery calcification measures, with excellent observer agreements. Visual intracranial internal carotid artery scores could be a rapid and practical method for epidemiological studies. PMID:26251250

  18. Association between Randall's Plaque and Calcifying Nanoparticles

    Science.gov (United States)

    Ciftcioglu, Neva; Vejdani, Kaveh; Lee, Olivia; Mathew, Grace; Aho, Katja M.; Kajander, Olavi; McKay, David S.; Jones, Jeff A.; Hayat, Matthew; Stoller, Marshall L.

    2007-01-01

    Randall's plaques, first described by Alexander Randall in the 1930s, are small subepithelial calcifications in the renal papillae (RP) that also extend deeply into the renal medulla. Despite the strong correlation between the presence of these plaques and the formation of renal stones, the precise origin and pathogenesis of Randall s plaque formation remain elusive. The discovery of calcifying nanoparticles (CNP) and their detection in many calcifying processes of human tissues has raised hypotheses about their possible involvement in renal stone formation. We collected RP and blood samples from 17 human patients who had undergone laparoscopic nephrectomy due to neoplasia. Homogenized RP tissues and serum samples were cultured for CNP. Scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) analysis were performed on fixed RP samples. Immunohistochemical staining (IHS) was applied on the tissue samples using CNP-specific monoclonal antibody (mAb). Randall s plaques were visible on gross inspection in 11 out of 17 collected samples. Cultures of all serum samples and 13 tissue homogenates had CNP growth within 4 weeks. SEM revealed spherical apatite formations in 14 samples, with calcium and phosphate peaks detected by EDS analysis. IHS was positive in 9 out of 17 samples. A strong link was found between the presence of Randall s plaques and the detection of CNP, also referred to as nanobacteria. These results suggest new insights into the etiology of Randall's plaque formation, and will help us understand the pathogenesis of stone formation. Further studies on this topic may lead us to new approaches on early diagnosis and novel medical therapies of kidney stone formation.

  19. Composition and genesis of calcium deposits in atheroma plaques.

    Science.gov (United States)

    Lara, María Jesús; Ros, Eduardo; Sierra, Manuel; Dorronsoro, Carlos; Aguilar, José

    2014-05-01

    The composition of atheromatous plaque determines its progression toward rupture or thrombosis. Although its histopathological structure has been widely studied, little attention has been paid to its structural and chemical composition and even less to its mineral component. Thirty-three atheromatous plaques were obtained by carotid thromboendarterectomy. Three types of materials were observed under polarized light microscopy: apatite crystals in the form of glomeruli (dark with plane polarized illumination and greensh with cross-polarized illumination); fibrous-like cholesterol (uncolored or grayish with plane-polarized illumination); and amorphous organic material as brownish deposits. SEM-EDX analysis showed an abundance of phosphorus and calcium in sufficient quantities to form calcium phosphates, and appreciably reduced levels of sodium. X-ray diffraction results differentiated samples into three groups: group I with predominance of hydroxyapatite-type crystals, group II with crystalline material containing an amorphous component, and group III with wholly amorphous material. The most abundant mineral in atheromatous plaque is hydroxyapatite, on which crystals of cholesterol and lipid nuclei are deposited, stratifying the plaque into layers that reflect the different stages of its formation. The difference in calcium and sodium concentrations between arteries with and without atheromata may indicate an important relationship in the pathophysiological development of calcium deposits. PMID:24134634

  20. CAROTID INTIMA-MEDIA THICKNESS AND THE ASSOCIATION WITH CARDIOVASCULAR RISK FACTORS IN THE ELDERLY

    Institute of Scientific and Technical Information of China (English)

    叶平; 王节; 尚延忠; 朱平

    2001-01-01

    Objective. To investigate the association of carotid arterial intima media thickness (IMT) with principal cardiovascular risk factors in the elderly. Methods. Carotid arterial IMT was measured by high resolution B mode ultrasound in 94 elderly subjects (old aged group), and compared with subjects aged < 60 (middle-aged group). Results. In comparison with the middle-aged group, the prevalence of coronary heart disease, cerebral vascular disease, hypertension and diabetes mellitus was significantly higher, and serum cholesterol and systolic blood pressure were also significantly higher in old aged group. Although there was no obvious difference in IMT between the two groups, carotid plaque and carotid wall thickening were more frequently found in old aged group. Age, systolic blood pressure and serum cholesterol were shown as the independent determinants for carotid IMT in the total participants, whereas no such independent relation was found in old-aged group. Conclusion. Age is the major risk factor for carotid atherosclerosis in the elderly. In other words, the occurrence of carotid atherosclerosis is the result of advancing age combined with the effect of multiple cardiovascular risk factors.

  1. Breast arterial calcification and risk of carotid atherosclerosis: Focusing on the preferentially affected layer of the vessel wall

    International Nuclear Information System (INIS)

    Objective: To assess the relationship between breast arterial calcification (BAC) detected on screening mammography and atherosclerosis of carotid arteries considering the most likely involved layer of the arterial wall. Materials and methods: A total of 537 consecutive women who underwent screening mammography were enrolled in this study. Seventy-nine subjects having BAC, aged 46-75 years, and 125 age-matched controls from those without BAC were selected for ultrasound examination of carotid arteries assessing intima-media thickness (IMT) and plaque presence. Participants were divided into three groups of risk including, low-risk: IMT 0.8 mm and/or plaque. Risk factors for atherosclerosis were obtained from medical records for independent effects. Results: BAC was present in 14.7% of mammograms. According to multivariable logistic regression analyses, significant association was identified between the carotid atherosclerosis risk and presence of BAC. Compared to women with IMT 0.8 mm had OR (95% CI) of 4.88 (1.47-16.16) and 23.36 (4.54-120.14), respectively. The OR (95% CI) for carotid plaque was 3.13 (1.3-7.57). There was no interaction between IMT category and plaque. Significant associations were also detected with postmenopausal duration (P = 0.02) and hypertension (P = 0.004). Conclusion: The risk of carotid atherosclerosis increases with the presence of BAC. Women with BAC are more likely to have thicker IMT than plaque, which could be attributed to the preferentially similar affected layer of media causing thick IMT rather than plaque.

