High-Resolution CT Imaging of Carotid Artery Atherosclerotic Plaques
| Autor: | S. Abedin, Gabriel Acevedo-Bolton, Tarik Tihan, Joseph H. Rapp, Benjamin Orwoll, Sumayya Jawadi, David Saloner, Max Wintermark, Sarah Schaeffer, Elizabeth Tong, Xian-Mang Pan, Benjamin M. Boudignon, David V. Glidden |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Sensitivity and Specificity medicine Humans Carotid Stenosis Radiology Nuclear Medicine and imaging cardiovascular diseases Prospective cohort study Head & Neck Stroke Aged Endarterectomy medicine.diagnostic_test Vascular disease business.industry Fibrous cap Reproducibility of Results Middle Aged medicine.disease Cerebral Angiography Radiographic Image Enhancement Carotid Arteries medicine.anatomical_structure Angiography Circulatory system Female Neurology (clinical) Radiology Tomography X-Ray Computed business Artery |
| Zdroj: | AJNR Am J Neuroradiol |
| ISSN: | 1936-959X 0195-6108 |
| DOI: | 10.3174/ajnr.a0950 |
| Popis: | BACKGROUND AND PURPOSE: 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 to the concept of “vulnerable plaque.” The purpose of this study was to evaluate the ability of multidetector-row CT angiography (CTA) to assess the composition and characteristics of carotid artery atherosclerotic plaques with use of histologic examination as the gold standard. MATERIALS AND METHODS: Eight patients with transient ischemic attacks who underwent carotid CTA and “en bloc” endarterectomy were enrolled in a prospective study. An ex vivo micro-CT study of each endarterectomy specimen was obtained, followed by histologic examination. A systematic comparison of CTA images with histologic sections and micro-CT images was performed to determine the CT attenuation associated with each component of the atherosclerotic plaques. A computer algorithm was subsequently developed that automatically identifies the components of the carotid atherosclerotic plaques, based on the density of each pixel. A neuroradiologist's reading of this computer analysis was compared with the interpretation of the histologic slides by a pathologist with respect to the types and characteristics of the carotid plaques. RESULTS: There was a 72.6% agreement between CTA and histologic examination in carotid plaque characterization. CTA showed perfect concordance for calcifications. A significant overlap between densities associated with lipid-rich necrotic core, connective tissue, and hemorrhage limited the reliability of individual pixel readings to identify these components. However, CTA showed good correlation with histologic examination for large lipid cores (κ = 0.796; P < .001) and large hemorrhages (κ = 0.712; P = .102). CTA performed well in detecting ulcerations (κ = 0.855) and in measuring the fibrous cap thickness (R(2) = 0.77; P < .001). CONCLUSION: The composition of carotid atherosclerotic plaques determined by CTA reflects plaque composition defined by histologic examination. |
| Databáze: | OpenAIRE |
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