High-Resolution CT Imaging of Carotid Artery Atherosclerotic Plaques

• DOI: 10.3174/ajnr.a0950
• Publication Date: 2008-02-14T01:35:26Z
• Authors: M. Wintermark; S.S. Jawadi; J.H. Rapp; T. Tihan; E. Tong; D.V. Glidden; S. Abedin; S. Schaeffer; G. Acevedo-Bolton; B. Boudignon; B. Orwoll; X. Pan; D. Saloner
• Keywords: Fibrous cap; Concordance; Stroke; Gold standard (test); Endarterectomy; Computed Tomography Angiography

<b>BACKGROUND AND PURPOSE:</b> Plaque morphologic features have been suggested as a complement to luminal narrowing measurements for assessing the risk of stroke associated with carotid atherosclerotic disease, giving rise concept “vulnerable plaque.” The purpose this study was evaluate ability multidetector-row CT angiography (CTA) assess composition and characteristics artery plaques use histologic examination gold standard. <b>MATERIALS METHODS:</b> Eight patients transient ischemic attacks who underwent CTA “en bloc” endarterectomy were enrolled in prospective study. An ex vivo micro-CT each specimen obtained, followed by examination. A systematic comparison images sections performed determine attenuation component plaques. computer algorithm subsequently developed that automatically identifies components plaques, based on density pixel. neuroradiologist9s reading analysis compared interpretation slides pathologist respect types <b>RESULTS:</b> There 72.6% agreement between plaque characterization. showed perfect concordance calcifications. significant overlap densities lipid-rich necrotic core, connective tissue, hemorrhage limited reliability individual pixel readings identify these components. However, good correlation large lipid cores (κ = 0.796; <i>P</i> &lt; .001) hemorrhages 0.712; .102). well detecting ulcerations 0.855) measuring fibrous cap thickness (<i>R</i>² 0.77; .001). <b>CONCLUSION:</b> determined reflects defined