An ultrasonographic multiparametric carotid plaque risk index associated with cerebrovascular symptomatology: A study comparing color Doppler imaging and contrast-enhanced ultrasonography
Journal article
Rafailidis, V., Chryssogonidis, I., Xerras, C., Grisan, E., Cheimariotis, G-A., Tegos, T., Rafailidis, P.S., Sidhu, P.S. and Charitanti-Kouridou, A. (2019). An ultrasonographic multiparametric carotid plaque risk index associated with cerebrovascular symptomatology: A study comparing color Doppler imaging and contrast-enhanced ultrasonography. American Journal of Neuroradiology. 40 (6), pp. 1022-1028. https://doi.org/10.3174/ajnr.A6056
| Authors | Rafailidis, V., Chryssogonidis, I., Xerras, C., Grisan, E., Cheimariotis, G-A., Tegos, T., Rafailidis, P.S., Sidhu, P.S. and Charitanti-Kouridou, A. |
|---|---|
| Abstract | BACKGROUND AND PURPOSE: Various ultrasonographic features of carortid plaques have been associated with the occurence of stroke, highlighting the need for multi-parametric assessment of plaque’s vulnerability. Our aim was to compare ultrasonographic multiparametric indices using color Doppler imaging and contrast-enhanced sonography between symptomatic and asymptomatic carotid plaques. MATERIALS AND METHODS: This was a cross-sectional observational study recruiting 54 patients (72.2% male; median age, 61 years) undergoing sonography and contrast-enhanced sonography. Patients were included if a moderately or severely stenotic internal carotid artery plaque was detected, with the plaque being considered symptomatic if it was ipsilateral to a stroke occuring within the last 6 months. A vulnerability index, previously described by Kanber et al, combined the degree of stenosis, gray-scale median, and a quantitative measure of surface irregularities (surface irregularity index) derived from color Doppler imaging and contrast-enhanced ultrasonography, resulting in 2 vulnerability indices, depending on the surface irregularity index used. Mann-Whitney U and t tests were used to compare variables between groups, and receiver operating characteristic curves were used to compare diagnostic accuracy. RESULTS: Sixty-two plaques were analyzed (50% symptomatic), with a mean degree of stenosis of 68.9%. Symptomatic plaques had a significantly higher degree of stenosis (mean, 74.7% versus 63.1%; P .001), a lower gray-scale median (13 versus 38; P .001), and a higher Kanber vulnerability index based both on color Doppler imaging (median, 61.4 versus 16.5; P .001) and contrast-enhanced ultrasonography (median, 88.6 versus 25.2; P .001). The area under the curve for the detection of symptomatic plaques was 0.772 for the degree of stenosis alone, 0.783 for the vulnerability index–color Doppler imaging, and 0.802 for the vulnerability index–contrast-enhanced ultrasonography, though no statistical significance was achieved. CONCLUSIONS: Symptomatic plaques had a higher degree of stenosis, lower gray-scale median values, and higher values of the Kanber vulnerability index using both color Doppler imaging and contrast-enhanced ultrasonography for plaque surface delineation. © 2019 American Society of Neuroradiology. All rights reserved. |
| Year | 2019 |
| Journal | American Journal of Neuroradiology |
| Journal citation | 40 (6), pp. 1022-1028 |
| Publisher | American Society of Neuroradiology |
| ISSN | 1936-959X |
| Digital Object Identifier (DOI) | https://doi.org/10.3174/ajnr.A6056 |
| Publication dates | |
| 03 Jun 2019 | |
| Online | 09 May 2019 |
| Publication process dates | |
| Accepted | 30 Mar 2019 |
| Deposited | 27 Nov 2019 |
| Accepted author manuscript | License All rights reserved File Access Level Restricted |
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Hooshmand, M, Zordan, D, Del Testa, D, Grisan, E and Rossi, M (2017). Boosting the Battery Life of Wearables for Health Monitoring Through the Compression of Biosignals. IEEE Internet of Things Journal. 4, pp. 1647-1662. https://doi.org/10.1109/JIOT.2017.2689164Detection of a slow-flow component in contrast-enhanced ultrasound of the synovia for the differential diagnosis of arthritis
Rizzo, G, Tonietto, M, Castellaro, M, Raffeiner, B, Coran, A, Fiocco, U, Stramare, R and Grisan, E (2017). Detection of a slow-flow component in contrast-enhanced ultrasound of the synovia for the differential diagnosis of arthritis. SPIE Medical Imaging. Orlando, FL, USA 11 - 16 Feb 2017 SPIE. https://doi.org/10.1117/12.2250818Improving the quantification of contrast enhanced ultrasound using a Bayesian approach
Rizzo, G, Tonietto, M, Castellaro, M, Raffeiner, B, Coran, A, Fiocco, U, Stramare, R and Grisan, E (2017). Improving the quantification of contrast enhanced ultrasound using a Bayesian approach. SPIE Medical Imaging. Orlando, FL , USA 16 2016 - 11 Feb 2017 SPIE. https://doi.org/10.1117/12.2250195Superpixel-based classification of gastric chromoendoscopy images
Boschetto, D and Grisan, E (2017). Superpixel-based classification of gastric chromoendoscopy images. SPIE Medical Imaging. Orlando, FL, USA 11 - 16 Feb 2017 SPIE. https://doi.org/10.1117/12.2254187Boosted learned kernels for data-driven vesselness measure
Grisan, E (2017). Boosted learned kernels for data-driven vesselness measure. Proceedings Volume 10137, Medical Imaging 2017: Biomedical Applications in Molecular, Structural, and Functional Imaging; 101370Z (2017). Orlando, FL, USA 11 - 16 Feb 2017 SPIE. https://doi.org/10.1117/12.2250370Cortical Thickness variability in Multiple Sclerosis: The role of lesion segmentation and filling
Palombit, A, Castellaro, M, Calabrese, M, Romualdi, C, Pizzini, FB, Montemezzi, S, Grisan, E and Bertoldo, A (2017). Cortical Thickness variability in Multiple Sclerosis: The role of lesion segmentation and filling. 2017 IEEE 14th International Symposium on Biomedical Imaging (ISBI 2017). Melbourne, VIC, Australia 18 - 21 Apr 2017 pp. 792-795 https://doi.org/10.1109/ISBI.2017.7950637From macro to nano: Linking quantitative CEUS perfusion parameters to CD4+ T cells subtypes in spondyloarthtitis
Grisan, E, Rizzo, G, Tonietto, M, Coran, A, Raffeiner, B, Scanu, A, Martini, V, Stramare, R and Fiocco, U (2017). From macro to nano: Linking quantitative CEUS perfusion parameters to CD4+ T cells subtypes in spondyloarthtitis. 2017 IEEE 14th International Symposium on Biomedical Imaging (ISBI 2017). Melbourne, VIC, Australia 17 - 21 Apr 2017 Institute of Electrical and Electronics Engineers (IEEE). pp. 899-902 https://doi.org/10.1109/ISBI.2017.7950661Grade and location of power doppler are predictive of damage progression in rheumatoid arthritis patients in clinical remission by anti-tumour necrosis factor α
Raffeiner, B, Grisan, E, Botsios, C, Stramare, R, Rizzo, G, Bernardi, L, Punzi, L, Ometto, F and Doria, A (2017). Grade and location of power doppler are predictive of damage progression in rheumatoid arthritis patients in clinical remission by anti-tumour necrosis factor α. Rheumatology (United Kingdom). 56, pp. 1320-1325. https://doi.org/10.1093/rheumatology/kex084