Abstract
BackgroundPlaque morphology directly correlates with risk of embolism and the recently developed dual-source computed tomography angiography (DSCTA) may help to detect plaques more precisely. The aim of our study was to evaluate the prevalence and morphology of carotid and cerebrovascular atherosclerotic plaques in patients with symptomatic type 2 diabetes mellitus (DM) by DSCTA.MethodsFrom July 2009 to August 2010, DSCTA was prospectively performed in 125 consecutive patients with symptomatic type 2 DM. We retrospectively analyzed plaque type, distribution, and extensive and obstructive natures were determined for each segment for all patients.ResultsAtherosclerotic plaques were detected in 114 (91.2%) patients. Relatively more noncalcified (45%) and calcified (39%) plaques and less mixed (16%) plaques were observed (p < 0.001). Noncalcified plaques were found mainly in the intracranial arteries (81.8%), mixed plaques in the intracranial arteries (25.2%) and intracranial internal carotid artery (ICA) (56.1%). Calcified plaques were found mainly in the intracranial ICA (65.9%) and extracranial arteries (28.2%) (for all, p < 0.001). Extension of plaques from the 1st to 5th segments was observed in 67 (58.8%) patients and from the 6th to 10th segments in 35 (30.7%) patients. The most common site of all detected plaques was the cavernous segment. Regarding stenosis, there were significantly more nonobstructive than obstructive stenosis (91% vs. 9%, p < 0.001).ConclusionDSCTA detected a high prevalence of plaques in patients with symptomatic type 2 DM. A relatively high proportion of plaques were noncalcified, as well as with nonobstructive stenosis. The distribution of plaques was extensive, with the cavernous portion of ICA being the most common site.
Highlights
Plaque morphology directly correlates with risk of embolism and the recently developed dual-source computed tomography angiography (DSCTA) may help to detect plaques more precisely
Patient characteristics Carotid and cerebrovascular DSCTA was performed in 125 patients with symptomatic type 2 diabetes mellitus (DM)
The most common site of all detected plaques in the patients was the cavernous portion of internal carotid artery (ICA) (131/658, 19.9%) followed by C5 (70/658, 10.6%) and carotid bifurcation (CB) (68/658, 10.3%)
Summary
Plaque morphology directly correlates with risk of embolism and the recently developed dual-source computed tomography angiography (DSCTA) may help to detect plaques more precisely. The aim of our study was to evaluate the prevalence and morphology of carotid and cerebrovascular atherosclerotic plaques in patients with symptomatic type 2 diabetes mellitus (DM) by DSCTA. Digital subtraction angiography (DSA) is the gold standard for assessing degree of stenosis [6], it cannot precisely predict plaque composition. The characteristics of carotid and cerebrovascular plaques detected by the recently developed dual-source CT angiography (DSCTA) in patients with symptomatic type 2 DM have not been discussed systematically. The purpose of this study was to evaluate the prevalence and morphology of carotid and cerebrovascular atherosclerotic plaques by DSCTA in a large cohort of patients with symptomatic type 2 DM
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