Wenxu Qi MBBCh, BMedSc, Presenter: Nothing to Disclose

Qiyong Guo MD, Abstract Co-Author: Nothing to Disclose

To prospectively analyze the relationship between the carotid plaque features, as assessed by 256-slice CT angiography and ischemic TIA/stroke events.

This retrospective study had ethics review board endorsement, and the need for informed consent was waived. We retrospectively identified 136 consecutive patients with suspected hemispheric ischemic cerebrovascular events. Consecutive patients were evaluated with 256-slice CT angiography for the degree of stenosis, presence of atherosclerotic plaque, and plaque ulceration in carotid artery. Plaque volume and plaque component proportions of LR-NC (lipid-rich necrotic core), fibrous tissue, and calcification were measured.

452 Atherosclerotic plaques were present in 136 patients; these plaques were classified as: smooth (277,61.3%), irregular (97,21.5%); and ulcerated (78,17.3%); calcified (181,40.0%), lipid core (97,21.5%) ,fibrous tissue (48 ,10.6%), mixed (126,27.9%). lipid core plaques were significantly (P<0.001) more common in carotid arteries with stenosis <30% than in those with stenosis >30%. Complicated plaques were significantly (P<0.001) more common in carotid arteries with stenosis >30% than in those with stenosis <30%.Multivariate analysis showed that>70% stenosis (P =0 .07, OR = 1.9) and the presence of lipid-rich necrotic core (P =0 .03, OR = 4.53) were significantly associated with symptomatic side ischemic TIA/stroke events.

256-slice CT angiography allows adequate evaluation of the type of plaque. Plaque volume, degree of stenosis, and composition evaluated noninvasively with 256-slice CT angiography are associated with ischemic TIA/stroke events.

Plaque volume and composition analysis with 256 -slice CT angiography may identify rupture prone plaques and improve risk stratification in ischemic stroke patients.

Qi, W, Guo, Q, Association between Carotid Plaque Characteristics Evaluated with 256-Slice CT Angiography and Ischemic Cerebrovascular Events.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11006425.html