AHA classification of coronary and carotid atherosclerotic plaques by grating-based phase-contrast computed tomography.
Eur Radiol
; 26(9): 3223-33, 2016 Sep.
Article
em En
| MEDLINE
| ID: mdl-26679184
ABSTRACT
OBJECTIVES:
To evaluate the potential of grating-based phase-contrast computed-tomography (gb-PCCT) to classify human carotid and coronary atherosclerotic plaques according to modified American Heart Association (AHA) criteria.METHODS:
Experiments were carried out at a laboratory-based set-up consisting of X-ray tube (40 kVp), grating-interferometer and detector. Eighteen human carotid and coronary artery specimens were examined. Histopathology served as the standard of reference. Vessel cross-sections were classified as AHA lesion type I/II, III, IV/V, VI, VII or VIII plaques by two independent reviewers blinded to histopathology. Conservative measurements of diagnostic accuracies for the detection and differentiation of plaque types were evaluated.RESULTS:
A total of 127 corresponding gb-PCCT/histopathology sections were analyzed. Based on histopathology, lesion type I/II was present in 12 (9.5 %), III in 18 (14.2 %), IV/V in 38 (29.9 %), VI in 16 (12.6 %), VII in 34 (26.8 %) and VIII in 9 (7.0 %) cross-sections. Sensitivity, specificity and positive and negative predictive value were ≥0.88 for most analyzed plaque types with a good level of agreement (Cohen's kappa = 0.90). Overall, results were better in carotid (kappa = 0.97) than in coronary arteries (kappa = 0.85). Inter-observer agreement was high with kappa = 0.85, p < 0.0001.CONCLUSIONS:
These results indicate that gb-PCCT can reliably classify atherosclerotic plaques according to modified AHA criteria with excellent agreement to histopathology. KEY POINTS ⢠Different atherosclerotic plaque types display distinct morphological features in phase-contrast CT. ⢠Phase-contrast CT can detect and differentiate AHA plaque types. ⢠Calcifications caused streak artefacts and reduced sensitivity in type VI lesions. ⢠Overall agreement was higher in carotid than in coronary arteries.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Interpretação de Imagem Radiográfica Assistida por Computador
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Artérias Carótidas
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Tomografia Computadorizada por Raios X
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Vasos Coronários
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Placa Aterosclerótica
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article