  2. The Clinical Value of High-Intensity Signals on the Coronary Atherosclerotic Plaques: Noncontrast T1-Weighted Magnetic Resonance Imaging

    Directory of Open Access Journals (Sweden)

    Shoichi Ehara

    2016-07-01

    Full Text Available Over the past several decades, significant progress has been made in the pathohistological assessment of vulnerable plaques and in invasive intravascular imaging techniques. However, the assessment of plaque morphology by invasive modalities is of limited value for the detection of subclinical coronary atherosclerosis and the subsequent prediction or prevention of acute cardiovascular events. Recently, magnetic resonance (MR imaging technology has reached a sufficient level of spatial resolution, which allowed the plaque visualization of large and static arteries such as the carotids and aorta. However, coronary wall imaging by MR is still challenging due to the small size of coronary arteries, cardiac and respiratory motion, and the low contrast-to-noise ratio between the coronary artery wall and the surrounding structures. Following the introduction of carotid plaque imaging with noncontrast T1-weighted imaging (T1WI, some investigators have reported that coronary artery high-intensity signals on T1WI are associated with vulnerable plaque morphology and an increased risk of future cardiac events. Although there are several limitations and issues that need to be resolved, this novel MR technique for coronary plaque imaging could influence treatment strategies for atherothrombotic disease and may be useful for understanding the pathophysiological mechanisms of atherothrombotic plaque formation.

  3. Auto-amplification of cortisol actions in human carotid atheroma is linked to arterial remodeling and stroke.

    Science.gov (United States)

    Ayari, Hanène; Legedz, Liliana; Lantelme, Pierre; Feugier, Patrick; Randon, Jacques; Cerutti, Catherine; Lohez, Olivier; Scoazec, Jean-Yves; Li, Jacques Yuan; Gharbi-Chihi, Jouda; Bricca, Giampiero

    2014-02-01

    High cortisol and aldosterone levels increase cardiovascular risk, but the respective roles of each hormone within the arterial wall remain controversial. We tested the hypothesis that cortisol production within the arterial wall may contribute to atherosclerotic remodeling and act through illicit activation of the mineralocorticoid receptor (MR). Gene expression studies of the corticoid system components and marker genes of the atherosclerotic process in human carotid atheroma plaque and nearby macroscopically intact tissue (MIT) were considered together with clinical data and compared with pharmacological stimulations of human vascular smooth muscle cells (VSMCs) in contractile or lipid-storing phenotypes. The components of corticoid production and action were present and active within the human carotid wall and VSMCs. Atheroma plaque and lipid-storing VSMCs expressed 11β-hydroxysteroid deshydrogenase-1 (11β-HSD1) at two- to tenfold higher levels than MIT or contractile VSMCs. The 11β-HSD1 expression was stimulated by cortisol and cortisone, especially in lipid-storing VSMCs. MR mRNA level was lower in atheroma and lipid-storing VSMCs and downregulated via MR by fludrocortisone and cortisol. Cortisol upregulated collagen1 and MCP-1 mRNAs via the glucocorticoid receptor (GRα), in both VSMC phenotypes, whereas fludrocortisone stimulated the collagen1 expression only in lipid-storing VSMCs. The GRα mRNA level in MIT was higher in patients with previous stroke and correlated positively with the collagen1 mRNA but negatively with diastolic blood pressure. Local cortisol production by 11β-HSD1, and its action via high parietal GRα could be relevant from the first step of atherosclerotic remodeling and auto-amplify with transdifferentiation of VSMCs during atheroma progression. PMID:23025717

  4. 脑梗死与血Hcy及颈动脉粥样硬化的相关性探讨%Correlation Study between Serum Homocysteine Level and Carotid Artery Atherosclerosis in Patients with Cerebral Infarction

    Institute of Scientific and Technical Information of China (English)

    许媛媛; 冯敏; 朱方方; 赵宏

    2013-01-01

    Objective To explore the serum homocysteine (Hey) level in patients with cerebral infarction (CI) and discuss its correlation with carotid artery atherosclerosis (CAA). Methods Total 54 patients with CI were chosen as the cerebral infarction group and 25 patients without cerebrovascular diseases hospitalized during the same period were chosen as the control group. The serum Hey level,four indices of blood lipids, fasting blood glucose(FBS) and serum uric acid(UA) were tested,and the inti-mal-medial wall thickness (IMT) were examined by color Doppler ultrasound. All the dates were compared between the two groups. Results Elevation of serum Hey level was shown in 40 patients (74.07% ) in the cerebral infarction group and 6 pa-tients(24.00% ) in the control group. The mean serum Hey levels were(20.00 ±5. 67) μmol/L in the cerebral infarction group and(13.80±2.10)μmol/L in in the control group(P 0.05) ,but positively correlated with the carotid intimal-medial wall thickness(r =0.329,P<0.05). Conclusion The high serum homocysteine level is a main risk factor for cerebral infarction and is closely related to CAA.%目的 观察脑梗死患者血清同型半胱氨酸(homocysteine,Hcy)水平,并探讨其与颈动脉粥样硬化(Carotid artery atherosclerosis,CAA)的相关性.方法 检测54例脑梗死患者的血清同型半胱氨酸(Hcy)、血脂4项、空腹血糖(FBS)、血尿酸(UA),并应用彩色多普勒超声检测其颈动脉内膜-中层厚度(intimal-medial wall thickness,IMT),并与对照组25例的检测结果进行比较.结果 脑梗死组和对照组血清Hcy水平升高者分别有40例和6例,占74.07%和24.00%,血清Hcy水平分别为(20.00±5.67) μmol/L和(13.80±2.10) μmol/L,两组比较差异均有统计学意义(均P<0.01);Hcy水平与颈动脉内膜-中层厚度呈显著正相关性(r=0.329,P<0.05),与血脂、FBS、血UA均无相关性(均P>0.05).结论 高Hcy血症是脑梗死重要危险因素,且与颈动脉粥样硬化的形成密切相关.

  5. Serum ferritin levels are associated with carotid atherosclerosis in Chinese postmenopausal women: the Shanghai Changfeng Study.

