Carotid Plaque Vulnerability Assessed by Combined Shear Wave Elastography and Ultrafast Doppler Compared to Histology
Autor: | Patrick Bruneval, O. Pedreira, Guillaume Goudot, Jean-Marc Alsac, Pierre Julia, Hélène Mortelette, Emmanuel Messas, Kisaki Amemyia, Mathieu Pernot, Mickael Tanter, David Calvet, Salma El Batti, Jonas Sitruk, Lina Khider, Anatole Jimenez, Tristan Mirault |
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Přispěvatelé: | Université Paris Cité (UPCité), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Physique pour la médecine (PhysMed Paris), Ecole Superieure de Physique et de Chimie Industrielles de la Ville de Paris (ESPCI Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), DHU NeuroVasc Sorbonne Paris-Cité, Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Goudot, Guillaume |
Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
0301 basic medicine
medicine.medical_treatment [SDV]Life Sciences [q-bio] Wall shear stress Carotid endarterectomy Gross examination 03 medical and health sciences symbols.namesake 0302 clinical medicine Ultrasound medicine Humans Carotid Stenosis Endarterectomy Endarterectomy Carotid Receiver operating characteristic business.industry General Neuroscience Histology Stepwise regression Carotid plaque Plaque Atherosclerotic [SDV] Life Sciences [q-bio] 030104 developmental biology Carotid Arteries Shear wave elastography cardiovascular system symbols Elasticity Imaging Techniques Neurology (clinical) Cardiology and Cardiovascular Medicine Nuclear medicine business Doppler effect 030217 neurology & neurosurgery |
Zdroj: | Translational stroke research./Transl Stroke Res Translational stroke research./Transl Stroke Res, 2021, 13, pp.100-111. ⟨10.1007/s12975-021-00920-6⟩ |
ISSN: | 1868-4483 |
Popis: | International audience; Ultrafast ultrasound imaging (UUI) provides an estimation of carotid plaque stiffness by shear wave elastography (SWE) and the quantification of wall shear stress (WSS) by ultrafast Doppler. We aimed to evaluate the combined criteria of plaque stiffness and WSS applied on the plaque as potential biomarkers of plaque vulnerability assessed by histology. We included patients for whom carotid endarterectomy had been decided by a multidisciplinary team. UUI was performed within 48 h before surgery, and acquisitions were obtained on a carotid longitudinal view. After endarterectomy, gross examination and histological analysis were performed on each removed plaque. Forty-six plaques with SWE data and 29 with WSS data were analyzed. Histological analysis revealed 29 vulnerable and 17 stable plaques. Gray-scale median analysis by B-mode, mean, and standard deviation of stiffness by SWE did not differ between vulnerable and stable plaques. SWE analysis revealed that the percentage of stiffness range of 3-5 m/s was significantly increased in vulnerable plaques (p = 0.048). WSS alone showed no difference between stable and vulnerable plaques regardless of the segment of the plaque which was analyzed. A multiparametric score using maximal WSS at the peak of the plaque associated with SWE texture analysis parameters was calculated by stepwise regression, leading to a score with a sensitivity of 80% and a specificity of 78%. Area under the receiver operating characteristics curve was 0.85. A multiparameter scoring system including plaque stiffness and flow analysis using UUI allows to effectively identify histologically vulnerable carotid plaques. ClinicalTrials.gov Identifier: NCT03234257. |
Databáze: | OpenAIRE |
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