title: Ultrasound-Based Carotid Elastography for Detection of Vulnerable Atherosclerotic Plaques Validated by Magnetic Resonance Imaging.
abstract: Ultrasound-based carotid elastography has been developed to estimate the mechanical properties of atherosclerotic plaques. The objective of this study was to evaluate the in vivo capability of carotid elastography in vulnerable plaque detection using high-resolution magnetic resonance imaging as reference. Ultrasound radiofrequency data of 46 carotid plaques from 29 patients (74 ± 5 y old) were acquired and inter-frame axial strain was estimated with an optical flow method. The maximum value of absolute strain rate for each plaque was derived as an indicator for plaque classification. Magnetic resonance imaging of carotid arteries was performed on the same patients to classify the plaques into stable and vulnerable groups for carotid elastography validation. The maximum value of absolute strain rate was found to be significantly higher in vulnerable plaques (2.15 ± 0.79 s(-1), n = 27) than in stable plaques (1.21 ± 0.37 s(-1), n = 19) (p < 0.0001). Receiver operating characteristic curve analysis was performed, and the area under the curve was 0.848. Therefore, the in vivo capability of carotid elastography to detect vulnerable plaques, validated by magnetic resonance imaging, was proven, revealing the potential of carotid elastography as an important tool in atherosclerosis assessment and stroke prevention.
authors.affiliation: Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China; Center for Biomedical Imaging Research, Tsinghua University, Beijing, China.
authors.forename: Chengwu
authors.initials: C
authors.lastname: Huang
authors.affiliation: Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China; Center for Biomedical Imaging Research, Tsinghua University, Beijing, China.
authors.forename: Xiaochang
authors.initials: X
authors.lastname: Pan
authors.affiliation: Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China; Center for Biomedical Imaging Research, Tsinghua University, Beijing, China.
authors.forename: Qiong
authors.initials: Q
authors.lastname: He
authors.affiliation: Department of Sonography, China Meitan General Hospital, Beijing, China.
authors.forename: Manwei
authors.initials: M
authors.lastname: Huang
authors.affiliation: Clinical Sites Research Program, Philips Research China, Shanghai, China.
authors.forename: Lingyun
authors.initials: L
authors.lastname: Huang
authors.affiliation: Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China; Center for Biomedical Imaging Research, Tsinghua University, Beijing, China. Electronic address: xihaizhao@tsinghua.edu.cn.
authors.forename: Xihai
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China; Center for Biomedical Imaging Research, Tsinghua University, Beijing, China; Department of Radiology, University of Washington, Seattle, Washington, USA.
authors.forename: Chun
authors.initials: C
authors.lastname: Yuan
authors.affiliation: Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Bai
authors.affiliation: Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China; Center for Biomedical Imaging Research, Tsinghua University, Beijing, China. Electronic address: luo_jianwen@tsinghua.edu.cn.
authors.forename: Jianwen
authors.initials: J
authors.lastname: Luo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000503:physiopathology*; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Carotid atherosclerotic plaque; Elastography; Plaque classification; Rupture risk; Vulnerability