Asymptomatic Carotid Disease-A New Tool for Assessing Neurological Risk.
Active carotid plaques are associated with atheroembolism and neurological events; its identification is crucial for stroke prevention. High-definition ultrasound ( HDU) can be used to recognize plaque structure in carotid bifurcation stenosis associated with plaque vulnerability and occurrence of b...
| Published in: | Echocardiography Vol. 31; no. 3; pp. 353 - 362 |
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| Main Authors: | , , , , |
| Format: | diagnostic images equations & formulas pictorial research tables/charts Journal Article |
| Published: |
Wiley-Blackwell
Mar2014
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104040103&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104040103 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07422822 GSE jtl: Echocardiography issn: 07422822 maglogo: Y pubinfo: dt: Mar2014 vid: 31 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 104040103 94801900 10.1111/echo.12348 NLM24117920 104040103 ppf: 353 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Asymptomatic Carotid Disease-A New Tool for Assessing Neurological Risk. aug: au: Pedro, Luís M. Sanches, J. Miguel Seabra, José Suri, Jasjit S. Fernandes e Fernandes, José affil: Faculty of Medicine, Lisbon Academic Medical Centre, University of Lisbon and Lisbon Cardiovascular Institute sug: subj: Carotid Stenosis Diagnosis Atherosclerosis Classification Ultrasonography Methods Diagnosis, Computer Assisted Stroke Risk Factors Risk Assessment Methods Human Descriptive Statistics ROC Curve Prospective Studies Cross Sectional Studies Portugal Academic Medical Centers Female Male Aged Confidence Intervals Aged: 65+ years Female Male ab: Active carotid plaques are associated with atheroembolism and neurological events; its identification is crucial for stroke prevention. High-definition ultrasound ( HDU) can be used to recognize plaque structure in carotid bifurcation stenosis associated with plaque vulnerability and occurrence of brain ischemic events. A new computer-assisted HDU method to study the echomorphology of the carotid plaque and to determine a risk score for developing appropriate symptoms is proposed in this study. Plaque echomorphology characteristics such as presence of ulceration at the plaque surface, juxta-luminal location of echolucent areas, echoheterogeneity were obtained from B-mode ultrasound scans using several image processing algorithms and were combined with measurement of severity of stenosis to obtain a clinical score-enhanced activity index ( EAI)-which was correlated with the presence or absence of ipsilateral appropriate ischemic symptoms. An optimal cutoff value of EAI was determined to obtain the best separation between symptomatic (active) from asymptomatic (inactive) plaques and its diagnostic yield was compared to other 2 reference methods by means of receiver-operating characteristic (ROC) analysis. Classification performance was evaluated by leave-one-patient-out cross-validation applied to a cohort of 146 carotid plaques from 99 patients. The proposed method was benchmarked against (a) degree of stenosis criteria and (b) earlier proposed activity index (AI) and demonstrated that EAI yielded the highest accuracy up to an accuracy of 77% to predict asymptomatic plaques that developed symptoms in a prospective cross-sectional study. Enhanced activity index is a noninvasive, easy to obtain parameter, which provided accurate estimation of neurological risk of carotid plaques. pubtype: Academic Journal doctype: diagnostic images equations & formulas pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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