Kurata Mie, Nose Masato, Shimazu Yoshihito, Aoba Takaaki, Kohada Yuki, Yorioka Soichiro, Suehiro Satomi, Fukuoka Erina, Matsumoto Shirabe, Watanabe Hideaki, Kumon Yoshiaki, Okura Takafumi, Higaki Jitsuo, Masumoto Junya
Department of Pathology, Ehime University Graduate School of Medicine and Proteo-Science Center, Toon, Ehime, Japan; Department of Cardiology, Erasmus Medical Center Rotterdam, the Netherlands.
Department of Pathology, Division of Pathogenomics, Ehime University, Graduate School of Medicine, Ehime, Japan.
J Stroke Cerebrovasc Dis. 2014 Jul;23(6):1440-6. doi: 10.1016/j.jstrokecerebrovasdis.2013.12.003. Epub 2014 Feb 12.
Microvessels in atheromatous plaques are well known to play a role in plaque vulnerability associated with intraplaque hemorrhage, but their architecture remains unclear. The morphometry of the microvasculature and hemorrhage of human carotid atheromatous plaques (CAPs) were evaluated, and 3-dimensional (3D) reconstruction of the microvessels was performed.
CAPs were obtained by endarterectomy in 42 patients. The specimens were analyzed using light microscopy. Plaque hemorrhage was defined as an area-containing red blood cells (>1 mm2). To determine the histopathologic features of plaque hemorrhage, the plaque area was divided into 4 regions: cap, shoulder, lipid/necrotic core, and media. Then, the density of microvessels and macrophages in each region was quantified. Two representative lesions with either hemorrhagic or nonhemorrhagic plaque were cut into 90 serial sections. The sections were double stained with anti-CD34 and anti-α smooth muscle actin antibodies, scanned using a digital microscope, and reconstructed using TRI-SRF2 software.
The hemorrhagic plaques showed a higher density of microvessels than nonhemorrhagic plaques in the shoulder, cap, and lipid/necrotic core (P=.03, .009, and .001, respectively), and there was positive correlations between its density and macrophages in each regions (P<.001, .001, and .019, respectively). 3D imaging also revealed dense microvessels with a network structure in the cap and shoulder regions of hemorrhagic plaques, and some of the vessels were fenestrated to the arterial lumen.
The microvasculature of plaques with intraplaque hemorrhage was dense, some of which fenestrated to the arterial lumen. The pathologic 3D imaging revealed precise architecture of microvasculature of plaques.
动脉粥样硬化斑块中的微血管在与斑块内出血相关的斑块易损性中所起的作用已广为人知，但其结构仍不清楚。对人类颈动脉粥样硬化斑块（CAPs）的微血管形态计量学和出血情况进行了评估，并对微血管进行了三维（3D）重建。
通过动脉内膜切除术获取42例患者的CAPs。使用光学显微镜对标本进行分析。斑块出血定义为含有红细胞的区域（>1平方毫米）。为确定斑块出血的组织病理学特征，将斑块区域分为4个区域：帽区、肩部、脂质/坏死核心区和中膜。然后，对每个区域的微血管和巨噬细胞密度进行定量分析。将两个具有出血性或非出血性斑块的代表性病变切成90个连续切片。切片用抗CD34和抗α平滑肌肌动蛋白抗体进行双重染色，使用数字显微镜扫描，并使用TRI-SRF2软件进行重建。
出血性斑块在肩部、帽区和脂质/坏死核心区的微血管密度高于非出血性斑块（分别为P = 0.03、0.009和0.001），且其密度与每个区域的巨噬细胞之间存在正相关（分别为P < 0.001、0.001和0.019）。3D成像还显示出血性斑块的帽区和肩部区域有密集的微血管网络结构，且一些血管与动脉腔相通。
有斑块内出血的斑块微血管密集，其中一些与动脉腔相通。病理3D成像揭示了斑块微血管的精确结构。
