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Association between carotid plaque enhancement shown by multidetector CT angiography and histologically validated microvessel density

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Abstract

Purpose

Carotid plaques analysed by MDCTA can show contrast enhancement. The purpose of this study was to explore the association between carotid plaque enhancement (CPE) and microvessel density.

Materials and methods

We obtained IRB approval. Twenty-nine consecutive (male, 20; median age, 63) symptomatic patients studied with 16-detector CT were prospectively analysed. Examinations were performed before and after intravenous contrast medium administration, and analysis of plaque enhancement was performed. Patients underwent “en bloc” carotid endarterectomy; histological sections were prepared and the presence of microvessels quantified. Logistic regression analysis as well as ROC curve and area under the curve was calculated.

Results

A statistically significant association between the degree of CPE and microvessel density (P = 0.009; rho = 0.553) was observed. The ROC curve analysis confirmed this association with an area under the curve of 0.906, 0.735, 0.644 and 0.546 for CPE of 10 HU, 15 HU, 20 HU and 25 HU respectively. There was a statistically significant difference between the CPE and the degree of neovascularisation (P = 0.0003).

Conclusion

Results of this preliminary study suggest that CPE might be associated with the microvessel density. Histological analysis seems to demonstrate that the degree of intra-plaque neo-vascularisation is statistically associated with CPE.

Key Points

  • Carotid artery plaque enhancement at CT is associated with microvessel density.

  • The degree of intra-plaque neo-vascularisation is statistically associated with carotid plaque enhancement.

  • Plaque enhancement at CT should be considered when assessing vulnerable plaques.

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Authors and Affiliations

  1. Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari–Polo di Monserrato, s.s. 554, Monserrato, Cagliari, 09045, Italy

    Luca Saba & Mario Piga

  2. Department of Pathology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari–Polo di Monserrato, s.s. 554, Monserrato, Cagliari, 09045, Italy

    Maria Letizia Lai, Elisabetta Tamponi & Gavino Faa

  3. Department of Vascular Surgery, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari–Polo di Monserrato, s.s. 554, Monserrato, Cagliari, 09045, Italy

    Roberto Montisci & Roberto Sanfilippo

Authors
  1. Luca Saba
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  2. Maria Letizia Lai
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  3. Roberto Montisci
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  4. Elisabetta Tamponi
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  5. Roberto Sanfilippo
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  6. Gavino Faa
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  7. Mario Piga
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Correspondence to Luca Saba.

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Saba, L., Lai, M.L., Montisci, R. et al. Association between carotid plaque enhancement shown by multidetector CT angiography and histologically validated microvessel density. Eur Radiol 22, 2237–2245 (2012). https://doi.org/10.1007/s00330-012-2467-5

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  • DOI: https://doi.org/10.1007/s00330-012-2467-5

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