title: Histopathologic Validation of Grayscale Carotid Plaque Characteristics Related to Plaque Vulnerability.
abstract: Inflammation and angiogenesis play major roles in carotid plaque vulnerability. The purpose of this study was to determine whether gray-scale features of carotid plaques are associated with histologic markers for inflammation. Thirty-eight individuals completed a dedicated research carotid ultrasound exam before carotid endarterectomy. Gray-scale analysis was performed on plaque images to measure plaque echogenicity (gray-scale median [GSM] pixel brightness), plaque area, presence of discrete white areas (DWAs) and the percent of black area near the lumen on any one component of the plaque. Plaques with higher ultrasound GSM had greater percent calcification (p = 0.013) on histopathology. Presence of an ultrasound DWA was associated with more plaque hemosiderin (p = 0.0005) and inflammation (p = 0.019) on histopathology examination. The percent of plaque black area in any one component was associated with a higher score for macroscopic ulceration (p = 0.028). Ultrasound plaque characteristics (GSM, DWAs and black areas) represent histopathologic markers associated with plaque vulnerability. ClinicalTrials.gov identifier: NCT02476396.
authors.affiliation: Cardiovascular Medicine Division, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. Electronic address: ccm@medicine.wisc.edu.
authors.forename: Carol C
authors.initials: CC
authors.lastname: Mitchell
authors.affiliation: Cardiovascular Medicine Division, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: James H
authors.initials: JH
authors.lastname: Stein
authors.affiliation: Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Cook
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Shahriar
authors.initials: S
authors.lastname: Salamat
authors.affiliation: Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Xiao
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Tomy
authors.initials: T
authors.lastname: Varghese
authors.affiliation: Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Daren C
authors.initials: DC
authors.lastname: Jackson
authors.affiliation: Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Carolina
authors.initials: C
authors.lastname: Sandoval Garcia
authors.affiliation: Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Stephanie M
authors.initials: SM
authors.lastname: Wilbrand
authors.affiliation: Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Dempsey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000648:ultrastructure; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000648:ultrastructure; D015203:Reproducibility of Results; D014463:Ultrasonography / Q000379:methods*
keywords: Carotid plaque; Ultrasound gray-scale imaging; Vulnerable plaque