Aortic and Internal Carotid Atherosclerosis in Patients with Carotid Stenosis: Semiautomatic Volumetric Analysis of Low-Attenuation Plaque on Curved Planar Reformations Using MDCT Angiographic Data.

Hiroshi Manaka,Zenjiro Sekikawa,Tetsuya Yamamoto,Shigeo Takebayashi,Izumi Torimoto,Keiichiro Kasama

doi:10.1155/2019/5817534

Abstract

This retrospective study included 65 patients who underwent multidetector computed tomography (MDCT) carotid angiography; 28 patients were <70 years old (group 1), and 37 were ≥70 years old (group 2). Each low-attenuation (<30 Hounsfield units [HU]) plaque volume (LPV) and total uncalcified plaque volume ([TUPV] ≤150 HU) were semiautomatically measured on each aortic arch and internal carotid artery (ICA) curved planar reformations (CPR), using MDCT angiographic data. Correlation coefficients were employed to assess the impact of each plaque volume on various factors including ICA stenosis. The correlations (r > 0.5) were observed between aortic LPV and each ICA stenosis ratio and >30% stenosis in group 1, between aortic TUPV and male gender in group 1, and between ICA-TUPV and each aortic TUPV or the largest plaque thickness in group 2. Marginal correlations were observed between hyperlipidemia and aortic LPV and ICA-TUPV in group 1. There was no association between cerebral infarction and the aortic and ICA plaques. Both the aortic arch and ICA plaque volumes can be measured clinically. The increasing aortic LPV may be a significant factor associated with the development of ICA stenosis in patients younger than 70 years old.

Highlights

Atherosclerosis is a diffuse pathological process characterized by the deposition of lipid and other blood-borne material within the arterial wall of almost all vascular territories
Between the two patient groups, there were no significant differences in frequency of number of men, cerebral infarction, hyperlipidemia, and >30% internal carotid artery (ICA) stenosis and the mean percentage of ICA stenosis ratio as well as mean diameters of the largest plaque in ICA (Table 1)
Atherosclerosis plaque depicted by multidetector computed tomography (MDCT) can be divided into low-attenuation plaque, uncalcified soft-tissue attenuation plaque, and calcified plaque

Summary

Introduction

Atherosclerosis is a diffuse pathological process characterized by the deposition of lipid and other blood-borne material within the arterial wall of almost all vascular territories. The relation of aortic plaques to stroke mainly originates from studies with transesophageal echocardiography (TEE) [3] and the association between aortic plaques and ischemic stroke is strong when the plaques are >4 mm thickness [4], computed tomography (CT) angiography has been shown to be a higher-sensitivity and specificity tool for the detection of atherosclerotic aortic plaques than TEE [5]. Cui et al [1], reported that plaques of >4 mm thickness in the aortic arch have no association with carotid plaques or intracranial arterial stenosis. Walker et al [6] reported that analysis of internal carotid artery (ICA) atherosclerosis plaque attenuation with single-slice spiral CT does not give useful information about plaque composition. Compared to complicated and time-consuming manual volumetric assessment as the plotting contour method, automatic or semiautomatic segmentation using various

Methods

Results

Conclusion