Τίτλος:
Dynamic carotid plaque imaging using ultrasonography
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objective: Dynamic image analysis of carotid plaques has demonstrated that during systole and early diastole, all plaque components will move in the same direction (concordant motion) in some plaques. However, in others, different parts of the plaque will move in different directions (discordant motion). The aim of our study was (1) to determine the prevalence of discordant motion in symptomatic and asymptomatic plaques, (2) to develop a measurement of the severity of discordant motion, and (3) to determine the correlation between the severity of discordant motion and symptom prevalence. Methods: A total of 200 patients with 204 plaques resulting in 50% to 99% stenosis (112 asymptomatic and 92 symptomatic plaques) had video recordings available of the plaque motion during 10 cardiac cycles. Video tracking was performed using Farneback's method, which relies on frame comparisons. In our study, these were performed at 0.1-second intervals. The maximum angular spread (MAS) of the motion vectors at 10-pixel intervals in the plaque area was measured in degrees. Plaques were classified as concordant (MAS, <70°), moderately discordant (MAS, 70°-120°), and discordant (MAS, >120°). Results: Motion was discordant in 89.1% of the symptomatic plaques but only in 17.9% of asymptomatic plaques (P < .001). The prevalence of symptoms increased with increasing MAS. For a MAS >120°, the hazard ratio for the presence of symptoms was 47.7 (95% confidence interval, 18.1-125.6) compared with the rest of the plaques after adjustment for the degree of stenosis and mean pixel motion. The area under the receiver operating characteristic curve for the prediction of the presence of symptoms using the MAS was 0.876 (95% confidence interval, 0.823-0.929). The use of the median MAS (120°) as a cutoff point classified 86% of the plaques correctly (sensitivity, 81.4%; specificity, 91.2%; positive predictive value, 90.2%; and negative predictive value, 83.0%). Conclusions: The use of the MAS value to identify asymptomatic plaques at increased risk of developing symptoms and, in particular, stroke should be tested in prospective studies. © 2020 Society for Vascular Surgery
Συγγραφείς:
Giannopoulos, A.A.
Kyriacou, E.
Griffin, M.
Pattichis, C.S.
Michael, J.
Richards, T.
Geroulakos, G.
Nicolaides, A.N.
Περιοδικό:
Journal of Vascular Surgery
Εκδότης:
Mosby Year Book Inc
Λέξεις-κλειδιά:
antithrombocytic agent; hydroxymethylglutaryl coenzyme A reductase inhibitor, aged; Article; asymptomatic disease; B scan; carotid artery obstruction; cross-sectional study; diagnostic accuracy; disease severity; duplex Doppler ultrasonography; echography; female; heart cycle; human; hypertension; image analysis; major clinical study; male; predictive value; prevalence; priority journal; prospective study; sensitivity and specificity; transient ischemic attack; videorecording; atherosclerotic plaque; carotid artery obstruction; cerebrovascular accident; clinical trial; color Doppler flowmetry; complication; computer assisted diagnosis; diagnostic imaging; diastole; internal carotid artery; middle aged; multicenter study; pathophysiology; prognosis; risk assessment; risk factor; rupture; severity of illness index; systole; very elderly, Aged; Aged, 80 and over; Carotid Artery, Internal; Carotid Stenosis; Cross-Sectional Studies; Diastole; Female; Humans; Image Interpretation, Computer-Assisted; Male; Middle Aged; Plaque, Atherosclerotic; Predictive Value of Tests; Prognosis; Prospective Studies; Risk Assessment; Risk Factors; Rupture, Spontaneous; Severity of Illness Index; Stroke; Systole; Ultrasonography, Doppler, Color; Video Recording
DOI:
10.1016/j.jvs.2020.10.021
