Comparison of pre-mortem 2D-3D ultrasound examination to post-mortem micro-CT of carotid arteries - first experiences

Ideggyogy Sz. 2024 Jan 30;77(1-2):13-20. doi: 10.18071/isz.77.0013.

Abstract

Background and purpose: <p>A prerequisite for the treatment of carotid atherosclerosis is the accurate measurement of the stenosis, that is most commonly evaluated by duplex ultrasonography. In this study, we aimed to verify the reliability of 2D and 3D ultrasonography, comparing the data to results of post-mortem micro-CT examination.</p>.

Methods: <p>Neurological patients with any life-threatening, presumably fatal neurological disease were enrolled. Ultrasound examinations were performed with a Philips Epiq 5G machine, using a VL13-5 broadband linear volume array transducer. Plaque length, diameter and vessel area reduction (stenosis) were calculated using the 2D images. Finally, the stenosis was reassessed using automatized, 3D application as well. After the death of the patient, autopsy was performed, during which the previously examined carotid artery was removed. The samples were examined with micro-CT. Similar to the ultrasound examination, plaque length, diameter and vessel area reduction (stenosis) were determined.</p>.

Results: <p>Ten vessels of seven patients were eligible for complex comparison. Plaque diameter and length measured by CT did not correlate with the ultrasound data. CT-measured axial plaque and vessel areas showed no correlation with ultrasound results either. While determining the strength of correlation between stenoses measured by the different modalities, significant correlation was found between the results measured by ultrasound (2D) and CT (Pearson r: 0.902, P&lt;0.001).</p>.

Conclusion: <p>Three-dimensional ultrasound analysis is a spectacular method for examining carotid plaques, as it can assist in a more detailed evaluation of the plaque morphology and composition, thereby identifying plaques with a particularly high risk of stroke. Micro-CT is an excellent tool for the exact determination of calcified plaque areas, but ultrasound images are not suitable yet for such a precise examination due to acoustic shadowing and artifacts.</p>.

Background and purpose: <p>A carotisatherosclerosis kezel&eacute;s&eacute;nek előfelt&eacute;tele a szűk&uuml;let m&eacute;rt&eacute;k&eacute;nek kellően pontos m&eacute;r&eacute;se, amit leggyakrabban duplex ultrahangvizsg&aacute;lat segíts&eacute;g&eacute;vel &eacute;rt&eacute;kel&uuml;nk. Ebben a tanulm&aacute;nyban c&eacute;lunk volt a 2D &eacute;s 3D ultrahang megbízhat&oacute;s&aacute;g&aacute;nak &eacute;rt&eacute;kel&eacute;se, &ouml;sszehasonlítva az adatokat post mortem mikro-CT-vizsg&aacute;lat eredm&eacute;nyeivel.<br><br></p>.

Methods: <p>&Eacute;letet vesz&eacute;lyeztető, feltehe&shy;tően v&eacute;gzetes neurol&oacute;giai betegs&eacute;gben szen&shy;vedő betegeket vontunk be a vizsg&aacute;latba. Az ultrahangos vizsg&aacute;latokat Philips Epiq 5G k&eacute;sz&uuml;l&eacute;kkel, VL13-5 sz&eacute;less&aacute;v&uacute; line&aacute;ris transzducerrel v&eacute;gezt&uuml;k. Plakkhossz, -&aacute;tm&eacute;rő &eacute;s &eacute;rker&uuml;let-cs&ouml;kken&eacute;s (szűk&uuml;let) kisz&aacute;mí&shy;t&aacute;&shy;sa a 2D k&eacute;pek segíts&eacute;g&eacute;vel t&ouml;rt&eacute;nt. A szű&shy;k&uuml;&shy;&shy;letet v&eacute;g&uuml;l automatiz&aacute;lt, 3D alkalmaz&aacute;s se&shy;&shy;gít&shy;s&eacute;&shy;g&eacute;vel is &eacute;rt&eacute;kelt&uuml;k. A betegek hal&aacute;la ut&aacute;n boncol&aacute;s t&ouml;rt&eacute;nt, mely sor&aacute;n a kor&aacute;bban vizsg&aacute;lt carotisart&eacute;ri&aacute;t elt&aacute;volítottuk. A min-t&aacute;kat mikro-CT segíts&eacute;g&eacute;vel vizsg&aacute;ltuk. Az ult&shy;rahangvizsg&aacute;lathoz hasonl&oacute;an plakkhossz, -&aacute;tm&eacute;rő &eacute;s &eacute;rker&uuml;let-cs&ouml;kken&eacute;s (szűk&uuml;let) meghat&aacute;roz&aacute;sa t&ouml;rt&eacute;nt.</p>.

Results: <p>H&eacute;t betegből tíz &eacute;r volt alkalmas az ultrahangadatok &eacute;s a mikro-CT-eredm&eacute;nyek &ouml;sszehasonlít&aacute;s&aacute;ra. A CT-vel m&eacute;rt plakk&aacute;tm&eacute;rő &eacute;s -hossz nem korrel&aacute;lt az ultrahangos adatokkal. A CT-vel m&eacute;rt axi&aacute;lis plakk- &eacute;s &eacute;rter&uuml;letek sem mutattak &ouml;sszef&uuml;gg&eacute;st az ultrahangos eredm&eacute;nyekkel. A k&uuml;l&ouml;nb&ouml;ző modalit&aacute;sokkal m&eacute;rt szűk&uuml;letek k&ouml;z&ouml;tti korrel&aacute;ci&oacute; erőss&eacute;g&eacute;nek meghat&aacute;roz&aacute;sa sor&aacute;n szignifik&aacute;ns korrel&aacute;ci&oacute;t tal&aacute;ltunk az ultrahanggal (2D) &eacute;s a CT-vel m&eacute;rt eredm&eacute;nyek k&ouml;z&ouml;tt (Pearson r: 0,902, p &lt; 0,001).</p>.

Conclusion: <p>A h&aacute;romdimenzi&oacute;s ultrahang-analízis egy l&aacute;tv&aacute;nyos m&oacute;dszer a carotisplakkok vizsg&aacute;lat&aacute;ra, mivel segíthet a plakkok morfol&oacute;gi&aacute;j&aacute;nak &eacute;s &ouml;sszet&eacute;tel&eacute;nek r&eacute;szletesebb &eacute;rt&eacute;kel&eacute;s&eacute;ben, ez&aacute;ltal segíthet azonosítani a k&uuml;l&ouml;n&ouml;sen magas stroke-kock&aacute;zat&uacute; plakkokat. A mikro-CT kiv&aacute;l&oacute; eszk&ouml;z a meszes plakkos ter&uuml;letek pontos meghat&aacute;roz&aacute;s&aacute;ra, de az ultrahangos felv&eacute;telek m&eacute;g nem alkalmasak ilyen precíz vizsg&aacute;latra az akusztikus &aacute;rny&eacute;kol&aacute;s &eacute;s a műterm&eacute;kek miatt.</p>.

Keywords: 3D ultrasound; carotid artery; ischemic stroke; micro-CT; stenosis.

MeSH terms

  • Autopsy
  • Carotid Arteries / diagnostic imaging
  • Carotid Stenosis* / diagnosis
  • Constriction, Pathologic
  • Humans
  • Imaging, Three-Dimensional* / methods
  • Reproducibility of Results
  • Ultrasonography / methods
  • X-Ray Microtomography