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Noninvasive quantitative tissue characterization and two-dimensional color-coded map of human atherosclerotic lesions using ultrasound integrated backscatter

Comparison between histology and integrated backscatter images

^a Second Department of Internal Medicine, Gifu University School of Medicine, Gifu, Japan

View larger version (76K): [in a new window]   Figure 1 Conventional ultrasound image and integrated backscatter (IB) image from the carotid artery at the same lesion. (A) Note that the intima and media are anatomically separated using conventional ultrasound imaging, as shown by the arrow. (B) Integrated backscatter values are measured at the region of interest placed in the plaque, as shown by a square, using the IB image. (C) Anterior arterial wall with an angle span of 120° between –60° and +60° were excluded from the IB evaluation because of the erratic diffraction phenomena and the influence of angle dependency. That is, the evaluation of IB values of the arterial wall was performed in the posterior wall with the exception of the anterior wall. Also, IB values of arterial lumen were measured just above posterior wall as shown by *. 2DE = two-dimensional echo.

View larger version (16K): [in a new window]   Figure 2 Corrected integrated backscatter (IB) values of various tissue types. In each of the ex vivo and in vivo studies, the corrected IB values from calcification (CL), mixed lesion (ML), fibrosis (FI), thrombus (TH) and lipid pool (LP), intimal hyperplasia (IH) or media show significant differences from each other. However, there are no significant differences among LP, IH and media. dB = decibels.

View larger version (56K): [in a new window]   Figure 3 Color-coded maps of the femoral arterial wall constructed from integrated backscatter (IB) + conventional two-dimensional (2D) echo findings obtained during life based on the five categories of tissue characterization. (Upper) large plaque (arrow). (A1) An IB image at autopsy. (A2) A color-coded map constructed from A1, based on the five IB categories and conventional 2D echo findings. (A3) A histologic finding stained with elastic van Gieson of the same segment as the IB measurement (bar = 1 mm). Note that the color-coded map accurately reflects histology. (Middle) intimal fibrosis (arrow). (B1) An IB image during life. (B2) A color-coded map constructed from B1, based on the five IB categories and conventional 2D echo. (B3) A histologic finding stained with Masson’s trichrome of the same segment as the IB measurement (bar = 1 mm). Note that the color-coded map accurately reflects histology. (Lower) intimal hyperplasia consisting of smooth muscle cells (arrow). (C1) An integrated backscatter image during life. (C2) A color-coded map constructed from C1, based on the five IB categories and conventional 2D echo. (C3) A histologic finding stained with Masson’s trichrome of the same segment as the IB measurement (bar = 1 mm). Note that the color-coded map accurately reflects histology.