title: Quantification of carotid plaque neovascularization using contrast-enhanced ultrasound with histopathologic validation.
abstract: We sought to evaluate contrast-enhanced ultrasound (CEUS) imaging for the quantification of carotid plaque neovascularization. Seventeen patients underwent carotid endarterectomy after standard ultrasound and CEUS. Semiquantitative and quantitative analyses of contrast enhancement within the plaque were performed using a visual interpretation scale and quantitative analysis software, respectively. Enhancement intensity (dB) was measured at the plaque (EI(plaque)). Each specimen was stained with CD34 and CD68 to assess for microvessels and macrophages, respectively. Semiquantitative CEUS analyses were correlated with neovascularization at histology (r = 0.70, p = 0.002). Quantitative analysis was also correlated with neovascularization at histology (EI(plaque)r = 0.81, p < 0.001). EI(plaque) (r = 0.64, p = 0.01) was correlated with the degree of enhancement as assessed visually. Semiquantitative and quantitative analyses were not correlated with macrophage infiltration at the plaque. Contrast enhancement in the carotid plaque was correlated with neovascularity at the histopathologic exam. Furthermore, semiquantitative and quantitative measurements were highly correlated with each other, suggesting that either can be used to detect intraplaque neovascularization.
authors.affiliation: Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Chaolun
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Wanyuan
authors.initials: W
authors.lastname: He
authors.affiliation: Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Daqiao
authors.initials: D
authors.lastname: Guo
authors.affiliation: Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Lingli
authors.initials: L
authors.lastname: Chen
authors.affiliation: Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Xuejuan
authors.initials: X
authors.lastname: Jin
authors.affiliation: Imaging Institute, Section of Interventional Radiology, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Weiping
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Beijian
authors.initials: B
authors.lastname: Huang
authors.affiliation: Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China. Electronic address: Puguang61@126.com.
authors.forename: Wenping
authors.initials: W
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000601:surgery; D003287:Contrast Media; D016894:Endarterectomy, Carotid / Q000379:methods; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging*; D010743:Phospholipids; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000601:surgery; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride
keywords: Carotid atherosclerosis; Contrast; Neovascularization; Quantitative analysis; Ultrasound