    Science.gov (United States)

    Ma, Hui; Lin, Huandong; Hu, Yu; Li, Xiaoming; He, Wanyuan; Jin, Xuejuan; Gao, Jian; Zhao, Naiqing; Song, Binbin; Pan, Boshen; Gao, Xin

    2015-10-14

    Postmenopausal women are at increased risk of CVD: the increased serum ferritin level may be involved in the pathogenesis. The aim of the present study is to investigate the relationship of ferritin and carotid atherosclerosis in postmenopausal women. A total of 1178 postmenopausal women (mean age, 60·8 years) were enrolled from the Changfeng Study. A standard interview, anthropometric measurements and laboratory analyses were performed for each participant. Bilateral CIMT (carotid intima-media thickness) were measured using ultrasonography, and the presence of carotid plaques was assessed. Serum ferritin was measured using electrochemiluminescence immunoassay. The results showed that serum ferritin was 181·9 (sd 65·8) ng/ml in the postmenopausal women. Multivariate, linear, stepwise regression analysis demonstrated that age (standardised β = 0·233, PCVD risk factors, Hb, leucocytes, log urine albumin:creatinine ratio and liver function, the ferritin level of postmenopausal women in the fourth quartile had a 1·587-fold increased risk of carotid plaques relative to those in the lowest quartile. In conclusion, these results suggest that serum ferritin is independently and positively associated with carotid atherosclerosis in postmenopausal women and that ferritin may be implicated in atherosclerosis. PMID:26395322

  6. Intraplaque hemorrhage, a potential consequence of periodontal bacteria gathering in human carotid atherothrombosis.

    Science.gov (United States)

    Brun, Adrian; Rangé, Hélène; Prouvost, Bastien; Meilhac, Olivier; Mazighi, Mikael; Amarenco, Pierre; Lesèche, Guy; Bouchard, Philippe; Michel, Jean-Baptiste

    2016-01-01

    Periodontal diseases are multifactorial inflammatory diseases, caused by a bacterial biofilm involving both innate and adaptative immunity, characterized by the destruction of tooth-supporting tissues. In the context of periodontitis, the spread of weak pathogenic bacteria into the bloodstream has been described. These bacteria will preferentially localize to existing clot within the circulation. Atherothrombosis of the carotid arteries is a local pathology and a common cause of cerebral infarction. Intraplaque hemorrhages render the lesion more prone to clinical complications such as stroke. The main objective of this study is to explore the biological relationship between carotid intraplaque hemorrhage and periodontal diseases. This study included consecutive patients with symptomatic or asymptomatic carotid stenosis, admitted for endarterectomy surgical procedure (n=41). In conditioned media of the carotid samples collected, markers of neutrophil activation (myeloperoxidase or MPO, DNA-MPO complexes) and hemoglobin were quantified. To investigate the presence of DNA from periodontal bacteria in atherosclerotic plaque, PCR analysis using specific primers was performed. Our preliminary results indicate an association between neutrophil activation and intraplaque hemorrhages, reflected by the release of MPO (p<0,01) and MPO-DNA complexes (p<0,05). Presence of DNA from periodontitis-associated bacteria was found in 32/41 (78%) atheromatous plaque samples. More specifically, DNA from Pg, Tf, Pi, Aa was found in 46%, 24%, 34% and 68% of the samples, respectively. Hemoglobin levels were higher in conditioned media in carotid samples where the bacteria were found, but this was not statistically significant. Our data confirm the relationship between intraplaque hemorrhage and neutrophil activation. In addition, the presence of periodontal bacteria DNA in carotid atheromatous plaque, may contribute to this activation. Further analysis is needed to fully explore the raw

  7. Carotid revascularization: risks and benefits

    Directory of Open Access Journals (Sweden)

    O'Brien M

    2014-07-01

    Full Text Available Marlene O'Brien, Ankur Chandra Department of Surgery, Division of Vascular Surgery, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA Abstract: Despite a decline during the recent decades in stroke-related death, the incidence of stroke has remained unchanged or slightly increased, and extracranial carotid artery stenosis is implicated in 20%–30% of all strokes. Medical therapy and risk factor modification are first-line therapies for all patients with carotid occlusive disease. Evidence for the treatment of patients with symptomatic carotid stenosis greater than 70% with either carotid artery stenting (CAS or carotid endarterectomy (CEA is compelling, and several trials have demonstrated a benefit to carotid revascularization in the symptomatic patient population. Asymptomatic carotid stenosis is more controversial, with the largest trials only demonstrating a 1% per year risk stroke reduction with CEA. Although there are sufficient data to advocate for aggressive medical therapy as the primary mode of treatment for asymptomatic carotid stenosis, there are also data to suggest that certain patient populations will benefit from a stroke risk reduction with carotid revascularization. In the United States, consensus and practice guidelines dictate that CEA is reasonable in patients with high-grade asymptomatic stenosis, a reasonable life expectancy, and perioperative risk of less than 3%. Regarding CAS versus CEA, the best-available evidence demonstrates no difference between the two procedures in early perioperative stroke, myocardial infarction, or death, and no difference in 4-year ipsilateral stroke risk. However, because of the higher perioperative risks of stroke in patients undergoing CAS, particularly in symptomatic, female, or elderly patients, it is difficult to recommend CAS over CEA except in populations with prohibitive cardiac risk, previous carotid surgery, or prior neck radiation. Current treatment

  8. Determinant factors of the severity of carotid atherosclerosis in relation to accumulation of visceral fat in type 2 diabetic subjects

    International Nuclear Information System (INIS)

    Our aim was to verify the possible association of visceral fat accumulation with the severity of carotid atherosclerosis in order to clarify practical and feasible determinants for each parameter of atherosclerosis in type 2 diabetic subjects. The subjects studied were consecutive 151 diabetic subjects and age-matched 83 nondiabetic subjects, with no history of atherosclerotic disease. All subjects gave written informed consent to participate in the study. Subcutaneous and visceral fat areas on a CT scan at the level of the umbilicus were measured. Ambulatory 24-h blood pressure (BP) was recorded. Pulse pressure (PP) was defined as systolic BP (sBP) minus diastolic BP (dBP). Stiffness index β as a functional change and intima-media thickness (IMT) and plaque formation as structural changes were measured by echo-Doppler examinations of the carotid arteries. Insulin sensitivity was estimated by homeostasis model assessment for insulin resistance (HOMA-IR). Serum levels of adiponectin and tumor necrosis factor (TNF)-α were determined. Male gender, HbAlc, HOMA-IR and serum nonHDL-cholesterol (C) were higher, and visceral fat area was larger in the diabetic subjects than in the nondiabetic subjects. Serum adiponectin and TNF-α levels were similar between the two groups, while the TNF-α/adiponectin ratio in the diabetic subjects was significantly higher than that in the nondiabetic subjects. The IMT was thicker, and the stiffness index β was higher in the diabetic subjects than those in the nondiabetic subjects. These differences still remained highly significant after adjusting for age, sex and 24-h sBP. Plaque formation was also severer in the diabetic subjects than in the nondiabetic subjects. Visceral fat areas were correlated negatively with serum adiponectin levels, and positively with TNF-α/adiponectin ratio and serum nonHDL-C in diabetic subjects. The nighttime PP was associated with IMT, stiffness index β and the degree of plaque formation independently

  9. Cervical carotid pseudoaneurysm: A carotid artery stenting complication

    OpenAIRE

    Raso, Jair; Darwich, Rogerio; Ornellas, Carlos; Cariri, Gustavo

    2011-01-01

    Background: As carotid artery stenting becomes increasingly used, more complications are likely to occur. We present a case of Staphylococcus septicemia and pseudoaneurysm arising in the neck portion of the carotid artery after stenting. Case Description: A 51-year-old man was admitted with mild left hemiparesis. CT and MRI showed right hemisphere ischemia. Duplex Scan and MRA showed bilateral severe stenosis of the carotid arteries in the neck. A percutaneous angioplasty with stenting of the...

