Ultrasound measurement of the fibrous cap in symptomatic and asymptomatic atheromatous carotid plaques

Details

Serval ID
serval:BIB_2164CFE472D4
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Ultrasound measurement of the fibrous cap in symptomatic and asymptomatic atheromatous carotid plaques
Journal
Circulation
Author(s)
Devuyst  G., Karapanayiotides  T., Ruchat  P., Pusztaszeri  M., Lobrinus  J. A., Jonasson  L., Cuisinaire  O., Kalangos  A., Despland  P. A., Thiran  J. P., Bogousslavsky  J.
ISSN
1524-4539 (Electronic)
Publication state
Published
Issued date
05/2005
Volume
111
Number
21
Pages
2776-82
Notes
Evaluation Studies
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: May 31
Abstract
BACKGROUND: Fibrous cap thickness (FCT) is an important determinant of atheroma stability. We evaluated the feasibility and potential clinical implications of measuring the FCT of internal carotid artery plaques with a new ultrasound system based on boundary detection by dynamic programming. METHODS AND RESULTS: We assessed agreement between ultrasound-obtained FCT values and those measured histologically in 20 patients (symptomatic [S]=9, asymptomatic [AS]=11) who underwent carotid endarterectomy for stenosing (>70%) carotid atheromas. We subsequently measured in vivo the FCT of 58 stenosing internal carotid artery plaques (S=22, AS=36) in 54 patients. The accuracy in discriminating symptomatic from asymptomatic plaques was assessed by receiver operating characteristic curves for the minimal, mean, and maximal FCT. Decision FCT thresholds that provided the best correct classification rates were identified. Agreement between ultrasound and histology was excellent, and interobserver variability was small. Ultrasound showed that symptomatic atheromas had thinner fibrous caps (S versus AS, median [95% CI]: minimal FCT=0.42 [0.34 to 0.48] versus 0.50 [0.44 to 0.53] mm, P=0.024; mean FCT=0.58 [0.52 to 0.63] versus 0.79 [0.69 to 0.85] mm, P<0.0001; maximal FCT=0.73 [0.66 to 0.92] versus 1.04 [0.94 to 1.20] mm, P<0.0001). Mean FCT measurement demonstrated the best discriminatory accuracy (area under the curve [95% CI]: minimal 0.74 [0.61 to 0.87]; mean 0.88 [0.79 to 0.97]; maximal 0.82 [0.71 to 0.93]). The decision threshold of 0.65 mm (mean FTC) demonstrated the best correct classification rate (82.8%; positive predictive value 75%, negative predictive value 88.2%). CONCLUSIONS: FCT measurement of carotid atheroma with ultrasound is feasible. Discrimination of symptomatic from asymptomatic plaques with mean FCT values is good. Prospective studies should determine whether this ultrasound marker is reliable.
Keywords
Aged Atherosclerosis/diagnosis/pathology Carotid Artery Diseases/diagnosis/*pathology Diagnosis, Differential Female Humans Male Middle Aged Observer Variation Predictive Value of Tests ROC Curve Software Ultrasonography/*methods/standards
Pubmed
Web of science
Open Access
Yes
Create date
25/01/2008 11:40
Last modification date
20/08/2019 12:57
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