Tissue Characterization

  • Eugenio Picano


Echocardiography shares the same principles present in nature in the sonar of bats and dolphins. These animals send out an ultrasonic signal and — based on the arrival time of the reflected ultrasound wave — can detect reflecting structures, locate them in space, and perceive their form and motion. However, animal sonar has a greater potential than is dreamt of in commercially available instruments, since bats and dolphins can differentiate edible from inedible reflecting structures [1]. From the captured echo, they extract information on the internal composition of the target. In the same way, the underlying hypothesis in tissue characterization studies is that a different biochemical structure or internal architectural arrangement of normal versus diseased tissue can affect the physical properties of the tissue and can therefore be detected by ultrasound [2].


Kawasaki Disease Cyclic Variation Tissue Characterization Carotid Atherosclerotic Plaque Integrate Backscatter 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Picano E, Landini L, Urbani MP, et al (1994) Ultrasound tissue characterization techniques for the evaluation of the plaque structures. Am J Cardiac Imaging 8:123–128Google Scholar
  2. 2.
    Perez JE, Miller JG, Barzilai B, et al (1988) Progress in quantitative ultrasonic characterization of myocardium: from the laboratory to the bedside. J Am Soc Echocardiogr 1:294–305PubMedGoogle Scholar
  3. 3.
    Mimbs JS, Bauwens D, Cohen RD, et al (1981) Effects of myocardial ischemia on quantitative ultrasonic backscatter and identification of responsible determinants. Circ Res 49:89–96PubMedCrossRefGoogle Scholar
  4. 4.
    Glueck RM, Mottely JG, Miller JG, et al (1986) Intramyocardial variability in integrated backscatter. Effects of coronary occlusion and reperfusion. Circulation 75:436–442Google Scholar
  5. 5.
    Picano E, Pelosi G, Marzilli M, et al (1990) In vivo quantitative ultrasonic evaluation of myocardial fibrosis in man. Circulation 81:58–64PubMedCrossRefGoogle Scholar
  6. 6.
    Lattanzi F, Di Bello V, Picano E, et al (1992) A normal ultrasonic myocardial reflectivity in athletes with increased left ventricular mass: a tissue characterization study. Circulation 85:1828–1834PubMedCrossRefGoogle Scholar
  7. 7.
    Lattanzi F, Spirito P, Picano E, et al (1991) Quantitative assessment of ultrasonic myocardial reflectivity in hypertrophic cardiomyopathy. J Am Coll Cardiol 17:1085–1090PubMedCrossRefGoogle Scholar
  8. 8.
    Lucarini AR, Talarico L, Di Bello V, et al (1998) Increased myocardial ultrasonic reflectivity is associated with extreme hypertensive left ventricular hypertrophy: a tissue characterization study in man. Am J Hypertension 11:1442–1449CrossRefGoogle Scholar
  9. 9.
    Lattanzi F, Picano E, Landini L, et al (1990) In vivo identification of mitral valve fibrosis and calcium by real time quantitative ultrasonic analysis. Am J Cardiol 65:355–359PubMedCrossRefGoogle Scholar
  10. 10.
    Marini C, Ghelardini G, Picano E, et al (1993) Effects of coronary blood flow on myocardial gray level amplitude in two-dimensional echocardiography: an experimental study. Cardio-vasc Res 27:279–283CrossRefGoogle Scholar
  11. 11.
    Picano E, Faletra F, Marini C, et al (1993) Increased echodensity of transiently asynergic myocardium in humans: a novel echocardiographic sign of myocardial ischemia. J Am Coll Cardiol 21:199–207PubMedCrossRefGoogle Scholar
  12. 12.
    Lythall DA, Gibson DG, Kushwaha SS, et al (1992) Myocardial echo amplitude changes during reversible ischemia in humans. Br Heart J 67:368–376PubMedCrossRefGoogle Scholar
  13. 13.
    Vitale DE, Bonow RO, Gerundo G, et al (1995) Alterations in ultrasonic backscatter during exercise-induced myocardial ischemia in humans. Circulation 92:1452–1457PubMedCrossRefGoogle Scholar
  14. 14.
    Yu X, Hashimoto I, Ichida F, et al (2001) Dipyridamole stress ultrasonic myocardial tissue characterization in patients with Kawasaki disease. J Am Soc Echocardiogr 14:682–690PubMedCrossRefGoogle Scholar
  15. 15.
    Pingitore A, Kozakova M, Picano E, et al (1993) Acute myocardial gray level intensity changes detected by transesophageal echocardiography during intraoperative ischemia. Am J Cardiol 72:465–469PubMedCrossRefGoogle Scholar
  16. 16.
    Gigli G, Maffei S, Picano E, et al (1995) Cardiac cycle-dependent gray-level variation is not distorted by abnormal septal motion after cardiac surgery: a transesophageal videodensito-metric study in humans J Am Soc Echocardiogr 8:475–481PubMedCrossRefGoogle Scholar
  17. 17.
    Wickline SA, Thomas LJ III, Miller JG, et al (1996) Cyclic variation in myocardial gray level as a marker of viability in man. A videodensitometric study. Eur Heart J 17:472–479CrossRefGoogle Scholar
