Neuroradiology

, Volume 54, Issue 5, pp 487–493

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

Authors

    • Department of Neurosurgery and Radiology, Graduate School of Medical ScienceKanazawa University
    • Department of Neurosurgery, Division of Neuroscience, Graduate School of Medical ScienceKanazawa University
  • Kouichi Misaki
    • Department of Neurosurgery and Radiology, Graduate School of Medical ScienceKanazawa University
  • Masanao Mohri
    • Department of Neurosurgery and Radiology, Graduate School of Medical ScienceKanazawa University
  • Takuya Watanabe
    • Department of Neurosurgery and Radiology, Graduate School of Medical ScienceKanazawa University
  • Yuichi Hirota
    • Department of Neurosurgery and Radiology, Graduate School of Medical ScienceKanazawa University
  • Mitsutoshi Nakada
    • Department of Neurosurgery and Radiology, Graduate School of Medical ScienceKanazawa University
  • Yutaka Hayashi
    • Department of Neurosurgery and Radiology, Graduate School of Medical ScienceKanazawa University
  • Fumiaki Ueda
    • Department of Neurosurgery and Radiology, Graduate School of Medical ScienceKanazawa University
  • Jun-ichiro Hamada
    • Department of Neurosurgery and Radiology, Graduate School of Medical ScienceKanazawa University
Interventional Neuroradiology

DOI: 10.1007/s00234-011-0920-9

Cite this article as:
Uchiyama, N., Misaki, K., Mohri, M. et al. Neuroradiology (2012) 54: 487. doi:10.1007/s00234-011-0920-9

Abstract

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 <0, 0–60, 60–130, and >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 < 0, 0–60, 60–130, and >600 were 5.4, 200, 260, and 59 mm3, respectively. There was a strong correlation between the number of high-signal DWI lesions in the ipsilateral side and the plaque volume of HU < 0 (r = 0.927; P < 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 < 0 and HU 0–60 (r = 0.609; P = 0.0047).

Conclusions

Quantitative and qualitative tissue characterization of carotid plaques using MDCT might be a useful predictor for silent ischemic lesions after CAS.

Keywords

Carotid plaqueCarotid stentingDiffusion-weighted imagingDistal embolismMultidetector computed tomography

Copyright information

© Springer-Verlag 2011