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

• Published in: Neuroradiology 2012-05, Vol.54 (5), p.487-493
• Main Authors: Uchiyama, Naoyuki, Misaki, Kouichi, Mohri, Masanao, Watanabe, Takuya, Hirota, Yuichi, Nakada, Mitsutoshi, Hayashi, Yutaka, Ueda, Fumiaki, Hamada, Jun-ichiro
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Aged; Aged, 80 and over; Arteriosclerosis; Biological and medical sciences; Carotid Stenosis - complications; Carotid Stenosis - diagnostic imaging; Carotid Stenosis - therapy; Comorbidity; Diffusion Magnetic Resonance Imaging; Female; Humans; Imaging; Incidence; Interventional Neuroradiology; Intracranial Embolism - diagnostic imaging; Intracranial Embolism - etiology; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Multidetector Computed Tomography - methods; Nervous system; Neurology; Neuroradiology; Neurosciences; Neurosurgery; Plaque, Atherosclerotic - complications; Plaque, Atherosclerotic - diagnostic imaging; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiology; Schizophrenia; Stents; Tomography; Vein & artery diseases
• ISSN: 0028-3940; 1432-1920
• DOI: 10.1007/s00234-011-0920-9

Introduction 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). Methods 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 600. The incidence of distal embolism was evaluated with DWI. Pearson's correlation analyses were used to assess the association between plaque composition and the incidence of cerebral embolization. Results Fifteen patients (79%) demonstrated new DWI lesions after CAS. High-signal DWIs were noted as follows: one in six patients, 2 ~ 5 in five patients, 6 ~ 10 in two patients, and >10 in two patients. The mean volumes of the plaque components for HU 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