Neuroradiology

, Volume 54, Issue 5, pp 487–493

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

  • Naoyuki Uchiyama
  • Kouichi Misaki
  • Masanao Mohri
  • Takuya Watanabe
  • Yuichi Hirota
  • Mitsutoshi Nakada
  • Yutaka Hayashi
  • Fumiaki Ueda
  • Jun-ichiro Hamada
Interventional Neuroradiology

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 plaque Carotid stenting Diffusion-weighted imaging Distal embolism Multidetector computed tomography 

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Naoyuki Uchiyama
    • 1
    • 2
  • Kouichi Misaki
    • 1
  • Masanao Mohri
    • 1
  • Takuya Watanabe
    • 1
  • Yuichi Hirota
    • 1
  • Mitsutoshi Nakada
    • 1
  • Yutaka Hayashi
    • 1
  • Fumiaki Ueda
    • 1
  • Jun-ichiro Hamada
    • 1
  1. 1.Department of Neurosurgery and Radiology, Graduate School of Medical ScienceKanazawa UniversityKanazawaJapan
  2. 2.Department of Neurosurgery, Division of Neuroscience, Graduate School of Medical ScienceKanazawa UniversityKanazawaJapan

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