  10. Hyperperfusion syndrome after carotid stent angioplasty

    International Nuclear Information System (INIS)

    This study assesses the incidence and causes of hyperperfusion syndrome occurring after carotid artery stenting (CAS). We retrospectively reviewed the clinical database of 417 consecutive patients who were treated with CAS in our department to identify patients who developed hyperperfusion syndrome and/or intracranial hemorrhage. Magnetic resonance imaging (MRI) including fluid-attenuated inversion recovery and diffusion-weighted imaging was performed before and after CAS in 269 cases. A Spearman's rho nonparametric correlation was performed to determine whether there was a correlation between the occurrence/development of hyperperfusion syndrome and the patient's age, degree of stenosis on the stented and contralateral side, risk factors such as diabetes, smoking, hypertension, adiposity, gender and fluoroscopy time, and mean area of postprocedural lesions as well as preexisting lesions. Significance was established at p < 0.05. Of the 417 carotid arteries stented and where MRI was also completed, we found hyperperfusion syndrome in 2.4% (ten cases). Patients who had preexisting brain lesions (previous or acute stroke) were at a higher risk of developing hyperperfusion syndrome (p = 0.022; Spearman's rho test). We could not validate any correlation with the other patient characteristics. Extensive microvascular disease may be a predictor of hyperperfusion syndrome after carotid stent placement. We believe that further studies are warranted to predict more accurately which patients are at greater risk of developing this often fatal complication. (orig.)

  11. Hyperperfusion syndrome after carotid stent angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Grunwald, I.Q.; Politi, M.; Reith, W.; Krick, C.; Karp, K.; Zimmer, A.; Struffert, T.; Kuehn, A.L.; Papanagiotou, P. [University of the Saarland, Department for Interventional and Diagnostic Neuroradiology, Homburg (Germany); Roth, C.; Haass, A. [University of the Saarland, Clinic for Neurology, Homburg (Germany)

    2009-03-15

    This study assesses the incidence and causes of hyperperfusion syndrome occurring after carotid artery stenting (CAS). We retrospectively reviewed the clinical database of 417 consecutive patients who were treated with CAS in our department to identify patients who developed hyperperfusion syndrome and/or intracranial hemorrhage. Magnetic resonance imaging (MRI) including fluid-attenuated inversion recovery and diffusion-weighted imaging was performed before and after CAS in 269 cases. A Spearman's rho nonparametric correlation was performed to determine whether there was a correlation between the occurrence/development of hyperperfusion syndrome and the patient's age, degree of stenosis on the stented and contralateral side, risk factors such as diabetes, smoking, hypertension, adiposity, gender and fluoroscopy time, and mean area of postprocedural lesions as well as preexisting lesions. Significance was established at p < 0.05. Of the 417 carotid arteries stented and where MRI was also completed, we found hyperperfusion syndrome in 2.4% (ten cases). Patients who had preexisting brain lesions (previous or acute stroke) were at a higher risk of developing hyperperfusion syndrome (p = 0.022; Spearman's rho test). We could not validate any correlation with the other patient characteristics. Extensive microvascular disease may be a predictor of hyperperfusion syndrome after carotid stent placement. We believe that further studies are warranted to predict more accurately which patients are at greater risk of developing this often fatal complication. (orig.)

  12. Analysis of the population at high risk of stroke detected with carotid artery ultrasonography in Tianjin urban communities

    Directory of Open Access Journals (Sweden)

    Wei YUE

    2015-04-01

    Full Text Available Objective To investigate the features of carotid atherosclerosis in a population at high risk of stroke in urban communities of Tianjin, so as to provide inspiration for carotid ultrasonography to play a greater role in the prevention and control of stroke.  Methods A total of 956 residents at high risk of stroke were selected from 4 urban communities in Tianjin using cluster random sampling method. Doppler ultrasound screening was performed in bilateral common carotid artery (CCA, internal carotid artery (ICA, external carotid artery (ECA, vertebral artery (VA, subclavian artery (SCA and innominate artery of the population. The intima-media thickness (IMT, atherosclerotic plaque formation and its location and size, vascular stenosis or occlusion, and flow spectrum were detected. The results and features of carotid ultrasound screening were analyzed and compared among different gender and age groups.  Results 1 The detection rate of carotid atherosclerosis was 71.55% (684/956, and the detection rate in males was significantly higher than that in females (79.08% vs 65.87%; χ2 = 20.067, P = 0.000. 2 Among the population with carotid atherosclerosis, the most common manifestation was the formation of atherosclerotic plaques (81.58%, 558/684, secondly intima-media thickening (13.01%, 89/684, followed by moderate to severe stenosis or occlusion (5.41%, 37/684. The proportion of intima-media thickening in males was lower than that in females (7.08% vs 18.38%; χ2 = 19.269, P = 0.000. The proportion of carotid atherosclerotic plaque formation in males was higher than that in females (86.46% vs 77.16%; χ2 = 9.824, P = 0.002. The median rating of carotid atherosclerosis was 1.79, with males higher than females [1.98 (0.70, 3.26 vs 1.52 (0.20, 2.84; Z = 2.304, P = 0.042]. The site of plaque formation was most commonly located in carotid bulb (36.61%, secondly SCA (22.18%. Of the type of carotid stenosis, ICA stenosis was detected in 30 cases, VA

  13. Three-dimensional reconstruction and analysis of structure characteristics on senile plaques of Alzheimer's disease

    Institute of Scientific and Technical Information of China (English)

    YE Wei; LIU Jianwu; ZHOU Jiangning; HU Xiangyou; TANG Xiaowei

    2005-01-01

    Alzheimer's disease is a progressive neuro- degenerative disorder characterized by the presence of senile plaques primarily composed of amyloid ( in brain. Abnormal secretion and aggregation of amyloid ( are the key events in pathogenesis of Alzheimer's disease. Reduction of amyloid ( production and inhibition of amyloid ( aggregation to form senile plaques are hopeful strategies for the treatment and prevention of Alzheimer's disease. In the present study, the silver and immunohistochemical staining methods were applied to discover senile plaques in the hippocampus of Alzheimer's disease patients, and then images were processed and three-dimensionally reconstructed by Matlab and AVS software. The structure characteristics of senile plaques were measured through correlation function calculation and fractal dimension by a computer-aided method. Diffuse plaque had no amyloid center, but classic plaque presented compact central core structure; two types of plaques were both of porous structure, but the sizes of their pores were significantly different. Furthermore, there was difference in fractal dimension value between the diffuse plaque and classic plaque in the two staining methods. The comparison of structure characteristics between two types of plaques indicated that they developed independently. Establishment of the methods for reconstructing the three-dimen- sional structure of senile plaque and analyzing their structure characteristics is helpful for further study on the aggregation mechanism of senile plaque.

