Carotid artery plaque characterization with a wide-detector computed tomography using a dedicated post-processing 3D...

Area of Science:

• Vascular imaging
• Radiology
• Cardiovascular research

Background:

• Atherosclerotic carotid plaque characterization is crucial for identifying patients at risk of stroke.
• Accurate plaque composition assessment aids in risk stratification.

Purpose of the Study:

• To evaluate the potential of carotid computed tomography angiography (CCTA) in assessing the composition of atherosclerotic plaques.
• To compare CCTA findings with histological analysis for plaque component quantification.

Main Methods:

• Retrospective analysis of 29 patients undergoing carotid endarterectomy.
• Pre-surgical CCTA using a 320-slice scanner with specialized post-processing software.
• Quantification of adipose, fibrotic, and calcific plaque components using Hounsfield units, compared with histology.

Main Results:

• Significant correlation found between CCTA and histology for adipose, fibrotic, and calcified plaque areas.
• Proportional bias observed, with lower discrepancies for adipose and fibrotic plaque areas.
• Bland-Altman analysis showed mean biases of 3.2% (adipose), 2.5% (fibrotic), and 0.6% (calcified) between CCTA and histology.

Conclusions:

• Multi-detector CT angiography is a valuable tool for quantitative assessment of atherosclerotic plaque composition.
• CCTA is particularly effective in evaluating fibrotic tissue prevalence.
• This technique can improve risk stratification for patients susceptible to cerebral stroke.