Document Detail

What pathological components indicate carotid atheroma activity and can these be identified reliably using ultrasound?
MedLine Citation:
PMID:  10781655     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The aim of this project was to determine whether histological features of 'active' plaque as described in the coronary circulation following acute myocardial infarction were similar in the carotid circulation, and whether these factors could be detected ultrasonically. METHOD: Endarterectomy specimens were prospectively collected, and examined histologically and assessed by two observers for ulceration, inflammation, size of necrotic core, thickness of fibrous cap, haemorrhage and luminal thrombosis. Ultrasound of the plaque obtained preoperatively was similarly coded (blind to pathology) and compared with the pathology. RESULTS: In 42 endarterectomy specimens, there was a highly significant relationship between a thin fibrous cap and a large necrotic core (P<0.002), irregular plaque contour (P<0.05) and ulceration (P<0.01) and between a large necrotic core (P<0.002) and ulceration and inflammation (P<0.05). Increasing amounts of necrosis were associated with more surface thrombosis (P<0.02). Ultrasound detected the thickness of the fibrous cap and 'any necrosis or haemorrhage' with some reliability (kappas are 0.53 and 0.5, respectively), but not ulceration, necrosis or haemorrhage on their own. CONCLUSION: Features corresponding to active atheromatous plaque are similar in the carotid and coronary arteries, and some of these, namely lucent areas in the plaque (corresponding to necrosis or haemorrhage) and the thickness of the fibrous cap, can be determined reliably with ultrasound.
G A Lammie; J Wardlaw; P Allan; C V Ruckley; R Peek; D F Signorini
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of ultrasound : official journal of the European Federation of Societies for Ultrasound in Medicine and Biology     Volume:  11     ISSN:  0929-8266     ISO Abbreviation:  Eur J Ultrasound     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-08-24     Completed Date:  2000-08-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9440414     Medline TA:  Eur J Ultrasound     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  77-86     Citation Subset:  IM    
Department of Pathology, Neuropathology Laboratory, The University of Edinburgh, Western General Hospital, Edinburgh, UK.
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MeSH Terms
Arteriosclerosis / pathology,  ultrasonography*
Carotid Arteries / pathology,  ultrasonography*
Carotid Artery Diseases / pathology,  ultrasonography*
Carotid Stenosis / pathology,  ultrasonography

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