Multidetector-Row Computed Tomography in Evaluation of Atherosclerotic Carotid Plaques Complicated with Intraplaque Hemorrhage

Imaging of the Carotid Artery Vulnerable Plaque

“…e, f Smooth plaque ulcers (white arrowheads) for CT and US respectively [48][49][50] by distinguishing different patterns on T1-w, T2-w, PD, and TOF images. Authors tried to identify IPH using CT and found a strong correlation between very low HU value and IPH [51,52].…”

“…5). Very low HU value in the plaque (\0 HU) are associated with the presence of intraplaque haemorrhage [53,54]. The presence of fatty plaques are associated with an increase risk of stroke [55], whereas the presence of calcium in the carotid artery plaques seems to be a protective factor [18,56], which is unlike the coronary arteries [57,58].…”

Carotid Artery Plaque Characterization Using CT Multienergy Imaging

“…2,3 The attenuation of the carotid artery plaque varies according to the histologic composition of the plaque, with lipid core and intraplaque hemorrhage associated with low HU values and calcified elements associated with high HU values. 4,5 In CT clinical use, there are thresholds in attenuation that distinguish plaques as fatty, mixed, or calcified; and according to the inclusion of a plaque in a specific category, there is a different risk stratification. 6,7 In past years, a new type of CT scanner has been introduced: dual-energy CT. With this technology, it is possible to obtain, during a single examination, the attenuation value of a tissue at multiple energy levels and to postprocess the dataset to evaluate the tissue attenuation determined by only 1 specific kiloelectron volt value.…”

Assessment of the Correlation Between Carotid Artery Plaque Density Determined by Histogram Analysis and Positive Remodeling on Computerized Tomography Angiography

“…Multi-detector computed tomography (MDCT) allows evaluation of the carotid artery with thin slice thickness (no more than 1 mm), and more detailed analysis of carotid artery stenosis and plaque components. Previous studies reported that differences in Hounsfield unit (HU) on MDCT can characterize components of atherosclerotic plaque (2,4,9). However, high density influenced by luminal enhancement and calcification of the plaque may limit calculation of the accurate mean plaque density, leading to inaccurate characterization of fibrous and lipid-rich plaques (10,11).…”

“…However, patients with mild stenosis in the internal carotid artery (ICA) can unexpectedly experience strokes. Vulnerable atherosclerotic plaques have been reported to be an additional risk of atherosclerotic disease (2)(3)(4). The vulnerability to rupture of atherosclerotic plaques is related to the intrinsic composition, such as the hemorrhage of intraplaque and lipid core size (2-6).…”