  14. Carotid chemoreceptor development in mice

    OpenAIRE

    Shirahata, Machiko; Kostuk, Eric W.; Pichard, Luis E

    2012-01-01

    Mice are the most suitable species for understanding genetic aspects of postnatal developments of the carotid body due to the availability of many inbred strains and knockout mice. Our study has shown that the carotid body grows differentially in different mouse strains, indicating the involvement of genes. However, the small size hampers investigating functional development of the carotid body. Hypoxic and/or hyperoxic ventilatory responses have been investigated in newborn mice, but these r...

  15. Cerebral hyperperfusion following carotid endarterectomy

    DEFF Research Database (Denmark)

    Schroeder, T; Sillesen, H; Sørensen, O;

    1987-01-01

    Serial measurements of cerebral blood flow (CBF) were performed in 56 patients before and one to four times after uncomplicated carotid endarterectomy. The findings were related to the ratio between internal carotid artery (ICA) and common carotid artery (CCA) mean pressures. Within the 1st...... ratio suggests a temporary impairment of autoregulation. Special care should be taken to avoid postoperative hypertension in such patients, who typically have preoperative hypoperfusion, to avoid the occurrence of cerebral edema or hemorrhage....

  16. Autologous Bone Marrow Mononuclear Cell Transplantation Delays Progression of Carotid Atherosclerosis in Rabbits.

    Science.gov (United States)

    Cui, Kefei; Ma, Xiao; Yu, Lie; Jiang, Chao; Fu, Chao; Fu, Xiaojie; Yu, Xiaofang; Huang, Yuanjing; Hou, Suyun; Si, Caifeng; Chen, Zhengguang; Yu, Jing; Wan, Jieru; Wang, Jian

    2016-09-01

    Bone marrow mononuclear cells (BMMNCs) can counteract oxidative stress and inhibit the inflammatory response in focal ischemic stroke models. However, the effect of BMMNC transplantation on carotid atherosclerosis needs to be determined. The carotid atherosclerotic plaque model was established in New Zealand White rabbits by balloon injury and 8 weeks of high-fat diet. Rabbits were randomized to receive an intravenous injection of autologous bromodeoxyuridine (BrdU)-labeled BMMNCs or an equal volume of phosphate-buffered saline. Plaques were evaluated for expression of proinflammatory and anti-inflammatory cytokines, anti-oxidant proteins, and markers of cell death. BMMNCs migrated into atherosclerotic plaque on the first day after cell transplantation. BMMNC-treated rabbits had smaller plaques and more collagen deposition than did the vehicle-treated controls on day 28 (p < 0.05). BMMNC treatment significantly increased endothelial nitric oxide synthase and the anti-oxidant enzymes glutathione peroxidase and superoxide dismutase in plaques compared to vehicle treatment on day 7. BMMNC-treated rabbits also had lower levels of cleaved caspase-3 expression; lower levels of proinflammatory cytokines interleukin-1β, tumor necrosis factor alpha, and matrix metalloproteinase 9; and higher levels of insulin-like growth factor-1 and its receptor (p < 0.05). Autologous BMMNC transplantation can suppress the process of atherosclerotic plaque formation and is associated with enhanced anti-oxidative effect, reduced levels of inflammatory cytokines and cleaved caspase-3, and increased expression of insulin-like growth factor-1 and its receptor. BMMNC transplantation represents a novel approach for the treatment of carotid atherosclerosis. PMID:26232064

  17. Intima-media thickness of carotid artery in middle-aged and old-aged people with different age and sex at nanchang city by ultrasound

    International Nuclear Information System (INIS)

    Objective: To investigate the intima-media thickness (IMT) of carotid artery in middleaged and old-aged people at different age and sex at Nanchang city and to establish the normal reference value. Methods: Excluding coronary heart disease, cerebrovascular disease and diabetes mellitus, 422 patients, above 30 years old were divided into the normal and the control groups based on whether the dangerous factors of atherosclerosis existed or not. Then each group was divided into 5 sub-groups according to age and sex and IMT of carotid artery measurement was perfrmed with ultrasound. Results: Means of IMT of carotid artery becomes higher as the age became older. IMT got predominant thick only when the age was more than 40 in male and 50 in female. Means of IMT is little higher than that in female,but there was no statistical difference between male and female group at age below 39 or above 50. Means of IMT in the control groups were higher than that in the normal groups and the differences was predominant. The ages older, the inner diameters of common carotid arteries wider, and became more predominant wide as the age was more than 50. Compared with female groups, the inner diameters of common carotid arteries of male groups were wider than those in the female groups'. The incidence rate of carotid atherosclerosis plaques was higher as the age became older, but the atherosclerosis plaques was not observed in population below 39 years old. In the population above 40 years old, the incidence rate of carotid atherosclerosis plaques was 5. 06% in the normal groups and 20. 60% in the control groups. No statistic differences exited in the incidence rate of carotid atherosclerosis plaques between the male and female groups. Carotid artery stenosis were observed i. e. five arteries were found in three control patients, and the stenosis degree exceed 50% of the diameter of artery. Conclusions: The IMT of common carotid arteries in the people at age of 40 and above 40 in the

  18. Numerical observer for atherosclerotic plaque classification in spectral computed tomography.

    Science.gov (United States)

    Lorsakul, Auranuch; Fakhri, Georges El; Worstell, William; Ouyang, Jinsong; Rakvongthai, Yothin; Laine, Andrew F; Li, Quanzheng

