Preliminary Analysis Of The Characteristics Of The Component Of Carotid Atherosclerotic Plaque With MDCTA And Its Clinical Significance

Objective: To analyze morphological features of the atherosclerotic plaque and characteristics of the component of the carotid atherosclerotic plaque by multi-director computed tomography angiography(MDCTA),explore the relationship between atherosclerotic plaque and the occurrence of cerebral embolism or cerebral hemorrhage.To provide the risk assessment of atherosclerotic plaque and the scientific data for the prevention and treatment on cerebral embolism and cerebral hemorrhage patients.Methods: 400 patients of the people's hospital of gaomi city,with symptoms of carotid artery stenosis caused by carotid atherosclerosis from November 2013 to November 2016,were studied.Other possible causes of carotid artery stenosis,such as cerebral infarction,diabetes,moyamoya disease,arteritis,were excluded.The patients were examined by Philips 64 128 layer spiral CT.All the data,including the plaque volume,CT value,the degree of carotid artery stenosis,were collected and classified according to CT value.Then the relationship between the characteristics of the component of the carotid atherosclerotic plaque,the degree of carotid artery stenosis,and the occurrence of cerebral embolism and cerebral hemorrhage were analyzed.Results:1.Totally,400 patients were enrolled in the study.Of these patients,there were 208 fibrous plaques cases,60 fatty plaques cases,80 calcified plaque cases,52 mixed plaque.Among these patients,plaques combined with ulceration occurred in 129 cases,and high occurrence of ischemic stroke was observed among the patients combined with ulceration.In total,ulcer plaque was found in 82% cerebral infarction patients.2.Of the patients with cerebral hemorrhage,60% of patients had calcified plaques.The percentage of patients with calcified plaques was significantly higher than patients with cerebral infarction and their levels of blood pressure were significantly higher than controls.3.The distribution of fatty plaques,fibrous plaques,and mix plaques of the patients with cerebral infarction was not different with patients with cerebral hemorrhage.4.In mild-to-moderate carotid stenosis group,fatty plaque volume percent and cerebral thrombosis were positively correlated the occurrence of cerebral infarction(odds ratio(OR)= 2.24,95% confidence intervene(CI): 1.17 4.67;P < 0.001),while calcified plaque volume percent are negatively correlated with the occurrence of cerebral infarction(OR = 0.36,95% CI: 0.29 0.83;P = 0.007).In severe carotid stenosis group,the low density plaque volume/total volume percentage was positively correlated with the occurrence of ischemic stroke(OR = 1.63,95% CI: 1.13 4.15;P = 0.005),and no significant difference of high density plaque volume/volume percentage between patients combined with ischemic stroke and non-ischemic stroke patients(OR = 0.89,95% CI: 0.53 2.17;P = 0.31).Significant difference of high density plaques and mixed density plaques was observed between patients combined with ischemic stroke and non-ischemic stroke patients(P<0.05).Moreover,ulcer plaque has significant correlation with the incidence of cerebral thrombosis symptoms(P < 0.05).Conclusions: Carotid stenosis degree is positively correlated with the incidence of ischemic stroke,and the incidence of ischemic stroke was higher among patients with irregular and ulcer plaque.Merge ulcer plaque were more found among patients with cerebral ischemia,and calcification plaque were more found among patients with cerebral hemorrhage.The component characteristics of carotid atherosclerotic plaques could be analyzed by MDCTA.the evaluation on vulnerability and instability of carotid atherosclerotic plaques would be helpful for the prevention of ischemic cerebral apoplexy patients.