Carotid artery wall thickness and ischemic symptoms: evaluation using multi-detector-row CT angiography

Abstract

The purpose of this study was to determine if carotid artery wall thickness (CAWT) studied by using multi-detector-row CT angiography (MDCTA) can be considered an effective parameter predictive of increased risk of stroke. A total of 217 patients were retrospectively studied by using MDCTA. In all patients CAWT was measured with an internal digital caliper. Continuous data were described as the mean value +/- standard deviation (SD), and they were compared with Student's t-test. Scatter plots to determine interobserver agreement were performed, and correlation coefficient was calculated with Pearson statistics. A P value <0.05 was considered to mean statistical significance. Measurements of the distal common CAWT ranged from 0.5 to 1.6 mm. In the patient group without stroke, average CAWT was 0.82 mm (0.22 SD), whereas in patient group with stroke it was 1.096 mm (0.21 SD). CAWT in patients without stroke showed statistical difference (P < 0.0001) when compared to patients with stroke. By using a threshold of 1 mm, an important statistical association between thick CAWT and stroke was found (P < 0.0001). In fact, patients with > or = 1 mm CAWT had stroke with an odds ratio of 8.16 when compared with patients with <1 mm CAWT. Resulting data suggested that an increased CAWT is an indicator for risk of stroke. This parameter should be considered in addition to other well-known risk factors such as diabetes, hypertension, smoking, and dyslipidemia.

Carotid Doppler Ultrasound Evaluation in Patients with Pulsatile Tinnitus

“…Increased carotid wall thickness has been shown to be a significant predictor of coronary and cerebrovascular diseases [21][22][23]. In our study, mean IMT was 1.05 and 0.85 mm for the patient and the control groups, respectively.…”

Associations between Carotid Artery Wall Thickness and Cardiovascular Risk Factors Using Multidetector CT

“…Each MDCTA examination was performed when it was clinically indicated and was ordered by the patient's physician as part of routine clinical care, as described previously. 10,15,16 In our institution, the inclusion criteria for performing MDCTA are as follows: a prior clinical indication for CTA of the supra-aortic vessels (when possible also confirmed by US-ECD study 15 ) as stated by the referring physician and established by the attending radiologist. In particular, the main reason for referral to MDCTA is the presence of a sonogram showing a pathologic stenosis and/or a plaque alteration, or when sonography cannot provide sufficient information about the degree of stenosis-for example, in the presence of large calcified plaques with acoustic shadowing, high carotid bifurcation, or a thick neck (edema, obese patients).…”

“…Part of our patient cohort had been included in previous studies. 15,[17][18][19] Vascular risk factors that are known before a stroke or TIA, coexisting comorbidities, and treatment before a stroke or TIA are systematically recorded at our institution. "Essential hypertension" was defined in those individuals who had systolic blood pressure Ͼ140 mm Hg and/or diastolic blood pressure Ͼ90 mm Hg or who were being treated with blood pressureϪlowering drugs.…”

“…[12][13][14] It was previously demonstrated 15 that the presence of CAWT of Ͼ1 mm is significantly associated with cerebral symptoms, and these data, together with the analysis of stenosis degree, type of plaque, and presence of ulceration, may lead to obtaining a better stroke-risk stratification for the patient.…”

“…3,4 It has been demonstrated that an increased CCA-IMT measured by B-mode sonography is associated with an increased risk of stroke and its severity. [5][6][7][8][9] With the development of CTA and, in particular, with the introduction of even more sophisticated software, MDCTA has become a valid method for studying the carotid artery and its pathology [10][11][12][13][14] ; it was recently proposed 15 that CAWT is the MDCTA equivalent of B-mode sonography CCA-IMT.…”