Relationship between Carotid Computed Tomography Dual-Energy and Brain Leukoaraiosis
Luca Saba1, Roberto Sanfilippo2, Antonella Balestrieri1
1Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), Cagliari 09045, Italy.
Insights
Dual-energy CT (DECT) plaque imaging reveals a link between carotid artery plaque characteristics and brain leukoaraiosis (LA) volume. Lower plaque attenuation, particularly in non-calcified plaques, correlates with increased LA volume.
Area of Science:
- Neuroimaging
- Vascular Biology
- Radiology
Background:
- Leukoaraiosis (LA) is a common finding in brain imaging, often associated with cerebrovascular disease.
- Carotid artery plaque characteristics, such as composition and attenuation, may influence brain health.
- Dual-energy CT (DECT) offers advanced plaque characterization capabilities.
Purpose of the Study:
- To investigate the correlation between carotid plaque attenuation values measured by DECT and the presence and volume of brain leukoaraiosis (LA).
- To explore the utility of DECT in assessing cerebrovascular risk through carotid plaque analysis.
Main Methods:
- Fifty patients underwent carotid DECT and brain MRI.
- Carotid computed tomography (CT) Hounsfield unit (HU)-based plaque attenuation was measured.
- Leukoaraiosis (LA) lesion volume was quantified using semiautomated segmentation.
Main Results:
- An inverse statistically significant correlation was observed between carotid artery plaque attenuation and LA lesion volume.
- Analysis considering fatty and mixed plaques at low kiloelectron volt (keV) levels revealed significant associations between plaque attenuation and brain LA volume.
- Calcified plaques were excluded in a secondary analysis to emphasize associations in non-calcified components.
Conclusions:
- DECT-derived carotid plaque HU attenuation, especially in non-calcified plaques, is associated with brain leukoaraiosis (LA) volume.
- Low keV energy levels enhance the detection of associations between carotid plaque characteristics and LA.
- These findings suggest DECT plaque imaging may provide insights into cerebrovascular disease progression.
Background:
The purpose of this study was to assess if there is a correlation between the carotid computed tomography (CT) Hounsfield unit (HU)-based plaque attenuation values measured using dual-energy CT (DECT) scanner and brain leukoaraiosis (LA).
Methods:
Fifty consecutive patients (34 males, 16 females; mean age, 69 years; age range, 46-84 years) who underwent carotid CT and brain magnetic resonance imaging were included in the study. CT examinations were performed with a DECT scanner, and LA lesion volume quantification was performed using a semiautomated segmentation technique.
Results:
We found an inverse statistically significant correlation between the HU-based carotid artery plaque attenuation and the LA lesion volume. Because of the presence of calcified plaques, a second model was calculated at low kiloelectron volt levels from 66 to 100 and 100 kV by taking into consideration the fatty and mixed plaques, and this further led to the associations between HU-based attenuation and LA volume in brain and vascular territories.
Conclusions:
The results of our study suggest that the associations between HU attenuation of the carotid artery plaques (with the exclusion of calcified plaques) and the volume of LA are emphasized at low keV energy levels.
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