(Circulation. 2000;102:766.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
Quantitative Ultrasonic Tissue Characterization Can Identify High-Risk Atherosclerotic Alteration in Human Carotid Arteries
From the Department of Geriatric Medicine (S.T., H.R., Y.Y., K.M., A.O., J.H., T.O.), Division of Legal Medicine (K.H.), Department of Internal Medicine and Therapeutics (T.M.), and Department of Surgery, Course of Interventional Medicine (N.H.), Osaka University Graduate School of Medicine, Suita, Japan; and Division of Cardiology (H.I., K.S.), Sakurabashi Watanabe Hospital, Osaka, Japan.
Correspondence to Jitsuo Higaki, MD, Department of Geriatric Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan. E-mail higaki{at}geriat.med.osaka-u.ac.jp
Background—Recently, ultrasonic tissue characterization of the composition of plaques has been performed in a quantitative fashion on the basis of integrated backscatter (IBS) analysis, but most of those studies have used high-frequency ultrasound to obtain microscopic images.
Methods and Results—We performed B-mode measurement and IBS
signal analysis with acoustic densitometry with a 7.5-MHz
linear-array transducer in freshly excised human aortas (n=58) (normal,
atheromatous, and fibrous tissue) obtained at autopsy.
Atheromatous and fibrous tissue had a similar
intima-media thickness (IMT), but the IBS value in
atheromatous specimens was lower than that in fibrous
specimens. We further applied this method to human carotid
ultrasonography. The subjects were young (80 regions), middle aged with
1 or no coronary risk factors (low risk) (120 regions), middle
aged with 
2 coronary risk factors (high risk) (240 regions),
or elderly (80 regions) or were patients with myocardial infarction
(MI) with multivessel disease (90 regions). The IMT was similar in
middle-aged, elderly, and MI subjects. In contrast, the IBS value was
significantly higher in elderly subjects and lower in high-risk
middle-aged and MI subjects compared with that in low-risk middle-aged
subjects. The percent of regions diagnosed as
atheromatous (IBS less than mean minus 2-SD
value of IBS in young subjects) was 11% in low-risk middle-aged
subjects, 29% in high-risk middle-aged subjects, and 63% in the MI
group.
Conclusions—In conjunction with conventional B-mode imaging, IBS analysis with carotid ultrasonography appeared to provide prognostic information to identify a high-risk group with systemic atherosclerosis, which could lead to coronary heart disease in individuals with early-stage disease.
Key Words: atherosclerosis • ultrasonics • plaque • arteries • myocardial infarction
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