AJDRAJNR - American Journal of Neuroradiology

Published ahead of print on February 13, 2008
doi: 10.3174/ajnr.A0950
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High-Resolution CT Imaging of Carotid Artery Atherosclerotic Plaques

M. Wintermarka, S.S. Jawadif, J.H. Rappe, T. Tihanb, E. Tonga, D.V. Gliddenc, S. Abedinf, S. Schaeffera, G. Acevedo-Boltona, B. Boudignond, B. Orwolld, X. Pane and D. Salonera

a Department of Radiology, Neuroradiology Section, University of California, San Francisco, Calif
b Department of Pathology, University of California, San Francisco, Calif
c Department of Epidemiology and Biostatistics, University of California, San Francisco, Calif
d Division of Endocrinology, University of California, San Francisco, Calif
e Department of Vascular Surgery, San Francisco Veterans Administration Medical Center, San Francisco, Calif
f Department of Diagnostic Radiology, University of Missouri-Kansas City School of Medicine, Kansas City, Mo


Figure 1
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  		Fig 1. In vivo CTA image of the common carotid artery, and matching ex vivo micro-CT and histologic sections. Automated classification computer algorithm-derived overlay shows lipid-rich necrotic core (yellow), calcification (blue), blood products (red), and remaining connective tissue (green). CTA overlay demonstrates a plaque with a large lipid core, small calcifications, and an ulceration, making it a VIa lesion according to the AHA classification, in agreement with histologic examination, the gold standard for noncalcified carotid wall components, and with ex vivo micro-CT, the reference for carotid wall calcium (specimens were decalcified before histologic sectioning).


Figure 2
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  		Fig 2. In vivo CTA image of the ICA, and matching ex vivo micro-CT and histologic sections. Automated classification computer algorithm-derived overlay demonstrates a plaque with sparse "lipid" pixels (yellow) and an ulceration, making it a VIa lesion according to the AHA classification, in agreement with histologic examination.


Figure 3
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  		Fig 3. In vivo CTA image of the ICA, and matching ex vivo histologic section. Automated classification computer algorithm-derived overlay demonstrates a plaque with a superficial calcification (blue), making it a Vc lesion according to the AHA classification, in agreement with histologic examination.


Figure 4
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  		Fig 4. In vivo CTA image of the ICA, and matching ex vivo histologic section. Automated classification computer algorithm-derived overlay demonstrates a plaque with a large hemorrhage (red), making it a VIb lesion according to the AHA classification, in agreement with histologic examination.





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X