Visualization of the carotid body in situ in fixed human carotid bifurcations using a xylene-based tissue clearing method

The anatomy of the carotid body (CB) and its nerve supply are important, because it is a potential therapeutic target for treatment of various clinical conditions. Visualization of the CB in situ in fixed human anatomical specimens is hampered by obscuring adipose and connective tissues. We developed a tissue clearing method to optimize identification of the CB. We used single sided carotid bifurcations of six human cadavers fixed long term. Visualization of the CB was accomplished by clearing tissue with xylene. Under incident light, carotid bifurcations exhibited a less transparent, darker colored CB; hematoxylin and eosin stained paraffin sections confirmed its identity. Our visualization of the CB in situ in human carotid bifurcations fixed long term enabled targeted resection and subsequent topographic and morphometric measurements of the CB. Our procedure does not interfere with immunohistochemical staining of sections prepared from such specimens

Histopathological characterization of intimal lesions and arterial wall calcification in the arteries of the leg of elderly cadavers

Introduction: Although arteries of the leg have been studied in extensively diseased amputation specimens, little is known about the composition of vascular lesions present in the general population. The aim of this study was to describe the natural development of adaptive intimal thickening, atherosclerotic lesion development and vascular calcification in the leg of a general elderly population. Materials and Methods: Two hundred and seventy postmortem samples from the popliteal and posterior tibial arteries of 14 elderly cadavers were studied histologically. Results: Atherosclerotic lesions were more frequently observed in the popliteal (60%) than in the posterior tibial artery (34%; p <.0005). These atherosclerotic plaques were most often nonatheromatous (80% and 83% for popliteal and posterior tibial plaques, respectively). The atheroma's that were present were small (most <25% of plaque area). Atherosclerotic plaque calcification was observed more often in the popliteal (39%) than in the posterior tibial samples (17%; p <.0005). Medial arterial calcification was observed more often in the posterior tibial (62%) than in the popliteal samples (46%; p =.008). Plaque calcification and medial arterial calcification were not associated with lumen stenosis. Conclusions: In the leg of elderly cadavers, the presence of atherosclerotic plaque and intimal calcification decreases from the proximal popliteal artery to the more distal posterior tibial artery and most atherosclerotic lesions are of the fibrous nonatheromatous type. In contrast, the presence and severity of medial calcification increases from proximal to distal

Computed Tomographic Distinction of Intimal and Medial Calcification in the Intracranial Internal Carotid Artery

BACKGROUND: Intracranial internal carotid artery (iICA) calcification is associated with stroke and is often seen as a proxy of atherosclerosis of the intima. However, it was recently shown that these calcifications are predominantly located in the tunica media and internal elastic lamina (medial calcification). Intimal and medial calcifications are thought to have a different pathogenesis and clinical consequences and can only be distinguished through ex vivo histological analysis. Therefore, our aim was to develop CT scoring method to distinguish intimal and medial iICA calcification in vivo. METHODS: First, in both iICAs of 16 cerebral autopsy patients the intimal and/or medial calcification area was histologically assessed (142 slides). Brain CT images of these patients were matched to the corresponding histological slides to develop a CT score that determines intimal or medial calcification dominance. Second, performance of the CT score was assessed in these 16 patients. Third, reproducibility was tested in a separate cohort. RESULTS: First, CT features of the score were circularity (absent, dot(s), <90°, 90-270° or 270-360°), thickness (absent, ≥1.5mm, or <1.5mm), and morphology (indistinguishable, irregular/patchy or continuous). A high sum of features represented medial and a lower sum intimal calcifications. Second, in the 16 patients the concordance between the CT score and the dominant calcification type was reasonable. Third, the score showed good reproducibility (kappa: 0.72 proportion of agreement: 0.82) between the categories intimal, medial or absent/indistinguishable. CONCLUSIONS: The developed CT score shows good reproducibility and can differentiate reasonably well between intimal and medial calcification dominance in the iICA, allowing for further (epidemiological) studies on iICA calcification

Computed Tomographic Distinction of Intimal and Medial Calcification in the Intracranial Internal Carotid Artery

BACKGROUND: Intracranial internal carotid artery (iICA) calcification is associated with stroke and is often seen as a proxy of atherosclerosis of the intima. However, it was recently shown that these calcifications are predominantly located in the tunica media and internal elastic lamina (medial calcification). Intimal and medial calcifications are thought to have a different pathogenesis and clinical consequences and can only be distinguished through ex vivo histological analysis. Therefore, our aim was to develop CT scoring method to distinguish intimal and medial iICA calcification in vivo. METHODS: First, in both iICAs of 16 cerebral autopsy patients the intimal and/or medial calcification area was histologically assessed (142 slides). Brain CT images of these patients were matched to the corresponding histological slides to develop a CT score that determines intimal or medial calcification dominance. Second, performance of the CT score was assessed in these 16 patients. Third, reproducibility was tested in a separate cohort. RESULTS: First, CT features of the score were circularity (absent, dot(s), <90°, 90-270° or 270-360°), thickness (absent, ≥1.5mm, or <1.5mm), and morphology (indistinguishable, irregular/patchy or continuous). A high sum of features represented medial and a lower sum intimal calcifications. Second, in the 16 patients the concordance between the CT score and the dominant calcification type was reasonable. Third, the score showed good reproducibility (kappa: 0.72 proportion of agreement: 0.82) between the categories intimal, medial or absent/indistinguishable. CONCLUSIONS: The developed CT score shows good reproducibility and can differentiate reasonably well between intimal and medial calcification dominance in the iICA, allowing for further (epidemiological) studies on iICA calcification

Intracranial internal carotid artery calcification (iICA) score with Circularity (Dot, <90°, 90–270° and 270–360°); Thickness (Thick ≥ 1.5mm and Thin < 1.5mm) and Morphology (Indistinguishable, Irregular, Continuous).

<p>Calcifications are highlighted (light blue). In these examples all images are in the axial viewing plane except for the <90° and 90–270° images which are in the coronal plane.</p

Reproducibility of the calcification score.

<p>Reproducibility of the calcification score.</p

Internal elastic lamina calcification in the intracranial internal carotid artery (iICA) on a coronal brain CT image (left) and on a histological slide (right).

<p>On CT a blue circle is placed around the iICA. Calcification area of the internal elastic lamina is indicated by the black line. Reprinted from A. Vos et al. Stroke. 2016;47:221–223 (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0168360#pone.0168360.g001" target="_blank">Fig 1A</a>) under a CC BY license, with permission of the American Heart Association, original copyright 2016 American Heart Association.</p

Intimal calcification in the intracranial internal carotid artery (iICA) on a coronal brain CT image (left) and on a histological slide (right).

<p>On CT a blue circle is placed around the iICA. In histology the intimal calcification area is light blue and the calcification area of the internal elastic lamina indicated by the black line.</p

Performance of the calcification score in the intracranial internal carotid artery.

<p>Performance of the calcification score in the intracranial internal carotid artery.</p

Intracranial internal carotid artery calcification score for unenhanced CT.

<p>Intracranial internal carotid artery calcification score for unenhanced CT.</p