    2016-07-01

    Spectral computed tomography (SCT) generates better image quality than conventional computed tomography (CT). It has overcome several limitations for imaging atherosclerotic plaque. However, the literature evaluating the performance of SCT based on objective image assessment is very limited for the task of discriminating plaques. We developed a numerical-observer method and used it to assess performance on discrimination vulnerable-plaque features and compared the performance among multienergy CT (MECT), dual-energy CT (DECT), and conventional CT methods. Our numerical observer was designed to incorporate all spectral information and comprised two-processing stages. First, each energy-window domain was preprocessed by a set of localized channelized Hotelling observers (CHO). In this step, the spectral image in each energy bin was decorrelated using localized prewhitening and matched filtering with a set of Laguerre-Gaussian channel functions. Second, the series of the intermediate scores computed from all the CHOs were integrated by a Hotelling observer with an additional prewhitening and matched filter. The overall signal-to-noise ratio (SNR) and the area under the receiver operating characteristic curve (AUC) were obtained, yielding an overall discrimination performance metric. The performance of our new observer was evaluated for the particular binary classification task of differentiating between alternative plaque characterizations in carotid arteries. A clinically realistic model of signal variability was also included in our simulation of the discrimination tasks. The inclusion of signal variation is a key to applying the proposed observer method to spectral CT data. Hence, the task-based approaches based on the signal-known-exactly/background-known-exactly (SKE/BKE) framework and the clinical-relevant signal-known-statistically/background-known-exactly (SKS/BKE) framework were applied for analytical computation of figures of merit (FOM). Simulated data of a

  19. Prediction of Prolonged Hemodynamic Instability During Carotid Angioplasty and Stenting

    Science.gov (United States)

    Rhim, Jong Kook; Park, Jeong Jin; Choi, Hyuk Jai; Cho, Young Dae; Sheen, Seung Hun; Jang, Kyung-Sool

    2016-01-01

    Purpose The aim of this study was to assess the risk factors of prolonged hemodynamic instability (HDI) after carotid angioplasty and stenting (CAS). Herein, a simplified predictive scoring system for prolonged HDI is proposed. Materials and Methods Sixty-six patients who had CAS from 2011 to 2016 at a single institution were evaluated. Prolonged HDI was defined as systolic blood pressure >160 mm Hg or <90 mm Hg or heart rate <50 beats/min, lasting over 30 minutes despite medical treatments. For the study, clinical data and radiologic data, including plaque morphology and stenosis were analyzed. Results Prolonged HDI was observed in 21 patients (31.8%). Multivariable analysis revealed that calcification (OR, 6.726; p=0.006), eccentric stenosis (OR, 3.645; p=0.047) and extensive plaque distribution (OR, 7.169; p=0.006) were related to prolonged HDI. According to these results, a simplified scoring scale was proposed based on the summation of points: 2 points for calcified plaque, 2 points for extensive plaque distribution, and 1 point for eccentric stenosis. The percentages of prolonged HDI according to the total score were as follows: score 0, 8.7%; score 1, 20.0%; score 2, 38.5%; score 3, 72.7%; score 4, 66.7%; score 5, 100%. From the analysis, the total score in patients with prolonged HDI was significantly higher than those without prolonged HDI (p<0.001). Conclusion Prolonged HDI can be associated with calcification of plaque, eccentric stenosis and extensive plaque distribution, and a simplified scoring system enables prediction of prolonged HDI according to our cohort.

  20. Comparison of carotid and cerebrovascular disease between diabetic and non-diabetic patients using dual-source CT

    International Nuclear Information System (INIS)

    Purpose: To clarify the differences of the carotid and cerebrovascular disease between patients with and without type 2 diabetes using dual-source CT angiography. Materials and methods: Dual-source CT angiography of the carotid and cerebrovascular arteries was performed in 79 type 2 diabetic patients and 207 non-diabetic patients. The type, extent and distribution of plaques, and luminal stenosis were compared. Results: Compared with non-diabetic patients, diabetic patients had a higher overall incidence of plaque (p 0.05), as well as for the number of diseased segments and the distribution of plaques; both mainly involved the bilateral cavernous segment of the internal carotid artery. As for the stenosis, non-obstructive lesions were more common in diabetic patients (p 0.05). Conclusion: Diabetes is associated with a higher incidence of plaque and non-obstructive stenosis. However, no significant differences were observed in the type, extent and distribution of involved plaques between diabetic and non-diabetic patients.

  1. Analysis of carotid lumen surface morphology using three-dimensional ultrasound imaging

    Science.gov (United States)

    Chiu, Bernard; Beletsky, Vadim; Spence, J. David; Parraga, Grace; Fenster, Aaron

    2009-03-01

    Carotid plaque surface irregularity and ulcerations play an important role in the risk of ischemic stroke. Ulcerated or fissured plaque, characterized by irregular surface morphology, exposes thrombogenic materials to the bloodstream, possibly leading to life- or brain-threatening thrombosis and embolization. Therefore, the quantification of plaque surface irregularity is important to identify high-risk plaques that would likely lead to vascular events. Although a number of studies have characterized plaque surface irregularity using subjective classification schemes with two or more categories, only a few have quantified surface irregularity using an objective and continuous quantity, such as Gaussian or mean curvature. In this work, our goal was to use both Gaussian and mean curvatures for identifying ulcers from 3D carotid ultrasound (US) images of human subjects. Before performing experiments using patient data, we verified the numerical accuracy of the surface curvature computation method using discrete spheres and tori with different sampling intervals. We also showed that three ulcers of the vascular phantom with 2 mm, 3 mm and 4 mm diameters were associated with high Gaussian and mean curvatures, and thus, were easily detected. Finally, we demonstrated the application of the proposed method for detecting ulcers on luminal surfaces, which were segmented from the 3D US images acquired for two human subjects.

