Calcified plaque cross-sectional area in human arteries: Correlation between intravascular ultrasound and undecalcified histology☆,☆☆
Section snippets
Harvesting and imaging
Ten human atherosclerotic arterial segments (5 coronary, 5 iliac) from 6 cadavers (2 male, 4 female) ranging in age from 42 to 73 years (mean age 57.5 ± 12.9 years) were obtained from the Orange County Coroner’s Office and stored in formaldehyde until IVUS imaging. Although formaldehyde alters tissue characterization somewhat, calcium is such a strong reflector that recognition of calcium is not affected on the IVUS image. An acoustic reference was provided by 2 surgical needles placed through
Results
Twenty-four arterial cross sections were chosen for comparison with the IVUS images. These sections were chosen because they had homogeneous calcified plaques. In these 24 sections, there were 38 separate calcified plaques identified on histology. From the IVUS images, the independent observer correctly identified 34 of the 38 calcified lesions, for a sensitivity of 89%. The specificity in this cohort was 97%. A representative example of an IVUS image and the corresponding undecalcified
Discussion
This comparison study between histologic cross sections of human atherosclerotic arteries and IVUS images confirms the previously reported high sensitivity and specificity for the identification of calcified plaque by IVUS.3, 8, 9, 11, 12, 13 The unique feature of the current study is that GMA was used for the histologic preparation, which is a technique that does not require decalcification of the tissue. Embedding the arteries in this plastic produces durable cross-sectional cuts without
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Reprint requests: Jonathan M. Tobis, MD, UCI Medical Center, Division of Cardiology, 101 The City Dr, Bldg 53, Room 100, Orange, CA 92868-3298.
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