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. 2001 May;85(5):567–570. doi: 10.1136/heart.85.5.567

Correlation between high frequency intravascular ultrasound and histomorphology in human coronary arteries

F Prati 1, E Arbustini 1, A Labellarte 1, B Dal 1, L Sommariva 1, M Mallus 1, A Pagano 1, A Boccanelli 1
PMCID: PMC1729712  PMID: 11303012

Abstract

OBJECTIVE—To test the efficacy of high frequency intravascular ultrasound (IVUS) transducers in identifying lipid/necrotic pools in atherosclerotic plaques.
METHODS—40 MHz transducers were used for in vitro IVUS assessment of 12 arterial segments (10 coronary and two carotid arteries, dissected from five different necropsy cases). IVUS acquisition was performed at 0.5 mm/s after ligature of the branching points to generate a closed system. Lipid/necrotic areas were defined by IVUS as large echolucent intraplaque areas surrounded by tissue with higher echodensity. To obtain histopathological sections corresponding to IVUS cross sections, vessels were divided into consecutive 3 mm long segments using the most distal recorded IVUS image as the starting reference. Samples were then fixed with 10% buffered formalin, processed for histopathological study, serially cut, and stained using the Movat pentacrome method.
RESULTS—122 sections were analysed. Lipid pools were observed by histology in 30 sections (25%). IVUS revealed the presence of lipid pools in 19 of these sections (16%; sensitivity 65%, specificity 95%).
CONCLUSIONS—In vitro assessment of lipid/necrotic pools with high frequency transducers was achieved with good accuracy. This opens new perspectives for future IVUS characterisation of atherosclerotic plaques.


Keywords: intracoronary ultrasound; atherosclerosis; plaque morphology

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Figure 1  .

Figure 1  

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Photomicrograph of histological and corresponding IVUS cross sections in the left anterior descending coronary artery. Left panel: at 5 o'clock, there is a superficial calcific deposit adjacent to the emergence of a diagonal branch (black arrowhead) and a lipid pool deeply embedded in the atherosclerotic plaque (white arrowhead). Right panel: in the corresponding IVUS cross section the lipid pool cannot be identified because of echo signal attenuation caused by the presence of highly echogenic superficial fibrous tissue (arrowhead).  

Figure 2  .

Figure 2  

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Photomicrograph of a histological section from the left circumflex coronary artery (left panel) and the corresponding ultrasound imaging (right panel). The histological section shows a lipid/necrotic area restricted to the 8 and 10 o'clock positions (arrows). IVUS confirms the presence of the lipid/necrotic pool at 7 o'clock, where an echolucent lake is visible (arrow). At the 7-10 o'clock position, IVUS is not capable of revealing the lipid content owing to its diffuse distribution within the atherosclerotic plaque (arrowhead).

Figure 3  .

Figure 3  

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Photomicrograph of a histological section from the left anterior descending coronary artery (left panel) and the corresponding ultrasound imaging (right panel). A lipid/necrotic core (arrowhead), with a calcific deposit (arrow) deeply embedded in the atherosclerotic plaque, is visible at 5-6 o'clock. IVUS shows a corresponding echogenic area indicative of lipid core (arrowhead) with microcalcification (bright deposit identified by the arrow).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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