Pixel distribution analysis of B-mode ultrasound scan images predicts histologic features of atherosclerotic carotid plaques Brajesh K. Lal, MDa, Robert.

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Pixel distribution analysis of B-mode ultrasound scan images predicts histologic features of atherosclerotic carotid plaques Brajesh K. Lal, MDa, Robert W. Hobson, MDa, Peter J. Pappas, MDa, Richard Kubicka, MDa, Meera Hameed, MDb, Ellie Y. Chakhtura, MDa, Zafar Jamil, MDa, Frank T. Padberg, MDa, Paul B. Haser, MDa, Walter N. Durán, PhDa,c Journal of Vascular Surgery Volume 35, Issue 6, Pages 1210-1217 (June 2002) DOI: 10.1067/mva.2002.122888 Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 1 Pixel distribution analysis of B-mode ultrasound images predicts histologic features of atherosclerotic carotid plaques. B-mode DU scan shows subcutaneous fat (upper panel) and head of tibia (lower panel) in healthy control subject. Median grayscale intensity of selected tissue image was measured with histogram facility of Adobe Photoshop 6.0. Journal of Vascular Surgery 2002 35, 1210-1217DOI: (10.1067/mva.2002.122888) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 2 Pixel distribution analysis of B-mode ultrasound images predicts histologic features of atherosclerotic carotid plaques. PDA of symptomatic carotid plaque. A, Digitized B-mode DU scan image of carotid bifurcation with plaque outlined. B, PDA results. With computer imaging software, grayscale intensities of pixels in plaque image are counted, color-coded according to grayscale ranges for different tissues, and mapped onto plaque image. Red region identifies hemorrhage with grayscale range (0 to 4), yellow represents lipid (range, 8 to 26), green is fibrous and muscular tissue (ranges, 112 to 196 and 41 to 76), and blue is calcium (range, 211 to 255). L, Flow lumen of internal carotid artery. Journal of Vascular Surgery 2002 35, 1210-1217DOI: (10.1067/mva.2002.122888) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 3 Pixel distribution analysis of B-mode ultrasound images predicts histologic features of atherosclerotic carotid plaques. Pixel distribution analysis of asymptomatic carotid plaque. A, Digitized B-mode DU scan image of the carotid bifurcation with the plaque outlined. B, PDA results. Yellow represents lipid (pixel grayscale range, 8 to 26), green is fibrous and muscular tissue (ranges, 112 to 196 and 41 to 76), and blue is calcium (range, 211 to 255). L, Flow lumen of internal carotid artery. Journal of Vascular Surgery 2002 35, 1210-1217DOI: (10.1067/mva.2002.122888) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 4 Pixel distribution analysis of B-mode ultrasound images predicts histologic features of atherosclerotic carotid plaques. A, Section of internal carotid artery shows lipid core (C) located deep within plaque, separated from flow lumen (L) by several layers of fibrous tissue (F). B, Section of internal carotid artery shows plaque rupture with intraplaque hemorrhage (H). C, Image analysis of histology sections (see Methods section for details). Journal of Vascular Surgery 2002 35, 1210-1217DOI: (10.1067/mva.2002.122888) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 5 Pixel distribution analysis of B-mode ultrasound images predicts histologic features of atherosclerotic carotid plaques. PDA-derived measurements of individual tissue components (blood, fat, calcium, and fibromuscular tissue) correlated with histologic measurements made on explanted plaques. Journal of Vascular Surgery 2002 35, 1210-1217DOI: (10.1067/mva.2002.122888) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions