Assessment of 320-slice computed tomography angiography in distinguishing hemorrhage in carotid atherosclerotic plaques

Abstract

Objective To assess the value of 320⁃slice computed tomography angiography (CTA) in distinguishing hemorrhage/thrombus from lipid-rich necrotic core (LRNC) in atherosclerotic plaques of carotid artery. Methods Thirty-seven subjects who prepared to perform carotid endarterectomy (CEA), with stenosis rate about 50%-99% in at least unilateral carotid artery detected by ultrasound, were enrolled in this study. Both 320-slice CTA and 3.0T high-resolution MRI were conducted within one week before operation. CTA, MRI and pathological sections were matched with the carotid bifurcation and calcification features as the mark. According to American Heart Association (AHA) modified classification, CT slices were selected and divided into 2 groups: Type Ⅳ -Ⅴ (lipid plaques) and Type Ⅵ (hemorrhage plaques), and the density difference between lipid plaques and hemorrhage/thrombus plaques was analyzed. Results A total of 217 slices were included in final analysis, including 88 slices of Type Ⅳ -Ⅴ (lipid plaques) and 129 slices of Type Ⅵ (hemorrhage plaques). There was statistically significant difference in CT value between 2 groups. The mean CT value of lipid necrosis core in Type Ⅳ -Ⅴ and hemorrhage/thrombus in Type Ⅵ was (28.07 ± 26.84) and (97.17 ± 35.82) HU respectively, and the former was significantly lower than the latter (t = 16.141, P = 0.000). Conclusions CTA can distinguish hemorrhage/thrombus from lipid-rich necrotic core in carotid atherosclerotic plaques.
doi：10.3969/j.issn.1672-6731.2014.01.005