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Three-Dimensional Imaging of Aortic Tissues in Atherosclerosis
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Three-Dimensional Imaging of Aortic Tissues in Atherosclerosis

Published on: October 25, 2024

Significance of aortic atherosclerotic disease in possibly embolic stroke: 64-multidetector row computed tomography

Youngchai Ko1, Jung-Hyun Park, Mi Hwa Yang

  • 1Department of Neurology, Stroke Center, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, 463-707 Seongnam-si, Gyeonggi-do, Korea.

Journal of Neurology
|November 26, 2009
PubMed

Insights

Aortic atherosclerotic disease (AAD) detected by 64-multidetector row computed tomography (MDCT) is a significant risk factor for possibly embolic stroke (PES). High-risk AAD was found more frequently in PES patients compared to non-embolic stroke patients.

Area of Science:

  • Cardiovascular Imaging
  • Neurology
  • Radiology

Background:

  • Aortic atherosclerotic disease (AAD) is a potential source of cerebral emboli.
  • Identifying the source of embolic stroke is crucial for effective treatment.

Purpose of the Study:

  • To assess the significance of AAD using 64-multidetector row computed tomography (MDCT) in patients with possibly embolic stroke (PES).
  • To determine the association between high-risk AAD and embolic stroke in patients without an evident cardioembolic source.

Main Methods:

  • Prospective registry of patients with acute ischemic stroke meeting PES criteria and undergoing MDCT.
  • Definition of high-risk AAD: thrombus, ulceration, or plaque thickness ≥4 mm in the ascending aorta and aortic arch on MDCT.
  • Comparison group: patients with non-embolic stroke (NES) undergoing MDCT for coronary artery disease screening.

Main Results:

  • 50 PES patients and 106 NES patients were included.
  • High-risk AAD prevalence was significantly higher in the PES group (38.0%) compared to the NES group (13.2%, P < 0.01).
  • High-risk AAD showed an odds ratio of 4.03 (95% CI, 1.81-8.98) for PES, even after adjusting for atherosclerosis risk factors.

Conclusions:

  • MDCT can effectively detect high-risk aortic atherosclerotic disease.
  • AAD detected by MDCT plays a significant etiologic role in patients with possibly embolic stroke.
  • This finding aids in identifying the source of stroke in cryptogenic cases.

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