The purpose of the study is to determine the accuracy of carotid artery plaque density measurements using multi detector computed tomography (MDCT) with contrast administration to differentiate symptomatic from asymptomatic plaques.
Materials and Methods: Seventy-two patients who did not have calcified plaques were identified retrospectively among patients undergoing neck and brain MDCT due to atherosclerotic carotid artery disease diagnosis or pre-diagnosis. The plaque density measurements were made on the same axial unenhanced and contrast-enhanced sections in large window, using a circular ROI in 1-4 mm² in size. The symptom differentiation of patients was based on neurological examination and radiological findings. The measured density values were compared according to the clinical and laboratory findings and medical histories of the patients. Student t-test was used for statistical analyses.
Results: Significant differences (p<0.001) were found between the unenhanced and contrast-enhanced plaque densities, but the same density difference was not observed among symptomatic patients. A significant relationship was shown between the plaque density and localization (p<0.003). In addition, the comparison between the degree of stenosis and symptoms was statistically significant (p<0.001). There was no significant association between the plaque density and symptoms, gender, stenosis side, infarct type, hyperlipidemia, hypertension, diabetes, coronary artery disease and cigarette use.
Conclusion: An increased density with MDCT was determined depending on the contrast agent uptake in carotid plaques. However, it was not statistically significant between the symptomatic and the asymptomatic patients groups.