Vulnerable plaque: detection of agreement between multi-detector-row CT angiography and US-ECD.
OBJECTIVE
The purpose of this work was to evaluate the agreement between ultra-sound echo-color Doppler (US-ECD) and multi-detector-row CT angiography (MDCTA) in the characterization of vulnerable plaque.


METHODS
From January 2004 to January 2007 658 patients who underwent both MDCTA and US-ECD for the study of carotid arteries, were retrospectively evaluated (453 males, 205 females). For all subjects the following parameters were analysed: plaque morphology (regular versus irregular), type of the plaque (fatty, mixed and calcified) and presence of ulcerations. Statistical analysis was performed to calculate concordance between the two techniques employed.


RESULTS
In the definition of the type of plaque, the observed agreements were 77.2% and the kappa value was 0.657 (95% confidence interval: 0.615-0.699). The weighted kappa resulted 0.644. In the definition of ulceration plaque, the observed agreements were 88.4% but the kappa value was only 0.325 (95% confidence interval: 0.201-0.449). Agreement observed in the evaluation of plaque morphology was 78.3% with a kappa value of 0.513 (95% confidence interval: 0.452-0.574).


CONCLUSIONS
We observed a good agreement between US-ECD and MDCTA in the assessment of plaque type whereas a poor agreement resulted in the evaluation of plaque ulceration. The use of US-ECD and MDCTA provides different results in the evaluation of plaque. Our results suggest that information deriving from US-ECD should be always critically compared with other diagnostic techniques.
Department of Radiology Azienda Ospedaliera del Policlinico Universitario, University of Cagliari, ss 554 Monserrato, Cagliari 09045, Italy. lucasaba@tiscali.it
Luca
L
Saba
Roberto
R
Sanfilippo
Roberto
R
Montisci
Matteo
M
Atzeni
Diego
D
Ribuffo
Giorgio
G
Mallarini
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D016893:Carotid Stenosis / Q000175:diagnosis*; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*