Abstract
The identification of plaque characteristics that determine its vulnerability is extremely important. The purpose of this work was to evaluate CPE after administration of contrast material and to assess whether there is a statistical association between CPE and cerebrovascular symptoms. Ninety-seven consecutive patients (69 men, 28 women; mean age, 62 years; age range, 39-82 years), studied by using an MDCT scanner, were retrospectively analyzed. Examinations were performed before and after administration of contrast medium. Plaque enhancement was analyzed, and the obtained data were compared with the patient's symptoms. Patients were classified as symptomatic (TIA or stroke with a temporal window of 6 months) or asymptomatic according to neurologic assessment and the TOAST criteria. The ROC curve and Az were calculated, and multiple logistic regression analysis was performed. Thirty-nine patients were excluded because they had calcified plaques (40.2%). CPE was observed in 74% of the remaining 58 patients. A statistically significant difference was observed between symptomatic and asymptomatic patients for the presence of CPE (P = .0013; OR = 7.5). Moreover, we observed that CPE was higher in fatty plaques (P = .035) than in mixed ones and more frequent in the former (P = .0119). The ROC curve demonstrated that a threshold of 15 HU is associated with a specificity and sensitivity of 83.33% and 76.47%, respectively. Multiple logistic regression showed that CPE and symptoms are associated (P = .0315). The results of our study suggest that for noncalcified carotid plaques, the presence of CPE is associated with cerebrovascular symptoms. Fatty plaques are more likely to have CPE compared with mixed plaques.
Highlights
AND PURPOSE: The identification of plaque characteristics that determine its vulnerability is extremely important
The results of our study suggest that for noncalcified carotid plaques, the presence of CPE is associated with cerebrovascular symptoms
Several studies have demonstrated the relationship between lesion type progression and clinical events, which has led to efforts to characterize the types of lesions present, in terms of degree of stenosis and with regard to the composition and morphology of the plaque.[6,7,8,9,10,11]
Summary
The purpose of this work was to evaluate CPE after administration of contrast material and to assess whether there is a statistical association between CPE and cerebrovascular symptoms
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