  2. Prevalence and clinical characteristics of carotid atherosclerosis in newly diagnosed patients with ketosis-onset diabetes: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Li Lian-Xi

    2013-01-01

    Full Text Available Abstract Background The features of carotid atherosclerosis in ketosis-onset diabetes have not been investigated. Our aim was to evaluate the prevalence and clinical characteristics of carotid atherosclerosis in newly diagnosed Chinese diabetic patients with ketosis but without islet-associated autoantibodies. Methods In total, 423 newly diagnosed Chinese patients with diabetes including 208 ketosis-onset diabetics without islet-associated autoantibodies, 215 non-ketotic type 2 diabetics and 79 control subjects without diabetes were studied. Carotid atherosclerosis was defined as the presence of atherosclerotic plaques in any of the carotid vessel segments. Carotid intima-media thickness (CIMT, carotid atherosclerotic plaque formation and stenosis were assessed and compared among the three groups based on Doppler ultrasound examination. The clinical features of carotid atherosclerotic lesions were analysed, and the risk factors associated with carotid atherosclerosis were evaluated using binary logistic regression in patients with diabetes. Results The prevalence of carotid atherosclerosis was significantly higher in the ketosis-onset diabetic group (30.80% than in the control group (15.2%, p=0.020 after adjusting for age- and sex-related differences, but no significant difference was observed in comparison to the non-ketotic diabetic group (35.8%, p=0.487. The mean CIMT of the ketosis-onset diabetics (0.70±0.20 mm was markedly higher than that of the control subjects (0.57±0.08 mm, p Conclusions The prevalence and risk of carotid atherosclerosis were significantly higher in the ketosis-onset diabetics than in the control subjects but similar to that in the non-ketotic type 2 diabetics. The characteristics of carotid atherosclerotic lesions in the ketosis-onset diabetics resembled those in the non-ketotic type 2 diabetics. Our findings support the classification of ketosis-onset diabetes as a subtype of type 2 diabetes.

  3. Comparison among ultrasonography, multidetector-row CT and MRA for precise diagnosis of carotid stenosis

    International Nuclear Information System (INIS)

    We evaluated lesions at the common carotid artery bifurcation and in the internal carotid artery of patients with carotid stenosis employing carotid ultrasonography, multidetector-row CT (MDCT) and magnetic resonance angiography (MRA). We calculated the degree of stenosis with both the area methods and the North American Symptomatic Carotid Endarterectomy Trial (NASCET) methods. The findings of MDCT and MRA were analyzed with reconstruction images as the multiplanar reconstruction (MPR) and maximum intensity projection (MIP). In the short axis area method, we recognized a strong correlation in stenosis rates between MDCT and MRA, and between MRA and ultrasonography. In the NASCET methods, a correlation of stenosis rates was noted only between MDCT and MRA. We recognized a correlation only between MRA and ultrasonography by the short axis area method in the calcification group. It is inferred that MDCT is as useful as the other two methods. (author)

  4. Sex-differential genetic effect of phosphodiesterase 4D (PDE4D on carotid atherosclerosis

    Directory of Open Access Journals (Sweden)

    Guo Yuh-Cherng

    2010-06-01

    Full Text Available Abstract Background The phosphodiesterase 4D (PDE4D gene was reported as a susceptibility gene to stroke. The genetic effect might be attributed to its role in modulating the atherogenic process in the carotid arteries. Using carotid intima-media thickness (IMT and plaque index as phenotypes, the present study sought to determine the influence of this gene on subclinical atherosclerosis. Methods Carotid ultrasonography was performed on 1013 stroke-free subjects who participated in the health screening programs (age 52.6 ± 12.2; 47.6% men. Genotype distribution was compared among the high-risk (plaque index ≥ 4, low-risk (index = 1-3, and reference (index = 0 groups. We analyzed continuous IMT data and further dichotomized IMT data using mean plus one standard deviation as the cutoff level. Because the plaque prevalence and IMT values displayed a notable difference between men and women, we carried out sex-specific analyses in addition to analyzing the overall data. Rs702553 at the PDE4D gene was selected because it conferred a risk for young stroke in our previous report. Previous young stroke data (190 cases and 211 controls with an additional 532 control subjects without ultrasonic data were shown as a cross-validation for the genetic effect. Results In the overall analyses, the rare homozygote of rs702553 led to an OR of 3.1 (p = 0.034 for a plaque index ≥ 4. When subjects were stratified by sex, the genetic effect was only evident in men but not in women. Comparing male subjects with plaque index ≥ 4 and those with plaque index = 0, the TT genotype was over-represented (27.6% vs. 13.4%, p = 0.008. For dichotomized IMT data in men, the TT genotype had an OR of 2.1 (p = 0.032 for a thicker IMT at the common carotid artery compared with the (AA + AT genotypes. In women, neither IMT nor plaque index was associated with rs702553. Similarly, SNP rs702553 was only significant in young stroke men (OR = 1.8, p = 0.025 but not in women (p = 0

  5. Oxygen transfer in human carotid artery bifurcation

    Institute of Scientific and Technical Information of China (English)

    Z.G.Zhang; Y.B.Fan; X.Y.Deng

    2007-01-01

    Arterial bifurcations are places where blood flow may be disturbed and slow recirculation flow may occur.To reveal the correlation between local oxygen transfer and atherogenesis, a finite element method was employed to simulate the blood flow and the oxygen transfer in the human carotid artery bifurcation. Under steady-state flow conditions, the numerical simulation demonstrated a variation in local oxygen transfer at the bifurcation, showing that the convective condition in the disturbed flow region may produce uneven local oxygen transfer at the blood/wall interface.The disturbed blood flow with formation of slow eddies in the carotid sinus resulted in a depression in oxygen supply to the arterial wall at the entry of the sinus, which in turn may lead to an atherogenic response of the arterial wall, and contribute to the development of atherosclerotic stenosis there.

  6. Utilization of a global data grid repository in CAD assessment of carotid wall thickness

    Science.gov (United States)

    Gutierrez, Marco A.; Lee, Jasper; Zhou, Zheng; Pilon, Paulo E.; Lage, Silvia G.

    2007-03-01

    A CAD method of calculating wall thickness of carotid vessels addresses the time-consuming issue of using B-mode ultrasound as well as inter- and intra-observer variability in results. Upon selection of a region-of-interest and filtering of a series of ultrasound carotid images, the CAD is able to measure the geometry of the lumen and plaque surfaces using a least-square fitting of the active contours during systole and diastole. To evaluate the approach, ultrasound image sequences from 30 patients were submitted to the procedure. The images were stored on an international data grid repository that consists of three international sites: Image Processing and Informatics (IPI) Laboratory at University of Southern California, USA; InCor (Heart Institute) at Sao Paulo, Brazil, and Hong Kong Polytechnic University, Hong Kong. The three chosen sites are connected with high speed international networks including the Internet2, and the Brazilian National Research and Education Network (RNP2). The Data Grid was used to store, backup, and share the ultrasound images and analysis results, which provided a large-scale and a virtual data system. In order to study the variability between the automatic and manual definition of artery boundaries, the pooled mean and the standard deviation for the difference between measurements of lumen diameter were computed. The coefficient of variation and correlation were also calculated. For the studied population the difference between manual and automatic measurement of the lumen diameter (LD) and intima-media-thickness (IMT) were 0.12 +/-0.10 and 0.09+/- 0.06, respectively.

