RESUMO
OBJECTIVES: This study aimed to demonstrate the effectiveness of spectral photon-counting CT (SPCCT) in quantifying fibrous cap (FC) thickness, FC area, and lipid-rich necrotic core (LRNC) area, in excised carotid atherosclerotic plaques by comparing it with histopathological measurements. METHODS: This is a single-center ex vivo cross-sectional observational study. Excised plaques of 20 patients (71 +/- 6 years; 13 men), obtained from carotid endarterectomy were scanned with SPCCT using standardized acquisition settings (120k Vp/19 µA; 7-18 keV, 18-30 keV, 30-45 keV, 45-75 keV, and 75-118 keV). FC thickness, FC area, and LRNC area were quantified and compared between high-resolution 3D multi-energy CT images and histopathology using the Wilcoxon signed-ranks test and Bland-Altman analysis. Images were interpreted twice by two radiologists separately, blinded to the histopathology; inter- and intra-rater reliability were assessed with the intra-class correlation coefficients (ICC). RESULTS: FC thickness and FC area did not show significant differences between the SPCCT-derived radiological measurements versus the histopathological measurements (p value range 0.15-0.51 for FC thickness and 0.053-0.30 for FC area). For the LRNC area, the p value was statistically non-significant for reader 1 (range 0.36-0.81). The Bland-Altman analysis showed mean difference and 95% confidence interval for FC thickness, FC area, and LRNC area, 0.04 (-0.36 to 0.12) square root mm, -0.18 (-0.34 to -0.02) log10 mm2 and 0.10 (-0.088. to 0.009) log10 mm2 respectively. CONCLUSION: The result demonstrated a viable technique for quantifying FC thickness, FC area, and LRNC area due to the combined effect of high spatial and energy resolution of SPCCT. KEY POINTS: ⢠SPCCT can identify and quantify different components of carotid atherosclerotic plaque in ex vivo study. ⢠Components of atherosclerotic plaque did not show significant differences between the SPCCT-derived radiological measurements versus the histopathological measurements.
Assuntos
Placa Aterosclerótica , Masculino , Humanos , Placa Aterosclerótica/diagnóstico por imagem , Placa Aterosclerótica/patologia , Reprodutibilidade dos Testes , Estudos Transversais , Artérias Carótidas/diagnóstico por imagem , Artérias Carótidas/patologia , Tomografia Computadorizada por Raios X , FibroseRESUMO
Five monorchiid species are reported from Diagramma labiosum Macleay (Perciformes: Haemulidae) collected from Heron Island on the southern Great Barrier Reef (GBR): two described species, Helicometroides longicollis Yamaguti, 1934 and Diplomonorchis kureh Machida, 2005 and three new species, including one new genus, Asymmetrostoma heronensis n. g., n. sp., Lasiotocus arrhichostoma n. sp. and Proctotrema addisoni n. sp. Helicometroides longicollis and D. kureh were previously reported from the closely related species Diagramma pictum (Thunberg) from Japan. Two further monorchiid species known from D. pictum, Genolopa plectorhynchi (Yamaguti, 1934) and Paraproctotrema fusiforme Yamaguti, 1934, appear to be absent from the southern Great Barrier Reef. Previous reports of two other monorchiids from D. labiosum from the GBR, Paramonorcheides pseudocaranxi Dove & Cribb, 1998 and Helicometroides vitellosus (Durio & Manter, 1968), are shown to have been made in error. The high richness of monorchiids and other trematode families in D. labiosum is consistent with that seen in other haemulids elsewhere.
