title: Demographics of carotid atherosclerotic plaque features imaged by computed tomography.
abstract: OBJECTIVE
  This was a prospective, cross-sectional study to evaluate the risk factors and symptoms associated with specific carotid wall and atherosclerotic plaque features as seen on computed tomography-angiography (CTA) studies.
  
  
  METHODS
  A total of 120 consecutive consenting patients admitted to the emergency department with suspected cerebrovascular ischemia, and receiving standard-of-care CTA of the brain and neck on a 64-slice CT scanner, were prospectively enrolled in the study. The carotid wall features observed on CT were quantitatively analyzed with customized software using different radiodensities for contrast-phase acquisition of the carotids. Clinical datasets, including a complete medical history and examination, were obtained by research physicians or specially trained associates blinded to any findings on CT. Univariate and multivariate analyses were performed to assess the degree of association between clinical indicators and quantitative CT features of carotid atherosclerotic plaques.
  
  
  RESULTS
  Men tended to have increased carotid lumen (coefficient: 608.7; 95% CI: 356.9-860.6; P<0.001) and wall volumes (209.2; 54.5-364.0; P=0.008), and hypertension was associated with increased wall volume (260.6; 88.7-432.6; P=0.003). Advanced age was associated with increases in maximum wall thickness (0.02; 0.003-0.05; P=0.029), fibrous cap thickness (0.005; 0.001-0.008; P=0.016) and number of calcium voxels (2.7; 1.25-4.2; P<0.001), and the presence of a carotid bruit was associated with carotid stenosis length (21.0; 5.38-37.8; P=0.009). Exercise was inversely related to the number of calcium (-37.1; -71.5 - -2.7; P=0.035) and lipid (-7.9; -15.1 - -0.7; P=0.032) voxels. ACE inhibitor use was associated with fibrous cap thickness (0.1; 0.04-0.23; P=0.005).
  
  
  CONCLUSIONS
  Significant associations were found between clinical descriptors and carotid atherosclerotic plaque features as revealed by CT. Future studies are needed to validate our findings, and to continue investigations into whether CT features of carotid plaques can be used as biomarkers to quantify the impact of strategies aiming to correct vascular risk factors.
authors: University of California San Francisco, Department of Radiology and Biomedical Imaging, Neuroradiology Section, San Francisco, USA.
authors: Jeffrey D
authors: JD
authors: Chien
authors: Andre
authors: A
authors: Furtado
authors: Su-Chun
authors: SC
authors: Cheng
authors: Jessica
authors: J
authors: Lam
authors: Sarah
authors: S
authors: Schaeffer
authors: Kimberly
authors: K
authors: Chun
authors: Max
authors: M
authors: Wintermark
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000706:statistics & numerical data*; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D002340:Carotid Artery Diseases / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012495:San Francisco / Q000453:epidemiology; D017678:Sex Distribution; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*