  7. The usefulness of optical analyses for detecting vulnerable plaques using rabbit models

    Science.gov (United States)

    Nakai, Kanji; Ishihara, Miya; Kawauchi, Satoko; Shiomi, Masashi; Kikuchi, Makoto; Kaji, Tatsumi

    2011-03-01

    Purpose: Carotid artery stenting (CAS) has become a widely used option for treatment of carotid stenosis. Although technical improvements have led to a decrease in complications related to CAS, distal embolism continues to be a problem. The purpose of this research was to investigate the usefulness of optical methods (Time-Resolved Laser- Induced Fluorescence Spectroscopy [TR-LIFS] and reflection spectroscopy [RS] as diagnostic tools for assessment of vulnerable atherosclerotic lesions, using rabbit models of vulnerable plaque. Materials & Methods: Male Japanese white rabbits were divided into a high cholesterol diet group and a normal diet group. In addition, we used a Watanabe heritable hyperlipidemic (WHHL) rabbit, because we confirmed the reliability of our animal model for this study. Experiment 1: TR-LIFS. Fluorescence was induced using the third harmonic wave of a Q switch Nd:YAG laser. The TR-LIFS was performed using a photonic multi-channel analyzer with ICCD (wavelength range, 200 - 860 nm). Experiment 2: RS. Refection spectra in the wavelength range of 900 to 1700 nm were acquired using a spectrometer. Results: In the TR-LIFS, the wavelength at the peak was longer by plaque formation. The TR-LIFS method revealed a difference in peak levels between a normal aorta and a lipid-rich aorta. The RS method showed increased absorption from 1450 to 1500 nm for lipid-rich plaques. We observed absorption around 1200 nm due to lipid only in the WHHL group. Conclusion: These methods using optical analysis might be useful for diagnosis of vulnerable plaques. Keywords: Carotid artery stenting, vulnerable plaque, Time-Resolved Laser-Induced Fluorescence

  8. Carotid stenting versus carotid endarterectomy : Evidence basis and cost implications

    NARCIS (Netherlands)

    Janssen, M. P.; de Borst, G. J.; Mali, W. P. Th. M.; Kappelle, L. J.; Moll, F. L.; Ackerstaff, R. G. A.; Rothwell, P. M.; Brown, M. M.; van Sambeek, M. R.; Buskens, E.

    2008-01-01

    Objective: Carotid Angioplasty combined with Stenting (CAS) is increasingly performed because of its presumed benefits. A study was performed to identify key factors that determine the cost-effectiveness as compared to conventional carotid endarterectomy (CEA). Methods: The incremental cost-effectiv

  9. The clinical application of 64-slice spiral CT angiography in carotid artery bifurcation disease

    International Nuclear Information System (INIS)

    Objective: To explore the clinical value of 64-slice spiral CT angiography (CTA) in carotid stenosis and atherosclerotic plaque. Methods: 40 patients (80 carotid arteries) underwent CTA and DSA. These two examinations within one week. The results of CTA were compared with that of DSA, the sensitivity and specificity of CTA and DSA were figured out. Results: CTA performed well in the detection of mild (0% to 29%) carotid stenosis, as well as carotid occlusion, with values for sensitivity and specificity both near 100%. In determining that a stenosis was >50% by DSA measurement, CTA with a sensitivity, specificity of 89% and 91% respectively. While CTA was quite specific in identifying degrees of stenoses in either the 50% to 69% or the 70% to 99% ranges, in this task it was much less sensitive: 65% and 73% respectively. CTA can detect all kinds of ulcers while DSA can not. Conclusions: 64-slice CTA and DSA were correctly identified in detecting carotid stenosis. CTA could demonstrate ulcers associated with the carotid stenosis, hut DSA only show stenosis. (authors)

  10. Vulnerable plaque: Detection of agreement between multi-detector-row CT angiography and US-ECD

    International Nuclear Information System (INIS)

    Objectives: The purpose of this work was to evaluate the agreement between ultra-sound echo-color Doppler (US-ECD) and multi-detector-row CT angiography (MDCTA) in the characterization of vulnerable plaque. Methods: From January 2004 to January 2007 658 patients who underwent both MDCTA and US-ECD for the study of carotid arteries, were retrospectively evaluated (453 males, 205 females). For all subjects the following parameters were analysed: plaque morphology (regular versus irregular), type of the plaque (fatty, mixed and calcified) and presence of ulcerations. Statistical analysis was performed to calculate concordance between the two techniques employed. Results: In the definition of the type of plaque, the observed agreements were 77.2% and the kappa value was 0.657 (95% confidence interval: 0.615-0.699). The weighted kappa resulted 0.644. In the definition of ulceration plaque, the observed agreements were 88.4% but the kappa value was only 0.325 (95% confidence interval: 0.201-0.449). Agreement observed in the evaluation of plaque morphology was 78.3% with a kappa value of 0.513 (95% confidence interval: 0.452-0.574). Conclusion: We observed a good agreement between US-ECD and MDCTA in the assessment of plaque type whereas a poor agreement resulted in the evaluation of plaque ulceration. The use of US-ECD and MDCTA provides different results in the evaluation of plaque. Our results suggest that information deriving from US-ECD should be always critically compared with other diagnostic techniques.

  11. Vulnerable plaque: Detection of agreement between multi-detector-row CT angiography and US-ECD

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca, E-mail: lucasaba@tiscali.it [Department of Radiology Azienda Ospedaliera del Policlinico Universitario, University of Cagliari, s.s. 554 Monserrato (Cagliari) 09045 (Italy); Sanfilippo, Roberto; Montisci, Roberto [Department of Vascular Surgery, Policlinico Universitario, s.s. 554 Monserrato (Cagliari) 09045 (Italy); Atzeni, Matteo; Ribuffo, Diego [Section of Plastic Surgery, Department of Surgery, Policlinico Universitario, s.s. 554 Monserrato (Cagliari) 09045 (Italy); Mallarini, Giorgio [Department of Radiology Azienda Ospedaliera del Policlinico Universitario, University of Cagliari, s.s. 554 Monserrato (Cagliari) 09045 (Italy)

    2011-03-15

    Objectives: The purpose of this work was to evaluate the agreement between ultra-sound echo-color Doppler (US-ECD) and multi-detector-row CT angiography (MDCTA) in the characterization of vulnerable plaque. Methods: From January 2004 to January 2007 658 patients who underwent both MDCTA and US-ECD for the study of carotid arteries, were retrospectively evaluated (453 males, 205 females). For all subjects the following parameters were analyse