Abstract
To establish an objective method for evaluating the characteristics of carotid artery
lesions by B-mode ultrasonography, we compared the reproducibility of computer analysis
with that of visual evaluation. Using two different models of ultrasonograph, we evaluated
B-mode ultrasonographic images of 100 carotid artery lesions in a blinded fashion
by computer analysis and visual evaluation, two times at a 1-month interval. Another
35 lesions were simultaneously imaged by the two models of ultrasonograph and were
evaluated visually and by computer analysis to examine the correlation between results.
For visual evaluation, carotid artery lesions were divided into the following 3 types
based on texture and relative echogenicity as compared with that of adjacent muscle
tissue: heterogeneous, hypoechoic, and hyperechoic. For computer analysis, images
were computerized by means of a scanner (using Adobe Photoshop software). The echogenicity
of all pixels included in the lesion and adjacent areas of muscular tissue was measured,
and the lesion was classified into the following 3 types based on the shape of histograms
of echogenicity: mixed- echoic (M), hyperechoic (H), and lucent (L). The reproducibility
of the results derived by computer analysis had a significantly higher coincidence
coefficient (κ = 0.89) than those derived by visual evaluation (κ =0.68). The coincidence
coefficient (κ) of the same lesions depicted by two different models of equipment
was 0.77 for computer analysis as compared with only 0.32 for visual evaluation. These
findings indicate that computer analysis of histogram shape and lesion echogenicity
can improve intra-sonographer and inter-equipment reproducibility in the evaluation
of lesion echogenicity and texture. Copyright © 2003 by National Stroke Association
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Stroke and Cerebrovascular DiseasesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Morphological characterization of carotid artery stenoses by ultrasound duplex scanning.Ultrasound Med Biol. 1990; 16: 349-354
- Ultrasonic carotid artery plaque structure and the risk of cerebral infarction on computed tomography.J Vasc Surg. 1994; 20: 263-266
- Histologic characteristics of carotid artery plaque.J Vasc Surg. 1991; 13: 719-724
- Validity of B-mode ultrasonographic findings in patients undergoing carotid endarterectomy in comparison with angiographic and clinicopathologic features.Stroke. 1996; 27: 700-705
- Carotid plaque histology using real-time ultrasonography: Clinical and therapeutic implications.Am J Surg. 1983; 146: 188-193
- Correlation of B-mode ultrasound imaging and arteriography with pathologic findings at carotid endarterectomy.Arch Surg. 1985; 120: 443-449
- Characterisation of carotid artery: Comparison of duplex scanning with histology.Ultrasound Med Biol. 1985; 11: 835-840
- Carotid artery atheroma: Comparison of preoperative B-mode ultrasound appearance with carotid endarterectomy specimen pathology.J Cardiovasc Surg. 1988; 29: 676-681
- Tissue characterization of atheromatous plaques: Correlation between ultrasound image and histological findings.J Clin Ultrasound. 1990; 18: 611-617
- Carotid artery plaque composition -Relationship to clinical presentation and ultrasound B-mode imaging.Eur J Vasc Endovasc Surg. 1995; 10: 23-30
- What pathological components indicate carotid athemma activity and can these be identified reliably using ultrasound?.Eur J Ultrasound. 2000; 11: 77-86
- Ultrasonographic characterization of carotid plaques.Ultrasound Med Biol. 1998; 24: 489-493
- Reproducibility of computer-quantified carotid plaque echogenicity: Can we overcome the subjectivity?.Stroke. 2000; 31: 2189-2196
- Interrater reliability for clinical diagnoses of extracranial carotid plaques using B-mode ultrasonography (abstract in English).Zasshi Tokyo Ika Daigaku (Japan). 1995; 53: 637-643
- Carotid plaque characterization by duplex scanning: observer error may undetermine currem clinical trials.Stroke. 1999; 30: 61-65
- Consensus concerning the morphology and the risk of carotid plaques.Cerebrovasc Dis. 1997; 7: 289-296
- Reproducibility in ultrasonic characterization of carotid plaques.Cerebrovasc Dis. 1998; 8: 273-277
- Computer-assisted carotid plaque characterisation.Eur J Vasc Endovasc Surg. 1995; 9: 389-393
- An objective characterization of athemsclemtic lesion: An altemative method to identify unstable plaque.Stroke. 2000; 31: 1921-1934
- The identification of the high risk carotid plaque.Eur J Vasc Endovasc Surg. 1996; 11: 470-478
- Ultrasound densitometric analysis of carotid plaque composition: pathoanatomic correlation.Stroke. 1996; 27: 2173-2177
- Quantitative analysis of ultrasound B-mode images of carotid atherosclerotic plaque: Correlation with visual classification and histological examination.IEEE Trans Med Imaging. 1998; 17: 910-922
- Computer analysis of ultrasonic plaque echolucency in identifying high risk carotid bifurcation lesions.Eur J Vasc Endovasc Surg. 1999; 17: 476-479
- The effect of B-mode ultrasonic image standardisation on the echodensity of symptomatic and asymptomatic carotid bifurcation plaques.Int Angiol. 1998; 17: 179-186
- Comparability of the ultrasonic tissue characteristics of carotid plaques.J Ultrasound Med. 2000; 19: 399-407
- Comparison of computer-analyzed B-mode ultrasonographic images of carotid lesions with histology of endarterectomy specimen (abstract in English).Neurosonology. 2002; 15: 70-75
Article info
Publication history
Accepted:
December 19,
2002
Received:
October 11,
2002
Footnotes
*All funds for this study were obtained from the author's department.
**Address reprint requests to Toshihiko Iwamoto, MD, Department of Geriatric Medicine, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 106-0023, Japan. E-mail: [email protected]
★1052-3057/03/1202-0001$30.00/0
Identification
Copyright
© 2003 National Stroke Association. Published by Elsevier Inc. All rights reserved.
