Qualitative and quantitative accuracy of ultrasound-based virtual histology for detection of necrotic core in human coronary arteries

2014 ◽  
Vol 30 (3) ◽  
pp. 469-476 ◽  
Author(s):  
Salvatore Brugaletta ◽  
Clarissa Cola ◽  
Victoria Martin-Yuste ◽  
Gemma Vilahur ◽  
Juan Oriol ◽  
...  
Keyword(s):  
Coronary Arteries ◽  
Necrotic Core ◽  
Virtual Histology ◽  
Qualitative And Quantitative ◽  
Quantitative Accuracy

Abstract 1984: Histopathologic Validation of Virtual Histology Intravascular Ultrasound Analysis of Peri-calcific Necrotic Core Area

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Sang-Wook Kim ◽  
Gary S Mintz ◽  
Wang-Soo Lee ◽  
Hyoung-Joong Kim ◽  
Tae-Jin Lee ◽  
...  
Keyword(s):  
Smooth Muscle ◽  
Intravascular Ultrasound ◽  
Coronary Arteries ◽  
Smooth Muscle Actin ◽  
Empty Space ◽  
Necrotic Core ◽  
Core Area ◽  
Virtual Histology ◽  
Virtual Histology Intravascular Ultrasound ◽  
Collagenous Tissue

The effect of calcium-associated acoustic shadowing on Virtual Histology intravascular ultrasound (VH-IVUS) plaque component analysis is unknown. Methods. We harvested 87 coronary arteries from 30 autopsied specimens. IVUS imaging was performed 50mm from the LMCA ostium. We then selected 10 calcified segments for comparative VH-IVUS vs pathologic comparisons. Results. Pt age was 46±8.9yrs and 90% were males. VH-IVUS analysis of the calcified plaque showed 11±3.8% necrotic core, 8±1.9% fibrofatty plaque, 69±9.9% fibrotic plaque, and 10±6.6% dense calcium. Dense calcium was correlated with the size of the necrotic core (r=0.774, p=0.009). Three coronary arteries with moderate to severe calcium were examined histopathologically. VH-IVUS analysis showed fibrotic tissue behind the calcium, but histopathology showed an acellular sclerotic area (dense collagenous tissue) just beneath the calcium with a relatively well-preserved vascular smooth muscle layer. Within the necrotic core, VH-IVUS showed prominent red necrotic core area combined with calcium; however, histopathology showed empty space of decalcification surrounded by just collagenous tissue with outer smooth muscle actin positive cell layer. More importantly, no active inflammation was present around calcium. Conclusion. VH-IVUS necrotic core surrounding areas of dense calcium correlated with dense collagenous tissue histopathologically. It is important not to overinterpret VH IVUS studies of dense calcium with prominent necrotic core. More precise classification/validation for necrotic core is necessary.

105 Finding the culprit of the culprit lesion: the relationship between maximum necrotic core site and minimum lumen area using virtual histology

Heart ◽  
2010 ◽  
Vol 96 (Suppl 1) ◽  
pp. A62-A62
Author(s):  
S W Murray ◽  
R H Stables ◽  
G Hart ◽  
R A Perry ◽  
N D Palmer
Keyword(s):  
Necrotic Core ◽  
Lumen Area ◽  
Culprit Lesion ◽  
Virtual Histology ◽  
Core Site ◽  
The Relationship

scholarly journals Cellular-resolution 3D virtual histology of human coronary arteries using x-ray phase tomography

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
William Vågberg ◽  
Jonas Persson ◽  
Laszlo Szekely ◽  
Hans M. Hertz
Keyword(s):  
Coronary Arteries ◽  
Virtual Histology ◽  
X Ray ◽  
Cellular Resolution

VIRTUAL HISTOLOGY–INTRAVASCULAR ULTRASOUND IN ASSESSMENT OF CAROTID PLAQUES

Neurosurgery ◽  
2009 ◽  
Vol 65 (1) ◽  
pp. 146-152 ◽  
Author(s):  
Tomohito Hishikawa ◽  
Koji Iihara ◽  
Hatsue Ishibashi-Ueda ◽  
Kazuyuki Nagatsuka ◽  
Naoaki Yamada ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Ex Vivo ◽  
Necrotic Core ◽  
Interquartile Range ◽  
Intraplaque Hemorrhage ◽  
Virtual Histology ◽  
Carotid Plaques ◽  
Virtual Histology Intravascular Ultrasound ◽  
Histological Sections ◽  
Histological Images

