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A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
Published on: February 7, 2015
Assessment of vessel wall thickness in carotid atherosclerosis using spiral CT angiography
C Porsche1, L Walker, A D Mendelow
1Neuroradiology Division, Regional Neurosciences Centre, Newcastle General Hospital, Westgate Road, Newcastle upon Tyne NE4 6BE, U.K.
Insights
Significant carotid artery disease involves vessel wall thickening, more pronounced in the common carotid artery than the internal carotid artery. This finding impacts how stenosis is measured in atherosclerotic disease.
Area of Science:
- Vascular imaging
- Cardiovascular disease research
- Medical diagnostics
Background:
- Atherosclerotic disease commonly affects the carotid arteries, leading to stenosis.
- Accurate measurement of carotid artery stenosis is crucial for patient management.
- Vessel wall thickening is a key feature of atherosclerosis.
Purpose of the Study:
- To quantify and compare vessel wall thickening in the internal carotid artery (ICA) and common carotid artery (CCA).
- To investigate the extent of wall thickening in patients with significant atherosclerotic disease.
Main Methods:
- Spiral CT angiography was used to image 45 carotid systems in patients with >=70% stenosis.
- Standardized imaging protocol and axial CT sections were employed.
- Vessel wall thickness was measured in the distal CCA and mid-ICA.
Main Results:
- Vessel wall thickness was significantly greater and more variable in the CCA compared to the ICA.
- Mean vessel wall thickness constituted 28+/-12% of the total diameter in the CCA versus 15+/-6% in the ICA (p < 0.001).
Conclusions:
- Significant and extensive wall thickening is common in both CCA and ICA in patients with atherosclerotic disease.
- The ICA is significantly less affected by wall thickening than the CCA.
- The findings question the use of the CCA as a reference vessel for angiographic stenosis measurements.
Objectives:
the purpose of this study was to evaluate the amount of vessel wall thickening in the internal and common carotid arteries in patients undergoing spiral CT angiography for the investigation of significant atherosclerotic disease.
Materials And Methods:
forty-five carotid systems in patients with a 70% or greater stenosis (according to carotid duplex) were imaged with CT spiral angiography using a standardised protocol. The vessel wall thickness of the distal common and mid internal carotid artery was measured using axial CT sections.
Results:
vessel wall thickness was greater and more variable within the common carotid artery than within the internal carotid artery. The mean proportion of total vessel diameter constituted by vessel wall thickness was significantly greater in the common carotid artery as compared to the internal carotid artery: 28+/-12% (SD) vs 15+/-6%, respectively (p < 0.001).
Conclusions:
significant and extended wall thickening is commonly present in the internal and common carotid arteries of patients with atherosclerotic disease, but the internal carotid artery is significantly less affected than the common carotid artery. These observations question the validity of using the common carotid artery as a reference vessel for angiographic stenosis measurements.
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