Dong Jia, Bai Xuesong, Dmytriw Adam A, Xuan Lanlan, Wang Tao, Lu Xia, Feng Yao, Jiao Liqun
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Front Neurol. 2021 Dec 24;12:801683. doi: 10.3389/fneur.2021.801683. eCollection 2021.
C-arm cone-beam computed tomography (CBCT) offers a high imaging resolution with a wide range of contrast to visualize vessels, soft tissue, and bone. We report the usefulness of CBCT in observing neovascularization, microcalcification, and plaque rupture. A 56-year-old man presented with vertigo and complain of an unsteady gait for 5 months. Catheter angiography demonstrated right severe carotid stenosis with irregular filling defect, which on high-resolution MRI showed vessel wall enhancement. The CBCT showed high density structures and linear contrast enhancement from the vascular lumen to the plaque, related to microstructure and plaque rupture. Carotid endarterectomy was performed, and histopathology confirmed that the high-density areas represented neovascularization and microcalcification, with linear enhancement representing plaque rupture. This is the first report showing that microcalcifications and plaque rupture can be identified by CBCT. Thus, CBCT can be used as a promising supplement to current imaging modalities to evaluate plaque components more accurately.
C形臂锥形束计算机断层扫描（CBCT）具有高成像分辨率，对比度范围广，可清晰显示血管、软组织和骨骼。我们报告了CBCT在观察新生血管形成、微钙化和斑块破裂方面的应用价值。一名56岁男性出现眩晕，主诉步态不稳5个月。导管血管造影显示右侧严重颈动脉狭窄并伴有不规则充盈缺损，高分辨率MRI显示血管壁强化。CBCT显示高密度结构以及从血管腔到斑块的线性对比增强，这与微观结构和斑块破裂有关。患者接受了颈动脉内膜切除术，组织病理学证实高密度区域代表新生血管形成和微钙化，线性增强代表斑块破裂。这是首份表明CBCT可识别微钙化和斑块破裂的报告。因此，CBCT可作为一种有前景的补充手段，与目前的成像方式相结合，更准确地评估斑块成分。
