Validation of in vivo plaque characterisation by virtual histology in a rabbit model of atherosclerosis.
OBJECTIVE
Most acute coronary syndromes are caused by plaque rupture. The risk of plaque rupture is related to plaque composition. The purpose of this study was to validate VH-IVUS for in vivo plaque characterisation.


RESULTS
Six rabbits were fed a cholesterol-supplemented diet for 12 to 18 months. Thereafter, VH-IVUS imaging of the aorta was performed. After sacrifice, the VH-IVUS images were matched to the corresponding histological cross sections. A total of 260 atherosclerotic plaques were analysed. VH-IVUS had a high sensitivity, specificity and positive predictive value for the detection of non-calcified thin cap fibroatheroma (88%, 96%, 87%, respectively) and calcified thin cap fibroatheroma (95%, 99%, 93%, respectively). These values were respectively 82%, 94%, 85% for non-calcified fibroatheroma and 78%, 98%, 84% for calcified fibroatheroma. The lowest values were obtained for pathological intimal thickening (74%, 92%, 70%, respectively). For all plaque types, VH-IVUS had a kappa-value of 0.79. Linear regression analysis and Bland-Altman plots showed a strong correlation between VH-IVUS and histology for fibrous tissue, fibrofatty tissue, necrotic calcified tissue and confluent necrotic core.


CONCLUSIONS
VH-IVUS showed a good accuracy for in vivo plaque characterisation and is a promising technique for the detection of the vulnerable plaque.
Van Herck
Jozef
J
Division of Cardiology, Antwerp University Hospital, Belgium. jozef.vanherck@ua.ac.be
De Meyer
Guido
G
Ennekens
Guy
G
Van Herck
Paul
P
Herman
Arnold
A
Vrints
Christiaan
C
D000818:Animals; D001018:Aortic Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000209:etiology; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000209:etiology; D002791:Cholesterol, Dietary; D004195:Disease Models, Animal; D005355:Fibrosis; D009336:Necrosis; D011237:Predictive Value of Tests; D011817:Rabbits; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013997:Time Factors; D018084:Ultrasonography, Interventional; D014584:User-Computer Interface
D002791:Cholesterol, Dietary