Ajduk Marko, Pavić Ladislav, Bulimbasić Stela, Sarlija Mirko, Pavić Predrag, Patrlj Leonardo, Brkljacić Boris
Department of Vascular Surgery, University Hospital Dubrava, Zagreb, Croatia.
Ann Vasc Surg. 2009 Mar;23(2):186-93. doi: 10.1016/j.avsg.2008.05.008. Epub 2008 Jul 26.
Our aim was to determine the sensitivity and specificity of multidetector-row computed tomography (CT) in detecting atherosclerotic carotid plaques complicated with intraplaque hemorrhage. We examined carotid plaques from 31 patients operated for carotid artery stenosis. Results of preoperative multidetector-row CT analysis of carotid plaques were compared with results of histological analysis of the same plaque areas. Carotid endarterectomy was performed within 1 week of multidetector-row CT. American Heart Association classification of atherosclerotic plaques was applied for histological classification. Median tissue density of carotid plaques complicated with intraplaque hemorrhage was 22 Hounsfield units (HU). Median tissue density of noncalcified segments of uncomplicated plaques was 59 HU (p=0.0062). The highest tissue density observed for complicated plaques was 31 HU. Multidetector-row CT detected plaques complicated with hemorrhage with sensitivity of 100% and specificity of 64.7%, with tissue density of 31 HU as a threshold value. Multidetector-row CT showed a high level of sensitivity and a moderate level of specificity in detecting atherosclerotic carotid plaques complicated with hemorrhage.
我们的目的是确定多排螺旋计算机断层扫描（CT）检测合并斑块内出血的动脉粥样硬化性颈动脉斑块的敏感性和特异性。我们检查了31例因颈动脉狭窄接受手术的患者的颈动脉斑块。将术前多排螺旋CT对颈动脉斑块的分析结果与相同斑块区域的组织学分析结果进行比较。多排螺旋CT检查后1周内进行颈动脉内膜切除术。采用美国心脏协会动脉粥样硬化斑块分类进行组织学分类。合并斑块内出血的颈动脉斑块的组织密度中位数为22亨氏单位（HU）。未合并斑块的非钙化节段的组织密度中位数为59 HU（p=0.0062）。合并斑块观察到的最高组织密度为31 HU。以31 HU的组织密度为阈值，多排螺旋CT检测合并出血的斑块时敏感性为100%，特异性为64.7%。多排螺旋CT在检测合并出血的动脉粥样硬化性颈动脉斑块时显示出高敏感性和中等特异性。