Abstract OBJECTIVE Virtual histology–intravascular ultrasound (VH-IVUS) has been reported to be useful in detecting the components of coronary plaques in vivo. Recently, the application of VH-IVUS to peripheral interventions has been evaluated. The aim of this study was to examine the extent to which the necrotic core of carotid plaques could be assessed accurately by VH-IVUS compared with histopathology. METHODS A total of 37 carotid plaques underwent ex vivo VH-IVUS within 24 hours after endarterectomy. Ninety-five segments of virtual histological images were matched to histological sections. The area of the necrotic core on histological sections was compared with that on virtual histological images. Intraplaque hemorrhage (IPH) was histopathologically graded by its severity using immunohistochemical staining for glycophorin A as a marker. The relationship of the severity of the IPH to the necrotic core was histopathologically evaluated. The correlation between the necrotic core or IPH with symptomatology was also evaluated. RESULTS The area of the necrotic core on virtual histological images (median, 8.0%; interquartile range, 5.0%–13%) was significantly smaller compared with that of the histological sections (median, 50%; interquartile range, 40%–63%) (P < 0.0001). The Bland-Altman analysis showed poor agreement in the necrotic core measurement between virtual histological images and histological sections (mean difference, 39.8%; 95% confidence interval, 35.8%–43.8%). Severe IPH was significantly associated with a larger necrotic core and symptomatology (P < 0.0001 and P = 0.0039, respectively). The area of necrotic core on the virtual histological analysis did not correlate with symptomatology (P = 0.70), but that on pathological analysis tended to correlate with symptomatology (P = 0.059). CONCLUSION In the present virtual histological algorithm, the underestimation of the necrotic core was revealed. The lack of a hemorrhage component in the virtual histological algorithm is a leading cause of its underestimation.

scholarly journals Synergistic Effect of Cardiovascular Risk Factors on Necrotic Core in Coronary Arteries

2009 ◽  
Vol 2 (5) ◽  
pp. 629-636 ◽  
Author(s):  
Héctor M. García-García ◽  
Patrick W. Serruys ◽  
Gary S. Mintz ◽  
Satoshi Saito ◽  
Volker Klaus ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Synergistic Effect ◽  
Cardiovascular Risk Factors ◽  
Coronary Arteries ◽  
Necrotic Core

Relation Between Wall Shear Stress and Plaque Necrotic Core in the Left Coronary Arteries of Patients Using Intravascular Ultrasound and Computational Fluid Dynamics

2008 ◽  
Author(s):  
Jin Suo ◽  
Michael McDaniel ◽  
Habib Samady ◽  
Don Giddens
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Shear Stress ◽  
Wall Shear Stress ◽  
Intravascular Ultrasound ◽  
Coronary Arteries ◽  
Plaque Rupture ◽  
Necrotic Core ◽  
Elastic Membrane ◽  
Wall Shear

Atherosclerosis is a disease characterized by arterial plaques that include several components of which the necrotic core has been recognized as an important indicator of the likelihood of plaque rupture [1]. In the present study, the relation of hemodynamic wall shear stress (WSS) to necrotic core localization in the left coronary artery of patients was investigated using intravascular ultrasound (IVUS) and computational fluid dynamics (CFD). An innovative 3D measuring technique was developed and was successfully used to reconstruct coronary arteries in patients based on angiographic images and echo ultrasound slices from IVUS. The reconstruction includes lumen, external elastic membrane (EEM) and spatial distribution of plaque components such as fibrous tissue, necrotic core and calcium. WSS distribution in the vessel segment was computed by CFD, and the relative locations of necrotic core and WSS were determined. Results to date support the hypothesis that a greater necrotic core in coronary plaques is associated with areas of low WSS. The methodology developed has implications for the study of plaque progression and the prediction of likelihood of plaque rupture.

Comparison of Intravascular Ultrasound Virtual Histology Parameters in Diabetes versus Non-Diabetes with Acute Coronary Syndrome

Cardiology ◽  
2020 ◽  
Vol 145 (9) ◽  
pp. 570-577
Author(s):  
Sreenivas Reddy ◽  
Vikas Kadiyala ◽  
Jeet Ram Kashyap ◽  
Raghavendra Rao ◽  
Hithesh Reddy ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
High Risk ◽  
Intravascular Ultrasound ◽  
Vascular Complications ◽  
Necrotic Core ◽  
High Dose ◽  
Virtual Histology ◽  
Coronary Syndrome ◽  
Minimal Lumen Area ◽  
Significant Difference

Introduction: The progression and pattern of coronary atherosclerosis in diabetes mellitus (DM) is different from non-DM, leading to a higher rate of vascular complications in DM. Objective: This study aims to assess and compare the high-risk plaque characteristics in the culprit artery of DM and non-DM patients with acute coronary syndrome (ACS) using virtual histology intravascular ultrasound (VH-IVUS). Methods: A total of 158 ACS patients were included, 63 of whom were known to have DM. IVUS analysis was done in the de novo target vessel and culprit lesion for which percutaneous coronary intervention was planned. Culprit lesions with a visual-estimate angiographic stenosis of <70% were excluded. Results: The mean age of patients was 52.4 ± 11.6 years. The study group comprised 82% men, 31% with hypertension, and 39.87% with DM. No significant difference was observed between the DM and non-DM groups in relation to quantitative IVUS parameters like lesion length, minimal lumen area, and plaque area. However, there was a significant difference in VH-IVUS parameters like higher necrotic core and dense calcium in the DM patients than in the non-DM patients (p < 0.01). The occurrence of VH-derived thin-cap fibroatheroma (VH-TCFA) in the culprit vessel was significantly higher in the DM group than in the non-DM group (25.3 vs. 5.2%; p < 0.01). Positive vessel-wall remodeling was noted in both groups without any significant difference (p = 0.74). Conclusion: The DM patients had high-risk plaque composition features like a higher necrotic core, which is a marker of plaque vulnerability. Thus, aggressive medical therapy targeting vascular inflammation using high-dose statins would help in the stabilization of unstable plaque morphology and the reduction of major cardiovascular events.

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