Assuntos
Doenças dos Peixes/parasitologia , Perciformes/parasitologia , Filogenia , Trematódeos , Infecções por Trematódeos/parasitologia , Animais , Austrália , Dados de Sequência Molecular , RNA Ribossômico 28S/genética , Especificidade da Espécie , Trematódeos/anatomia & histologia , Trematódeos/classificação , Trematódeos/genéticaRESUMO
A key process in the development of atherosclerotic plaques is the recruitment of monocytes into the artery wall. Using spectral photon-counting computed tomography we examine whether monocyte deposition within the artery wall of ApoE-/- mouse can be detected. Primary mouse monocytes were labelled by incubating them with 15 nm gold nanoparticles coated with 11-mercaptoundecanoic acid The monocyte uptake of the particle was confirmed by electron microscopy of the cells before injection into 6-week-old apolipoprotein E deficient (ApoE-/-) mouse that had been fed with the Western diet for 10 weeks. Four days following injection, the mouse was sacrificed and imaged using a MARS spectral photon counting computed tomography scanner with a spectral range of 7 to 120 KeV with five energy bins. Imaging analysis showed the presence of X-ray dense material within the mouse aortic arch which was consistent with the spectral characteristic of gold rather than calcium. The imaging is interpreted as showing the deposition of gold nanoparticles containing monocytes within the mouse aorta. The results of our study determined that spectral photon-counting computed tomography could provide quantitative information about gold nanoparticles labelled monocytes in voxels of 90 × 90 × 90 µm3. The imaging was consistent with previous micro-CT and electron microscopy of mice using the same nanoparticles. This study demonstrates that spectral photon-counting computed tomography, using a MARS small bore scanner, can detect a fundamental atherogenic process within mouse models of atherogenesis. The present study demonstrates the feasibility of spectral photon-counting computed tomography as an emerging molecular imaging modality to detect atherosclerotic disease.
RESUMO
BACKGROUND AND AIMS: Atherosclerotic plaques are characterized as being vulnerable to rupture based on a series of histologically defined features, including a lipid-rich necrotic core, spotty calcification and ulceration. Existing imaging modalities have limitations in their ability to distinguish between different materials and structural features. We examined whether X-ray spectral photon-counting computer tomography (SPCCT) images were able to distinguish key plaque features in a surgically excised specimen from the carotid artery with comparison to histological images. METHODS: An excised carotid plaque was imaged in the diagnostic X-ray energy range of 30-120 keV using a small-bore SPCCT scanner equipped with a Medipix3RX photon-counting spectral X-ray detector with a cadmium telluride (CdTe) sensor. Material identification and quantification (MIQ) images of the carotid plaque were generated using proprietary MIQ software at 0.09 mm volumetric pixels (voxels). The plaque was sectioned, stained and photographed at high resolution for comparison. RESULTS: A lipid-rich core with spotty calcification was identified in the MIQ images and confirmed by histology. MIQ showed a core region containing lipid, with a mean concentration of 260 mg lipid/ml corresponding to a mean value of -22HU. MIQ showed calcified regions with mean concentration of 41 mg Ca/ml corresponded to a mean value of 123HU. An ulceration of the carotid wall at the bifurcation was identified to be lipid-lined, with a small calcification identified near the breach of the artery wall. CONCLUSIONS: SPCCT derived material identification and quantification images showed hallmarks of vulnerable plaque including a lipid-rich necrotic core, spotty calcifications and ulcerations.
RESUMO
Atherosclerotic plaques are complex tissues containing many different cell types. Macrophages contribute to inflammation, formation of the necrotic core, and plaque rupture. We examined whether macrophages in plaque can be activated and compared this to monolayer cells. The volume of calcium in the plaque was compared to the level of macrophage activation measured by total neopterin output. Carotid plaque samples were cut into 3â¯mm sections and cultured for up to 96â¯h. Live sections were stimulated with interferon-γ, phytohaemagglutinin or phorbol 12-myristate 13-acetate. Macrophage activation and oxidative stress were monitored by total neopterin (oxidized and non-oxidized 7,8-dihydroneopterin) and neopterin levels every 24â¯h for up to 4â¯d. The calcium content of two plaques was investigated by spectral imaging. Direct stimulation of macrophages in plaque sections with interferon-γ caused a sustained increase in neopterin (pâ¯=â¯.037) and total neopterin (pâ¯=â¯.003). The addition of phorbol 12-myristate 13-acetate to plaque had no significant effect on total neopterin production (pâ¯=â¯.073) but increased neopterin (pâ¯=â¯.037) whereas phytohaemagglutinin caused a significant increase in both neopterin and total neopterin (pâ¯=â¯.0279 and .0168). There was an inverse association (R2â¯=â¯0.91) between the volume of calcium and macrophage activation as measured by total neopterin production in stimulated plaque tissue. Resident macrophages within excised carotid plaque activated either directly or indirectly generate the biomarkers 7,8-dihydroneopterin and neopterin. Macrophage activation rather than the oxidative environment is associated with plaque calcification.