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Atherosclerotic Calcification Detection: A Comparative Study of Carotid Ultrasound and Cone Beam CT.

Jashari F, Ibrahimi P, Johansson E, Ahlqvist J, Arnerlöv C, Garoff M, Jäghagen EL, Wester P, Henein MY - Int J Mol Sci (2015)

Bottom Line: Plaques with high echogenic nodules and posterior shadowing were considered calcified.Carotid artery calcification by the two imaging techniques was compared using conventional correlations.Further development of ultrasound techniques should allow better detection of early arterial calcification.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden. fisnik.jashari@medicin.umu.se.

ABSTRACT

Background and aim: Arterial calcification is often detected on ultrasound examination but its diagnostic accuracy is not well validated. The aim of this study was to determine the accuracy of carotid ultrasound B mode findings in detecting atherosclerotic calcification quantified by cone beam computed tomography (CBCT).

Methods: We analyzed 94 carotid arteries, from 88 patients (mean age 70 ± 7 years, 33% females), who underwent pre-endarterectomy ultrasound examination. Plaques with high echogenic nodules and posterior shadowing were considered calcified. After surgery, the excised plaques were examined using CBCT, from which the calcification volume (mm3) was calculated. In cases with multiple calcifications the largest calcification nodule volume was used to represent the plaque. Carotid artery calcification by the two imaging techniques was compared using conventional correlations.

Results: Carotid ultrasound was highly accurate in detecting the presence of calcification; with a sensitivity of 88.2%. Based on the quartile ranges of calcification volumes measured by CBCT we have divided plaque calcification into four groups: <8; 8-35; 36-70 and >70 mm3. Calcification volumes ≥8 were accurately detectable by ultrasound with a sensitivity of 96%. Of the 21 plaques with <8 mm3 calcification volume; only 13 were detected by ultrasound; resulting in a sensitivity of 62%. There was no difference in the volume of calcification between symptomatic and asymptomatic patients.

Conclusion: Carotid ultrasound is highly accurate in detecting the presence of calcified atherosclerotic lesions of volume ≥8 mm3; but less accurate in detecting smaller volume calcified plaques. Further development of ultrasound techniques should allow better detection of early arterial calcification.

No MeSH data available.


Related in: MedlinePlus

Flowchart of the work process of the study, starting with preoperative ultrasound examination, Cone Beam Computed Tomography (CBCT) evaluation of the carotid specimens removed after carotid endarterectomy (CEA) to images reconstruction and data analysis. Red arrow: hyperechoic spot with posterior shadowing (calcification) on ultrasound. White arrow: calcification on CBCT image.
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ijms-16-19978-f002: Flowchart of the work process of the study, starting with preoperative ultrasound examination, Cone Beam Computed Tomography (CBCT) evaluation of the carotid specimens removed after carotid endarterectomy (CEA) to images reconstruction and data analysis. Red arrow: hyperechoic spot with posterior shadowing (calcification) on ultrasound. White arrow: calcification on CBCT image.

Mentions: Two observers blinded to the CBCT results of the excised plaques reviewed all stored US images. A plaque was defined as calcified if there was a hyperechogenic spot with posterior shadowing (Figure 2). Where there was disagreement between the two observers (n = 2), the examination was re-evaluated by both observers and consensus was reached.


Atherosclerotic Calcification Detection: A Comparative Study of Carotid Ultrasound and Cone Beam CT.

Jashari F, Ibrahimi P, Johansson E, Ahlqvist J, Arnerlöv C, Garoff M, Jäghagen EL, Wester P, Henein MY - Int J Mol Sci (2015)

Flowchart of the work process of the study, starting with preoperative ultrasound examination, Cone Beam Computed Tomography (CBCT) evaluation of the carotid specimens removed after carotid endarterectomy (CEA) to images reconstruction and data analysis. Red arrow: hyperechoic spot with posterior shadowing (calcification) on ultrasound. White arrow: calcification on CBCT image.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4581335&req=5

ijms-16-19978-f002: Flowchart of the work process of the study, starting with preoperative ultrasound examination, Cone Beam Computed Tomography (CBCT) evaluation of the carotid specimens removed after carotid endarterectomy (CEA) to images reconstruction and data analysis. Red arrow: hyperechoic spot with posterior shadowing (calcification) on ultrasound. White arrow: calcification on CBCT image.
Mentions: Two observers blinded to the CBCT results of the excised plaques reviewed all stored US images. A plaque was defined as calcified if there was a hyperechogenic spot with posterior shadowing (Figure 2). Where there was disagreement between the two observers (n = 2), the examination was re-evaluated by both observers and consensus was reached.

Bottom Line: Plaques with high echogenic nodules and posterior shadowing were considered calcified.Carotid artery calcification by the two imaging techniques was compared using conventional correlations.Further development of ultrasound techniques should allow better detection of early arterial calcification.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden. fisnik.jashari@medicin.umu.se.

ABSTRACT

Background and aim: Arterial calcification is often detected on ultrasound examination but its diagnostic accuracy is not well validated. The aim of this study was to determine the accuracy of carotid ultrasound B mode findings in detecting atherosclerotic calcification quantified by cone beam computed tomography (CBCT).

Methods: We analyzed 94 carotid arteries, from 88 patients (mean age 70 ± 7 years, 33% females), who underwent pre-endarterectomy ultrasound examination. Plaques with high echogenic nodules and posterior shadowing were considered calcified. After surgery, the excised plaques were examined using CBCT, from which the calcification volume (mm3) was calculated. In cases with multiple calcifications the largest calcification nodule volume was used to represent the plaque. Carotid artery calcification by the two imaging techniques was compared using conventional correlations.

Results: Carotid ultrasound was highly accurate in detecting the presence of calcification; with a sensitivity of 88.2%. Based on the quartile ranges of calcification volumes measured by CBCT we have divided plaque calcification into four groups: <8; 8-35; 36-70 and >70 mm3. Calcification volumes ≥8 were accurately detectable by ultrasound with a sensitivity of 96%. Of the 21 plaques with <8 mm3 calcification volume; only 13 were detected by ultrasound; resulting in a sensitivity of 62%. There was no difference in the volume of calcification between symptomatic and asymptomatic patients.

Conclusion: Carotid ultrasound is highly accurate in detecting the presence of calcified atherosclerotic lesions of volume ≥8 mm3; but less accurate in detecting smaller volume calcified plaques. Further development of ultrasound techniques should allow better detection of early arterial calcification.

No MeSH data available.


Related in: MedlinePlus