Association between carotid plaque composition assessed by multidetector computed tomography and cerebral embolism after carotid stenting

作者：Uchiyama Naoyuki^*; Misaki Kouichi; Mohri Masanao; Watanabe Takuya; Hirota Yuichi; Nakada Mitsutoshi; Hayashi Yutaka; Ueda Fumiaki; Hamada Jun ichiro

来源：Neuroradiology, 2012, 54(5): 487-493.

DOI：10.1007/s00234-011-0920-9

• Carotid plaque
• Carotid stenting
• Diffusion-weighted imaging
• Distal embolism
• Multidetector computed tomography

We aimed to assess the relationship between atherosclerotic carotid plaque composition analyzed using multidetector computed tomography (MDCT) and the appearance of new ischemic lesions detected by diffusion-weighted images (DWI) after carotid artery stenting (CAS). %26lt;br%26gt;We quantitatively and qualitatively analyzed plaque characteristics in carotid arteries using MDCT before CAS in 19 patients. Carotid plaques were expediently subdivided into four components with Hounsfield unit (HU) values of %26lt; 0, 0-60, 60-130, and %26gt; 600. The incidence of distal embolism was evaluated with DWI. Pearson%26apos;s correlation analyses were used to assess the association between plaque composition and the incidence of cerebral embolization. %26lt;br%26gt;Fifteen patients (79%) demonstrated new DWI lesions after CAS. High-signal DWIs were noted as follows: one in six patients, 2 similar to 5 in five patients, 6 similar to 10 in two patients, and %26gt; 10 in two patients. The mean volumes of the plaque components for HU %26lt; 0, 0-60, 60-130, and %26gt; 600 were 5.4, 200, 260, and 59 mm(3), respectively. There was a strong correlation between the number of high-signal DWI lesions in the ipsilateral side and the plaque volume of HU %26lt; 0 (r = 0.927; P %26lt; 0.0001). There was a moderate correlation between the number of high-signal DWI lesions and the plaque volume of HU 0-60 (r = 0.568; P = 0.0099) and the sum total of HU %26lt; 0 and HU 0-60 (r = 0.609; P = 0.0047). %26lt;br%26gt;Quantitative and qualitative tissue characterization of carotid plaques using MDCT might be a useful predictor for silent ischemic lesions after CAS.

• 出版日期2012-5