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BACKGROUND: Thromboembolism from carotid plaque is an important cause of stroke. Identification of unstable plaque would therefore be clinically useful. Unfortunately, studies of carotid plaque imaging have shown poor agreement with histology. However, this may be due to inconsistent methods and the variability of assessments of carotid plaque histology, rather than inadequate imaging. METHODS: We assessed the reproducibility of histological assessment in 60 plaques, and section-to-section variability along the length of 26 plaques. RESULTS: Kappa values ranged from 0.35 to 0.89 and from 0.44 to 0.68, respectively, for intra- and inter-observer reproducibility. There was considerable section-to-section variability within plaques. CONCLUSIONS: The accuracy of imaging of carotid plaque morphology will be underestimated unless variability in the histology assessment is taken into account.

Original publication

DOI

10.1159/000079259

Type

Journal article

Journal

Cerebrovasc Dis

Publication Date

2004

Volume

18

Pages

117 - 123

Keywords

Carotid Arteries, Carotid Artery Diseases, Humans, Observer Variation, Pathology, Clinical, Reproducibility of Results, Sensitivity and Specificity