Carotid Intraplaque-Hemorrhage Volume and Its Association with Cerebrovascular Events

• Published in: American journal of neuroradiology : AJNR Vol. 40; no. 10; pp. 1731 - 1737
• Main Authors: Saba, L, Micheletti, G, Brinjikji, W, Garofalo, P, Montisci, R, Balestrieri, A, Suri, J S, DeMarco, J K, Lanzino, G, Sanfilippo, R
• Format: Journal Article
• Language: English
• Published: United States American Society of Neuroradiology 01-10-2019
• Subjects: Aged; Carotid Stenosis - complications; Carotid Stenosis - pathology; Cerebral Hemorrhage - complications; Cerebral Hemorrhage - pathology; Cerebrovascular Disorders - etiology; Extracranial Vascular; Female; Humans; Male; Middle Aged; Plaque, Atherosclerotic - complications; Plaque, Atherosclerotic - pathology; Retrospective Studies; ROC Curve
• ISSN: 0195-6108; 1936-959X
• DOI: 10.3174/ajnr.A6189

Our aim was to assess the relationship between volume and percentage of intraplaque hemorrhage measured using CT and the occurrence of cerebrovascular events at the time of CT.
One-hundred-twenty-three consecutive subjects (246 carotid arteries) with a mean age of 69 years who underwent CTA were included in this retrospective study. Plaque volume of components and subcomponents (including intraplaque hemorrhage volume) was quantified with dedicated software.
Forty-six arteries were excluded because no plaque was identified. In the remaining 200 carotid arteries, a statistically significant difference was found between presentation with cerebrovascular events and lipid volume (
= .002), intraplaque hemorrhage volume (
= .002), percentage of lipid (
= .002), percentage of calcium (
= .001), percentage of intraplaque hemorrhage (
= .001), percentage of lipid-intraplaque hemorrhage (
= .001), and intraplaque hemorrhage/lipid ratio (
= .001). The highest receiver operating characteristic area under the curve was obtained with the intraplaque hemorrhage volume with a value of 0.793 (
= .001), percentage of intraplaque hemorrhage with an area under the curve of 0.812 (
= .001), and the intraplaque hemorrhage/lipid ratio with an area under the curve value of 0.811 (
= .001).
Results of our study suggest that Hounsfield unit values <25 have a statistically significant association with the presence of cerebrovascular events and that the ratio intraplaque hemorrhage/lipid volume represents a strong parameter for the association of cerebrovascular events.