Characterisation of carotid plaques with ultrasound elastography: feasibility and correlation with high-resolution magnetic resonance imaging |
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Authors: | Cyrille Naim Guy Cloutier Elizabeth Mercure François Destrempes Zhao Qin Walid El-Abyad Sylvain Lanthier Marie-France Giroux Gilles Soulez |
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Institution: | 1. Department of Radiology, University of Montreal Hospital Center (CHUM), Montréal, Québec, Canada 2. Department of Radiology, Radio-Oncology and Nuclear Medicine, and Institute of Biomedical Engineering, University of Montreal, Montréal, Québec, Canada 3. University of Montreal Hospital Research Center (CRCHUM), Montréal, Québec, Canada 4. Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montréal, Québec, Canada 5. Department of Medicine, University of Montreal Hospital Center (CHUM), Montréal, Québec, Canada 6. Department of Radiology, Centre Hospitalier de l’Université de Montréal (CHUM), H?pital Notre-Dame—Pavillon Lachapelle (Room B1038-A), 1560 Sherbrooke East, Montréal, Québec, Canada, H2L 4M1
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Abstract: | Objectives To evaluate the ability of ultrasound non-invasive vascular elastography (NIVE) strain analysis to characterise carotid plaque composition and vulnerability as determined by high-resolution magnetic resonance imaging (MRI). Methods Thirty-one subjects with 50 % or greater carotid stenosis underwent NIVE and high-resolution MRI of internal carotid arteries. Time-varying strain images (elastograms) of segmented plaques were generated from ultrasonic raw radiofrequency sequences. On MRI, corresponding plaques and components were segmented and quantified. Associations between strain parameters, plaque composition and symptomatology were estimated with curve-fitting regressions and Mann–Whitney tests. Results Mean stenosis and age were 72.7 % and 69.3 years, respectively. Of 31 plaques, 9 were symptomatic, 17 contained lipid and 7 were vulnerable on MRI. Strains were significantly lower in plaques containing a lipid core compared with those without lipid, with 77–100 % sensitivity and 57–79 % specificity (P?<?0.032). A statistically significant quadratic fit was found between strain and lipid content (P?<?0.03). Strains did not discriminate symptomatic patients or vulnerable plaques. Conclusions Ultrasound NIVE is feasible in patients with significant carotid stenosis and can detect the presence of a lipid core with high sensitivity and moderate specificity. Studies of plaque progression with NIVE are required to identify vulnerable plaques. Key points ? Non-invasive vascular elastography (NIVE) provides additional information in vascular ultrasound ? Ultrasound NIVE is feasible in patients with significant carotid stenosis ? Ultrasound NIVE detects a lipid core with high sensitivity and moderate specificity ? Studies on plaque progression with NIVE are required to identify vulnerable plaques |
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