Toshinori Hirai MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: To evaluate the relationship between percent stenosis, wall irregularity, plaque thickening, patient age, and degree of calcification in carotid atherosclerotic plaques using multiplanar reconstruction (MPR) images of CT angiography. Methods and Materials: Twenty-three patients with atherosclerotic plaque of the cervical carotid artery were examined with CT angiography and intraarterial digital subtraction angiography (DSA). Based on MPR images of CT angiography, the single largest lesion in each internal carotid artery was classified into three types: non-calcified plaque (type 1), partially calcified plaque (type 2), and extensively calcified plaque (type 3). Percent stenosis, wall irregularity, thickening of the plaque, and patient age were compared among the three groups. Wall irregularity on DSA was divided into four categories: smooth, mild irregularity, moderate irregularity, and severe irregularity with ulceration. Statistical multiple comparison was performed among the groups. Results: Thirty-six carotid arteries with large atherosclerotic plaque were identified on the MPR images. The types of plaque included type 1 in 10, type 2 in 17, and type 3 in nine. Percent stenosis was significantly (P < 0.05) smaller in the group with type 3 than the group with type 1 or type 2. Type-3 plaque tended to have less wall irregularity and be seen in patients with higher age. Ulceration was not observed in the type-3 plaque. There were no significant differences of plaque thickness among the three groups. Conclusion: The type-1 and type-2 plaques have various luminal appearances, while the type-3 plaque tends to have smaller percent stenosis and less wall irregularity, and be seen in elderly patients.      

Hirai MD, T, Significance of Calcification in Carotid Atherosclerotic Plaque: Evaluation with Multiplanar Reconstruction Images of CT Angiography and Conventional DSA.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3101930.html