Carotid Artery Plaque Classification: Does Contrast Enhancement Play a Significant Role?

Saba, Luca; Piga, M.; Raz, Eytan; Farina, D.; Montisci, R.

doi:10.3174/ajnr.a3073

Cited by 14 publications

(8 citation statements)

References 16 publications

(20 reference statements)

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“…In the literature, there are only a few studies on this topic which use the same technique presented here (i.e., MDCT) with inconsistent results. Saba et al have found statistically significant density increases in symptomatic plaques and suggested that the discrimination of "vulnerable" plaque could be made in MDCT angio examinations where unenhanced and enhanced contrast imaging is performed (22,23). On the contrary, we could not find any significant difference between the asymptomatic and symptomatic plaques in terms of density increase on the unenhanced and enhanced contrast images in MDCT.…”

Section: Discussioncontrasting

confidence: 52%

Multi dedektör bilgisayarlı tomografi ile karotid arter plaklarında kontrastlanma miktarlarının saptanması

Özdemir¹,

Çınar²,

Bozkaya³

et al. 2017

Ege Tıp Dergisi

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Aim: The purpose of the study is to determine the accuracy of carotid artery plaque density measurements using multi detector computed tomography (MDCT) with contrast administration to differentiate symptomatic from asymptomatic plaques. Materials and Methods:Seventy-two patients who did not have calcified plaques were identified retrospectively among patients undergoing neck and brain MDCT due to atherosclerotic carotid artery disease diagnosis or prediagnosis. The plaque density measurements were made on the same axial unenhanced and contrast-enhanced sections in large window, using a circular ROI in 1-4 mm² in size. The symptom differentiation of patients was based on neurological examination and radiological findings. The measured density values were compared according to the clinical and laboratory findings and medical histories of the patients. Student t-test was used for statistical analyses.Results: Significant differences (p<0.001) were found between the unenhanced and contrast-enhanced plaque densities, but the same density difference was not observed among symptomatic patients. A significant relationship was shown between the plaque density and localization (p<0.003). In addition, the comparison between the degree of stenosis and symptoms was statistically significant (p<0.001). There was no significant association between the plaque density and symptoms, gender, stenosis side, infarct type, hyperlipidemia, hypertension, diabetes, coronary artery disease and cigarette use. Conclusion:An increased density with MDCT was determined depending on the contrast agent uptake in carotid plaques. However, it was not statistically significant between the symptomatic and the asymptomatic patients groups.Keywords: Carotid plaque, plaque density, CT angiography. Öz Amaç: Multi dedektör bilgisayarlı tomografi (MDBT) ile karotid arter plaklarının kontrastsız ve kontrastlı görüntüleri üzerindeki dansite artışının saptanması ve bu dansite artışının semptomatik hastalardaki miktarının belirlenmesi amaçlandı. Gereç ve Yöntem: Aterosklerotik karotid arter hastalığı tanı ya da ön tanısıyla supraaortik damarların incelenmesine yönelik MDBT tetkiki yapılmış ve kalsifik plak içermeyen

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Section: Discussioncontrasting

confidence: 52%

Multi dedektör bilgisayarlı tomografi ile karotid arter plaklarında kontrastlanma miktarlarının saptanması

Özdemir¹,

Çınar²,

Bozkaya³

et al. 2017

Ege Tıp Dergisi

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“…However, the reproducibility and utility of this modality for clinical care are not well established [76]. On CT, the identification of plaque neovascularization is based on few studies [77][78][79][80][81] that demonstrated the ability of CT to detect contrast plaque enhancement (CPE) related to the degree of neovascularization (Fig. 7).…”

Section: The Plaque Neovascularizationmentioning

confidence: 99%

Imaging of the Carotid Artery Vulnerable Plaque

Saba¹,

Anzidei

Marincola

et al. 2013

Cardiovasc Intervent Radiol

111

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Atherosclerosis involving the carotid arteries has a high prevalence in the population worldwide. This condition is significant because accidents of the carotid artery plaque are associated with the development of cerebrovascular events. For this reason, carotid atherosclerotic disease needs to be diagnosed and those determinants that are associated to an increased risk of stroke need to be identified. The degree of stenosis typically has been considered the parameter of choice to determine the therapeutical approach, but several recently published investigations have demonstrated that the degree of luminal stenosis is only an indirect indicator of the atherosclerotic process and that direct assessment of the plaque structure and composition may be key to predict the development of future cerebrovascular ischemic events. The concept of ''vulnerable plaque'' was born, referring to those plaque's parameters that concur to the instability of the plaque making it more prone to the rupture and distal embolization. The purpose of this review is to describe the imaging characteristics of ''vulnerable carotid plaques.''

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“…This observation could support the hypothesis that the etiology of LA could be due to an atherosclerotic process 22 that involves not only the small vessels but also the large vessels. In particular, the presence of iodine in the plaque is mainly due to neovascularization, 23,24 and it could be associated with an increased, systemic atherosclerotic activity as demonstrated in a recent published study that demonstrated the association between carotid plaque features and increased risk of myocardial infarction. 25 Following this hypothesis, the presence of atherosclerotic disease, with plaques that show contrast (detected with the keV variation), could be considered as a surrogate marker of LA.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Carotid Computed Tomography Dual-Energy and Brain Leukoaraiosis

Saba

Sanfilippo

Balestrieri

et al. 2017

Journal of Stroke and Cerebrovascular Diseases

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Carotid Artery Plaque Classification: Does Contrast Enhancement Play a Significant Role?

Abstract: BACKGROUND AND PURPOSE:Previous articles have demonstrated that carotid artery plaques may have enhancement after administration of contrast material. The purpose of this study was to evaluate the effect of enhancement in carotid artery classification.

Cited by 14 publications

References 16 publications

Multi dedektör bilgisayarlı tomografi ile karotid arter plaklarında kontrastlanma miktarlarının saptanması

Multi dedektör bilgisayarlı tomografi ile karotid arter plaklarında kontrastlanma miktarlarının saptanması

Imaging of the Carotid Artery Vulnerable Plaque

Relationship between Carotid Computed Tomography Dual-Energy and Brain Leukoaraiosis

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