Department of Radiology, Azienda Ospedaliero, Universitaria di Cagliari, Polo di Monserrato s.s. 554 Monserrato, Cagliari 09045, Italy.
AJR Am J Roentgenol. 2012 Jul;199(1):151-6. doi: 10.2214/AJR.11.6955.
The purpose of this study was to evaluate the relationship between MDCT angiography-assessed carotid artery plaque volume and composition and the presence of ulceration.
Seventy consecutive patients (46 men and 24 women; mean age, 63 years; age range, 42-81 years) were studied using MDCT and were retrospectively analyzed. Component types of the carotid plaque were defined according to attenuation value ranges (lipid, < 60 HU; fibrous tissue, 60-130 HU; and calcification, > 130 HU). The plaque volumes of each component were calculated. Statistical analysis was performed using the receiver operating characteristic (ROC) statistic and Wilcoxon signed rank test to evaluate the association between the presence of ulceration and specific plaque components and their volume.
Eighteen carotid arteries were excluded, and 16 ulcerated plaques were detected in the remaining 122 carotid arteries. Wilcoxon and ROC curve analysis showed a statistically significant association between increased relative lipid volume and ulceration (p = 0.0001; area under the ROC curve, 0.916). The total volume of the plaque did not show an association with the presence of ulceration (p = 0.0526).
The results of our retrospective study suggest that there is no correlation between total carotid atherosclerotic plaque volume and ulcerations, whereas plaque relative lipid volume (using attenuation of < 60 HU) is associated with the presence of ulceration. This finding could indicate vulnerable plaques and increased risk for cerebrovascular events.
本研究旨在评估 MDCT 血管造影评估的颈动脉斑块体积和成分与溃疡的存在之间的关系。
对 70 例连续患者（46 名男性和 24 名女性；平均年龄 63 岁；年龄范围 42-81 岁）进行 MDCT 检查并进行回顾性分析。根据衰减值范围（脂质，<60HU；纤维组织，60-130HU；钙化，>130HU）定义颈动脉斑块的成分类型。计算每种成分的斑块体积。使用接收者操作特征（ROC）统计和 Wilcoxon 符号秩检验进行统计分析，以评估溃疡与特定斑块成分及其体积之间的关联。
排除 18 条颈动脉，在剩余的 122 条颈动脉中发现 16 个溃疡斑块。Wilcoxon 和 ROC 曲线分析表明，相对脂质体积增加与溃疡之间存在统计学显著关联（p=0.0001；ROC 曲线下面积为 0.916）。斑块的总体积与溃疡的存在无关联（p=0.0526）。
本回顾性研究结果表明，总颈动脉粥样硬化斑块体积与溃疡之间无相关性，而斑块相对脂质体积（衰减值<60HU）与溃疡的存在相关。这一发现可能表明易损斑块和增加脑血管事件的风险。
