Bashar Ababneh1, Loui Rejjal1, Yashashwi Pokharel2, Vijay Nambi3, Xukui Wang4, Ching-Hsuan Tung4, Richard I Han2, Addison A Taylor5, Panagiotis Kougias5, Alan B Lumsden6, Gerald Lawrie6, Michael Reardon6, Christie M Ballantyne7, Joel D Morrisett2, Gerd Brunner8. 1. Co-primary authors (contributed equally) Division of Atherosclerosis and Vascular Medicine, Department of Medicine, Baylor College of Medicine, Texas, USA. 2. Division of Atherosclerosis and Vascular Medicine, Department of Medicine, Baylor College of Medicine, Texas, USA. 3. Division of Atherosclerosis and Vascular Medicine, Department of Medicine, Baylor College of Medicine, Texas, USA Michael E DeBakey VA Medical Center, Houston, Texas, USA Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas, USA. 4. Department of Translational Imaging, Houston Methodist Research Institute, Houston, Texas, USA. 5. Division of Atherosclerosis and Vascular Medicine, Department of Medicine, Baylor College of Medicine, Texas, USA Michael E DeBakey VA Medical Center, Houston, Texas, USA. 6. Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas, USA. 7. Division of Atherosclerosis and Vascular Medicine, Department of Medicine, Baylor College of Medicine, Texas, USA Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas, USA. 8. Division of Atherosclerosis and Vascular Medicine, Department of Medicine, Baylor College of Medicine, Texas, USA Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas, USA gbrunner@bcm.edu.
Abstract
BACKGROUND: Calcification in atherosclerotic plaques has been viewed as a marker of plaque stability, but whether calcification accumulates in specific anatomic sites in the carotid artery is unknown. We determined the burden and distribution of calcified plaque in carotid endarterectomy (CEA) tissues. METHODS: A total of 22 CEA tissues were imaged with high-resolution micro-computed tomography (micro-CT). Total plaque burden and total calcium score using the Agatston method were quantified. The Agatston score (AS) was also normalized for tissue size. Plaque and calcium distribution were analyzed separately for three CEA regions: common segment (CS), bulb segment (BS), and internal/external segments (IES). RESULTS: The average CEA tissue length was 40.83 (interquartile range [IQR] 33.31-42.41) mm with total plaque burden of 103.45 (IQR: 78.84-156.81) mm(3) and total AS of 38.58 (IQR 11.59-89.97). Total plaque volume was 21.02 (IQR: 14.47-25.42) mm(3) in the CS, 37.89 (22.59-48.32) mm(3) in the BS, and 54.05 (36.87-74.52) mm(3) in the IES. Of the 22 tissues, 15 had no calcium in the CS compared with three in the bulb and two in the IES. Normalized calcified plaque was most prevalent in the BS, the IES and was least prevalent in the CS. The overall correlation of calcification between histology sections and matched micro-CT images was 0.86 (p<0.001). CONCLUSIONS: Calcified plaque is heterogeneously distributed in CEA tissues with most in the bulb and IES regions. The amount of calcification in micro-CT slices shows a high correlation with matched histology sections.
BACKGROUND:Calcification in atherosclerotic plaques has been viewed as a marker of plaque stability, but whether calcification accumulates in specific anatomic sites in the carotid artery is unknown. We determined the burden and distribution of calcified plaque in carotid endarterectomy (CEA) tissues. METHODS: A total of 22 CEA tissues were imaged with high-resolution micro-computed tomography (micro-CT). Total plaque burden and total calcium score using the Agatston method were quantified. The Agatston score (AS) was also normalized for tissue size. Plaque and calcium distribution were analyzed separately for three CEA regions: common segment (CS), bulb segment (BS), and internal/external segments (IES). RESULTS: The average CEA tissue length was 40.83 (interquartile range [IQR] 33.31-42.41) mm with total plaque burden of 103.45 (IQR: 78.84-156.81) mm(3) and total AS of 38.58 (IQR 11.59-89.97). Total plaque volume was 21.02 (IQR: 14.47-25.42) mm(3) in the CS, 37.89 (22.59-48.32) mm(3) in the BS, and 54.05 (36.87-74.52) mm(3) in the IES. Of the 22 tissues, 15 had no calcium in the CS compared with three in the bulb and two in the IES. Normalized calcified plaque was most prevalent in the BS, the IES and was least prevalent in the CS. The overall correlation of calcification between histology sections and matched micro-CT images was 0.86 (p<0.001). CONCLUSIONS: Calcified plaque is heterogeneously distributed in CEA tissues with most in the bulb and IES regions. The amount of calcification in micro-CT slices shows a high correlation with matched histology sections.
Authors: Richard I Han; Thomas M Wheeler; Alan B Lumsden; Michael J Reardon; Gerald M Lawrie; K Jane Grande-Allen; Joel D Morrisett; Gerd Brunner Journal: Comput Biol Med Date: 2016-01-22 Impact factor: 4.589
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