Phase-Contrast CT: Qualitative and Quantitative Evaluation of Atherosclerotic Carotid Artery Plaque

医学 组内相关 纤维帽 离体 放射科 核医学 对比度(视觉) 再现性 易损斑块 颈动脉 断层摄影术 病理 体内 内科学 生物 统计 临床心理学 生物技术 人工智能 心理测量学 计算机科学 数学
作者
Holger Hetterich,Marian Willner,Sandra Fill,Julia Herzen,Fabian Bamberg,Alexander Hipp,Ulrich Schüller,Silvia Adam-Neumair,Stéfan Wirth,Maximilian Reiser,Franz Pfeiffer,Tobias Saam
出处
期刊:Radiology 卷期号:271 (3): 870-878 被引量:62
标识
DOI:10.1148/radiol.14131554
摘要

To evaluate the potential of phase-contrast computed tomography (CT) for atherosclerotic plaque imaging in human carotid arteries in an experimental ex vivo study.The study was approved by the institutional review board, and informed consent was obtained from the patients' relatives. Seven postmortem human carotid artery specimens were imaged at a laboratory setup by using a conventional x-ray tube and grating interferometer. After histologic processing, phase-contrast imaging and histopathologic data were matched. Characteristics of the necrotic core (NC) covered by a fibrous cap (FC), intraplaque hemorrhage (IPH), and calcifications (CAs) were established, and sensitivity, specificity, and accuracy of phase-contrast CT for plaque detection and the potential for accurate quantification were assessed. The Cohen κ and Pearson correlation coefficient R were used to determine the agreement between phase-contrast imaging and histopathologic findings for plaque characterization and correlation of quantitative plaque measurements, respectively. A difference with a P value of less than .05 was considered significant.Characteristic criteria were found in all analyzed plaque components. Applying these criteria, phase-contrast CT had a good sensitivity for the detection of the FC and NC, IPH, and CAs (all, >80%) and excellent specificity and accuracy (all, >90%), with good interreader agreement (κ ≥ 0.72, P < .0001). There were excellent correlations for quantitative measurements of FC, NC, and CAs between phase-contrast imaging and histopathologic findings (R ≥ 0.92). Interreader reproducibility was excellent, with an intraclass correlation coefficient of 0.98 or higher for all measurements.The results of this study indicate that ex vivo phase-contrast CT can help identify and quantify atherosclerotic plaque components, with excellent correlation to histopathologic findings. Although not yet applicable in vivo, phase-contrast CT may become a valuable tool to monitor atherosclerotic disease process noninvasively.
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