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26.03.2019 | Computed Tomography

Carotid plaque composition by CT angiography in asymptomatic subjects: a head-to-head comparison to ultrasound

verfasst von: Ramshanker Ramanathan, Damini Dey, Bjarne L. Nørgaard, Markus Goeller, Ida S. Bjerrum, Ronald Antulov, Axel C. P. Diederichsen, Johannes J. Sidelmann, Jørgen B. Gram, Niels Peter R. Sand

Erschienen in: European Radiology | Ausgabe 11/2019

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Abstract

Objectives

To describe carotid plaque composition by computed tomography angiography (CTA) in asymptomatic subjects and to compare this to carotid plaque assessment by ultrasound, coronary plaques by coronary CTA, and inflammatory biomarkers in plasma.

Methods

Middle-aged asymptomatic men, n = 43, without known cardiovascular disease and diabetes were included. Plaques in coronary and carotid arteries were evaluated using CTA. Total plaque volumes and plaque composition were assessed by a validated plaque analysis software. The 60% centile cut point was used to divide the population into low or high carotid total plaque volumes. The occurrence of carotid plaques and intima-media thickness (IMT) was estimated by ultrasound.

Results

Carotid plaque by ultrasound was undiagnosed in 13 of 28 participants (46%) compared to CTA. Participants having carotid plaques by ultrasound had significantly higher absolute volumes of all CTA-defined carotid plaque subtypes and a higher fraction of calcified plaque. A high carotid total plaque volume was independently associated with age (adjusted odds ratio (OR) 1.41 [95% confidence interval (CI) 1.14–1.74], p = 0.001), IMT (adjusted OR 2.26 [95% CI 1.10–4.65], p = 0.03), and D-dimer (adjusted OR 8.86 [95% CI 1.26–62.37], p = 0.03). All coronary plaque features were significantly higher in participants with a high carotid total plaque volume.

Conclusion

The occurrence of carotid plaques in asymptomatic individuals is underestimated by ultrasound compared to plaque assessment by CTA. Carotid plaque composition by CTA is different in individuals with and without carotid plaques by ultrasound.

Key Points

• The occurrence of carotid plaques by ultrasound was underestimated in 46% of participants who had plaques by carotid CTA.

• Participants with carotid plaques by ultrasound had higher volumes of all plaque subtypes and a higher calcified plaque component as determined by carotid CTA compared to participants without carotid plaques by ultrasound.

• A high carotid total plaque volume was independently associated with age, intima-media thickness, and D-dimer.

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Titel: Carotid plaque composition by CT angiography in asymptomatic subjects: a head-to-head comparison to ultrasound
verfasst von: Ramshanker Ramanathan
Damini Dey
Bjarne L. Nørgaard
Markus Goeller
Ida S. Bjerrum
Ronald Antulov
Axel C. P. Diederichsen
Johannes J. Sidelmann
Jørgen B. Gram
Niels Peter R. Sand
Publikationsdatum: 26.03.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 11/2019
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-019-06086-y

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Carotid plaque composition by CT angiography in asymptomatic subjects: a head-to-head comparison to ultrasound