  18. 18.
    Marini C, Picano E, Varga A, et al (1996) Cyclic variation in myocardial gray level as a marker of viability in man. A videodensitometric study. Eur Heart J 17:472–479PubMedCrossRefGoogle Scholar
  19. 19.
    Lin LC, Wu CC, Ho YL, Chen MF, Liau CS, Lee YT (1998) Ultrasonic tissue characterization in predicting residual ischemia and myocardial viability for patients with acute myocardial infarction. Ultrasound Med Biol 24:1107–1120PubMedCrossRefGoogle Scholar
  20. 20.
    Iwakura K, Ito H, Nishikawa N, et al (2000) Use of echocardiography for predicting myocardial viability in patients with reperfused anterior wall myocardial infarction. Am J Cardiol 85744–748Google Scholar
  21. 21.
    Hancock JE, Cooke JC, Chin DT, et al (2002) Determination of successful reperfusion after thrombolysis for acute myocardial infarction: a noninvasive method using ultrasonic tissue characterization that can be applied clinically. Circulation 105:157–161PubMedCrossRefGoogle Scholar
  22. 22.
    Pasquet A, D’Hondt AM, Melin JA, Vanoverschelde JL (1998) Relation of ultrasonic tissue characterization with integrated backscatter to contractile reserve in chronic left ventricular ischemic dysfunction. Am J Cardiol 81:68–74, et alPubMedCrossRefGoogle Scholar
  23. 23.
    Falk E (1992) Why do plaques rupture? Circulation 86:11130–42Google Scholar
  24. 24.
    Davies MJ (1996) Stability and instability: two faces of coronary atherosclerosis. The Paul Dudley White Lecture 1995. Circulation 94:2013–2020PubMedCrossRefGoogle Scholar
  25. 25.
    Picano E, Landini L, Distante A, et al (1983) Different degrees of atherosclerosis detected by backscattered ultrasound: an in vitro study on fixed human aortic walls. J Clin Ultrasound 11:375–379PubMedCrossRefGoogle Scholar
  26. 26.
    Picano E, Landini L, Distante A, et al (1985) Fibrosis, lipids, and calcium in human atherosclerotic claque. In vitro differentiation from normal aortic walls by ultrasonic attenuation. Circ Res 56:556–562PubMedCrossRefGoogle Scholar
  27. 27.
    Picano E, Landini L, Distante A, et al (1985) Angle dependence of ultrasonic backscatter in arterial tissues: a study in vitro. Circulation 72:572–576PubMedCrossRefGoogle Scholar
  28. 28.
    Picano E, Landini L, Lattanzi F, et al (1986) The use of frequency histograms of ultrasonic backscatter amplitudes for the detection of atherosclerosis in vitro. Circulation 74:1093–1098PubMedCrossRefGoogle Scholar
  29. 29.
    Picano E, Landini L, Lattanzi F, et al (1988) Time domain echo pattern evaluation from normal and atherosclerotic arterial walls: a study in vitro. Circulation 77:654–659PubMedCrossRefGoogle Scholar
  30. 30.
    Urbani MP, Picano E, Parenti G, et al (1993) In vivo radiofrequency-based ultrasonic tissue characterization of the atherosclerotic plaque. Stroke 24:1507–1512PubMedCrossRefGoogle Scholar
  31. 31.
    Mazzone AM, Urbani MP, Picano E, et al (1995) In vivo ultrasonic parametric imaging of carotid atherosclerotic plaque by videodensitometric technique. Angiology 46:663–672PubMedCrossRefGoogle Scholar
  32. 32.
    Kawasaki M, Takatsu H, Noda T, et al (2001) Noninvasive quantitative tissue characterization and two-dimensional color-coded map of human atherosclerotic lesions using ultrasound integrated backscatter. Comparison between histology and integrated backscatter images before and after death. J Am Coll Cardiol 38:486–492PubMedCrossRefGoogle Scholar
  33. 33.
    Noguchi T, Yasuda S, Akiyama Y et al (2003) Quantitative tissue characterization of vulnerable plaques in carotid artery by ultrasonic backscatter analysis. J Am Coll Cardiol 42:610–618Google Scholar
  34. 34.
    Mathiesen EB, Bonaa KH, Joakimsen O (2001) Echolucent plaques are associated with high risk of ischemic cerebrovascular events in carotid stenosis. The Tromso study. Circulation 103:2171–2175PubMedCrossRefGoogle Scholar
  35. 35.
    Gronholdt ML (1999) Ultrasound and lipoproteins as predictors of lipid-rich, rupture-prone plaques in the carotid artery. Arterioscler Thromb Vasc Biol 19:2–13PubMedCrossRefGoogle Scholar
  36. 36.
    Yamagishi M, Terashima M, Awano K, et al (2000) Morphology of vulnerable coronary plaque: insights from follow-up of patients examined by intravascular ultrasound before an acute coronary syndrome. J Am Coll Cardiol 35:106–111PubMedCrossRefGoogle Scholar
  37. 37.
    Cohen A, Tzourio C, Bertrand B, et al (1997) Aortic plaque morphology and vascular events: a follow-up study in patients with ischemic stroke. FAPS Investigators. French Study of Aortic Plaques in Stroke. Circulation 96:3838–3841PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2003

Authors and Affiliations

  • Eugenio Picano
    • 1
  1. 1.Institute of Clinical PhysiologyNational Research CouncilPisaItaly

Personalised recommendations