title: Multilevel assessment of atherosclerotic extent using a 40-section multidetector scanner after transient ischemic attack or ischemic stroke.
abstract: OBJECTIVE
  The first part of this study assessed the potential of MDCT with a CTA examination of the aorta and the coronary, cervical, and intracranial vessels in the etiologic work-up of TIA or ischemic stroke compared with established imaging methods. The objective of the second part of this study was to assess the atherosclerotic extent by use of MDCT in these patients.
  
  
  METHODS
  From August 2007 to August 2011, a total of 96 patients with ischemic stroke or TIA without an evident cardioembolic source were enrolled. All patients underwent MDCT. Atherosclerotic extent was classified in 0, 1, 2, 3, and 4 atherosclerotic levels according to the number of arterial territories (aortic arch, coronary, cervical, intracranial) affected by atherosclerosis defined as ≥ 50% cervical, intracranial, or coronary stenosis or ≥ 4-mm aortic arch plaque.
  
  
  RESULTS
  There were 91 patients who had an interpretable MDCT. Mean age was 67.4 years (± 11 years), and 75 patients (83.3%) were men. The prevalence of 0, 1, 2, 3, and 4 atherosclerotic levels was 48.3%, 35.2%, 12.1%, 4.4%, and 0%, respectively. Aortic arch atheroma was found in 47.6% of patients with 1 atherosclerotic level. The combination of aortic arch atheroma and cervical stenosis was found in 63.6% of patients with ≥ 2 atherosclerotic levels. Patients with ≥ 2 atherosclerotic levels were older than patients with < 2 atherosclerotic levels (P = .04) in univariate analysis.
  
  
  CONCLUSIONS
  MDCT might be useful to assess the extent of atherosclerosis. It could help to screen for high-risk patients who could benefit from a more aggressive preventive strategy.
authors.affiliation: From the Stroke Unit (L.M., L.D., T.-H.C., N.N.), Hôpital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.
authors.forename: L
authors.initials: L
authors.lastname: Mechtouff
authors.forename: L
authors.initials: L
authors.lastname: Boussel
authors.forename: S
authors.initials: S
authors.lastname: Cakmak
authors.forename: J-L
authors.initials: JL
authors.lastname: Lamboley
authors.forename: M
authors.initials: M
authors.lastname: Bourhis
authors.forename: N
authors.initials: N
authors.lastname: Boublay
authors.forename: A-M
authors.initials: AM
authors.lastname: Schott
authors.forename: L
authors.initials: L
authors.lastname: Derex
authors.forename: T-H
authors.initials: TH
authors.lastname: Cho
authors.forename: N
authors.initials: N
authors.lastname: Nighoghossian
authors.forename: P C
authors.initials: PC
authors.lastname: Douek
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000150:complications* / Q000000981:diagnostic imaging*; D002545:Brain Ischemia / Q000209:etiology*; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D020521:Stroke / Q000209:etiology*