title: Computerized texture analysis of carotid plaque ultrasonic images can identify unstable plaques associated with ipsilateral neurological symptoms.
abstract: We estimated the value of objective, computerized texture analysis of ultrasonic images in distinguishing carotid plaques associated with neurological ipsilateral symptoms (amaurosis fugax [AmF; n = 30], transient ischemic attack [TIA; n = 52], and stroke [n = 55]) from asymptomatic plaques (n = 51). We performed 3 case-control studies (1/symptom with asymptomatic plaques as control). On logistic regression, AmF was independently associated with severity of stenosis, percentage of pixels with gray levels 0 to 10 (PPCS1; measure of echolucency), and spatial gray level dependence matrices (SGLDM) information measure of correlation (IMC-1; texture); TIAs with PPCS1 (echolucency), SGLDM correlation, and skewness (both texture); and stroke with PPCS1, SGLDM correlation, and percentage of pixels with gray levels 11 to 20 (PPCS2; echolucency). The area under the curve of the regression-derived predicted probability for AmF, TIA, and stroke was 0.92, 0.82, and 0.85, respectively (all P < .001). Texture analysis can identify carotid plaques associated with a neurological event, improving the diagnostic value of echolucency measures. Texture analyses could be applied to natural history studies.
authors.affiliation: Department of Vascular Surgery, Imperial College London, London, UK.
authors.forename: Stavros K
authors.initials: SK
authors.lastname: Kakkos
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Nicolaides
authors.forename: Efthyvoulos
authors.initials: E
authors.lastname: Kyriacou
authors.forename: Stella S
authors.initials: SS
authors.lastname: Daskalopoulou
authors.forename: Michael M
authors.initials: MM
authors.lastname: Sabetai
authors.forename: Constantinos S
authors.initials: CS
authors.lastname: Pattichis
authors.forename: George
authors.initials: G
authors.lastname: Geroulakos
authors.forename: Maura B
authors.initials: MB
authors.lastname: Griffin
authors.forename: Dafydd
authors.initials: D
authors.lastname: Thomas
mesh_terms: D020757:Amaurosis Fugax / Q000209:etiology*; D016893:Carotid Stenosis / Q000150:complications* / Q000000981:diagnostic imaging*; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D002546:Ischemic Attack, Transient / Q000209:etiology*; D008297:Male; D012720:Severity of Illness Index; D012984:Software; D020521:Stroke / Q000209:etiology*; D014463:Ultrasonography