دورية أكاديمية
Quantitative assessment of carotid plaque morphology (geometry and tissue composition) using computed tomography angiography.
| العنوان: | Quantitative assessment of carotid plaque morphology (geometry and tissue composition) using computed tomography angiography. |
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| المؤلفون: | Chrencik MT; Department of Vascular Surgery, University of Maryland School of Medicine, Baltimore, Md; Vascular Service, Veterans Affairs Medical Center, Baltimore, Md., Khan AA; Department of Bioengineering, George Mason University, Fairfax, Va., Luther L; Department of Vascular Surgery, University of Maryland School of Medicine, Baltimore, Md; Vascular Service, Veterans Affairs Medical Center, Baltimore, Md., Anthony L; Department of Vascular Surgery, University of Maryland School of Medicine, Baltimore, Md; Vascular Service, Veterans Affairs Medical Center, Baltimore, Md., Yokemick J; Department of Vascular Surgery, University of Maryland School of Medicine, Baltimore, Md; Vascular Service, Veterans Affairs Medical Center, Baltimore, Md., Patel J; Imaging Service, VA Maryland Health Care System, Baltimore, Md., Sorkin JD; Baltimore VA Medical Center Geriatric Research, Education, and Clinical Center, Baltimore Veterans Affairs Medical Center, Baltimore, Md; Claude D. Pepper Older Americans Independence Center, University of Maryland School of Medicine, Baltimore, Md., Sikdar S; Department of Bioengineering, George Mason University, Fairfax, Va., Lal BK; Department of Vascular Surgery, University of Maryland School of Medicine, Baltimore, Md; Vascular Service, Veterans Affairs Medical Center, Baltimore, Md. Electronic address: blal@som.umaryland.edu. |
| المصدر: | Journal of vascular surgery [J Vasc Surg] 2019 Sep; Vol. 70 (3), pp. 858-868. Date of Electronic Publication: 2019 Mar 06. |
| نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S. |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 8407742 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6809 (Electronic) Linking ISSN: 07415214 NLM ISO Abbreviation: J Vasc Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2008-> : New York, NY : Elsevier Original Publication: St. Louis, Mo. : Mosby, [c1984- |
| مواضيع طبية MeSH: | Computed Tomography Angiography* , Plaque, Atherosclerotic*, Carotid Arteries/*diagnostic imaging , Carotid Stenosis/*diagnostic imaging, Aged ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Observer Variation ; Predictive Value of Tests ; Prognosis ; Reproducibility of Results ; Severity of Illness Index |
| مستخلص: | Objective: Quantification of carotid plaque morphology (geometry and tissue composition) may help stratify risk for future stroke and assess plaque progression or regression in response to medical risk factor modification. We assessed the feasibility and reliability of morphologic measurements of carotid plaques using computed tomography angiography (CTA) and determined the minimum detectable change in plaque features by this approach. Methods: CTA images of both carotid arteries in 50 patients were analyzed by two observers using a semiautomatic image analysis program, yielding 93 observations per user (seven arteries were excluded because of prior stenting). One observer repeated the analyses 4 weeks later. Measurements included total plaque volume; percentage stenosis (by diameter and area); and tissue composition for calcium, lipid-rich necrotic core (LRNC), and intraplaque hemorrhage (IPH). Reliability of measurements was assessed by intraclass and interclass correlation and Bland-Altman plots. Dice similarity coefficient (DSC) and modified Hausdorff distance (MHD) assessed reliability of geometric shape measurements. We additionally computed the minimum amount of change in these features detectable by our approach. Results: The cohort was 51% male (mean age, 70.1 years), and 56% had a prior stroke. The mean (± standard deviation) plaque volume was 837.3 ± 431.3 mm 3 , stenosis diameter was 44.5% ± 25.6%, and stenosis area was 58.1% ± 29.0%. These measurements showed high reliability. Intraclass correlation coefficients for plaque volume, percentage stenosis by diameter, and percentage stenosis by area were 0.96, 0.87, and 0.83, respectively; interclass correlation coefficients were 0.88, 0.84, and 0.78. Intraclass correlations for tissue composition were 0.99, 0.96, and 0.86 (calcium, LRNC, and IPH, respectively), and interclass correlations were 0.99, 0.92, and 0.92. Shape measurements showed high intraobserver (DSC, 0.95 ± 0.04; MHD, 0.16 ± 0.10 mm) and interobserver (DSC, 0.94 ± 0.05; MHD, 0.19 ± 0.12 mm) luminal agreement. This approach can detect a change of at least 3.9% in total plaque volume, 1.2 mm 3 in calcium, 4.3 mm 3 in LRNC, and 8.6 mm 3 in IPH with the same observer repeating measurements and 9.9% in plaque volume, 1.9 mm 3 in calcium, 7.9 mm 3 in LRNC, and 6.8 mm 3 in IPH for two different observers. Conclusions: Carotid plaque geometry (total volume, diameter stenosis, and area stenosis) and tissue composition (calcium, LRNC, and IPH) are measured reliably from clinical CTA images using a semiautomatic image analysis program. The minimum change in plaque volume detectable is ∼4% if the same observer makes both measurements and ∼10% for different observers. Small changes in plaque composition can also be detected reliably. This approach can facilitate longitudinal studies for identifying high-risk plaque features and for quantifying plaque progression or regression after treatment. (Copyright © 2019 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.) |
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| معلومات مُعتمدة: | Z01 AG000513 United States ImNIH Intramural NIH HHS; U01 NS080168 United States NS NINDS NIH HHS; P30 AG028747 United States AG NIA NIH HHS; I01 CX001621 United States CX CSRD VA; P30 DK072488 United States DK NIDDK NIH HHS; I01 RX000995 United States RX RRD VA; R01 NS097876 United States NS NINDS NIH HHS |
| فهرسة مساهمة: | Keywords: Atherosclerosis; CT angiography; Carotid; Morphology; Stenosis |
| تواريخ الأحداث: | Date Created: 20190310 Date Completed: 20200129 Latest Revision: 20240607 |
| رمز التحديث: | 20240607 |
| مُعرف محوري في PubMed: | PMC7034302 |
| DOI: | 10.1016/j.jvs.2018.11.050 |
| PMID: | 30850296 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1097-6809 |
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| DOI: | 10.1016/j.jvs.2018.11.050 |