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このアイテムの引用には次の識別子を使用してください: http://hdl.handle.net/10564/4236

タイトル: Neovascularization From the Carotid Artery Lumen Into the Carotid Plaque Confirmed by Contrast-Enhanced Ultrasound and Histology
その他のタイトル: 血管内腔側から流入する頚動脈プラーク内新生血管の造影超音波及び病理学的検討
著者: Uchihara, Yuto
Saito, Kozue
Motoyama, Rie
Ishibashi-Ueda, Hatsue
Yamaguchi, Eriko
Hatakeyama, Kinta
Tanaka, Akito
Kataoka, Hiroharu
Iihara, Koji
Sugie, Kazuma
Koga, Masatoshi
Toyoda, Kazunori
Nagatsuka, Kazuyuki
Ihara, Masafumi
キーワード: Atherosclerosis
Neovascularization
Contrast-enhancedultrasound
発行日: 2023年8月
出版者: Elsevier Inc.
引用: Ultrasound in Medicine & Biology. 2023 Aug, vol.49, No.8, p.1798-1803
抄録: Objective: This study was aimed at assessing intraplaque neovessels, focusing on neovascularization from the vascular luminal side using contrast-enhanced ultrasound (CEUS) and determining that this contrast effect indicates that the neovessel is connected to the vessel lumen histopathologically. Whether plaque vulnerability can be assessed more accurately was also investigated. Methods: We enrolled consecutive patients with internal carotid artery stenosis who underwent carotid endarterectomy (CEA) and pre-operative CEUS with perflubutane of the carotid arteries. We graded the contrast effect semi-quantitatively from the vascular luminal and adventitial sides. We compared the contrast effect with the pathological findings, especially the neovascularization of the CEA specimens. Results: In total, 68 carotid arterial atheromatous plaques (47 symptomatic) were analyzed. Symptomatic plaques were significantly correlated with stronger contrast effects from the luminal side than from the adventitial side (p = 0.0095). Microbubbles from the luminal side appeared to flow mainly into the plaque shoulder. The contrast effect value for the plaque shoulder and neovessel density were significantly correlated (ρ = 0.35, p = 0.031). Neovessel density was significantly higher in symptomatic than in asymptomatic plaques (56.2 ± 43.7/mm2 and 18.1 ± 15.2/mm2, respectively, p < 0.0001). Serial histological sections of CEA specimens in a symptomatic plaque with a strong contrast effect from the luminal side revealed multiple neovessels fenestrated to the vessel lumen with endothelial cells, consistent with the CEUS findings. Conclusion: Contrast-enhanced ultrasound can be used to evaluate neovessels originating from the luminal side, histopathologically confirmed in serial sections. Symptomatic vulnerable plaque is correlated more significantly with intraplaque neovascularization from the luminal side than with neovascularization from the adventitia.
内容記述: 権利情報:© 2023 Published by Elsevier Inc. on behalf of World Federation for Ultrasound in Medicine & Biology.
URI: http://hdl.handle.net/10564/4236
DOI: https://doi.org/10.1016/j.ultrasmedbio.2023.04.002
学位授与番号: 24601甲第892号
学位授与年月日: 2023-12-22
学位名: 博士(医学)
学位授与機関: 奈良県立医科大学
出現コレクション:2023年度

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02甲892本文の要旨.pdf甲892本文の要旨87.26 kBAdobe PDF見る/開く
03甲892審査要旨.pdf甲892審査要旨213.66 kBAdobe PDF見る/開く
04甲892Figure.pdf甲892Figure377.41 kBAdobe PDF見る/開く
05甲892Supplementary Figure.pdf甲892Supplementary Figure338.9 kBAdobe PDF見る/開く
06甲892Table.pdf甲892Table67.94 kBAdobe PDF見る/開く

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