Comparison of multidetector-row computed tomography and duplex Doppler ultrasonography in detecting atherosclerotic carotid plaques complicated with intraplaque hemorrhage [Usporedba višeslojne kompjuterizirane tomografije i duplex Doppler ultrazvuka u otkrivanju aterosklerotskih karotidnih plakova kompliciranih krvarenjem u plak ]

Ajduk, Marko and Bulimbašić, Stela and Pavić, Ladislav and Šarlija, Mirko and Patrlj, Leonardo and Brkljačić, Boris and Pavić, Predrag and Čikara, Igor and Ivanac, Gordana (2013) Comparison of multidetector-row computed tomography and duplex Doppler ultrasonography in detecting atherosclerotic carotid plaques complicated with intraplaque hemorrhage [Usporedba višeslojne kompjuterizirane tomografije i duplex Doppler ultrazvuka u otkrivanju aterosklerotskih karotidnih plakova kompliciranih krvarenjem u plak ]. Collegium Antropologicum, 37 (1). pp. 213-219. ISSN 0350-6134

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Abstract

This study compared sensitivity and specificity of multidetector-row computed tomography and duplex Doppler ultrasonography in detecting atherosclerotic carotid plaques complicated with intraplaque hemorrhage. Carotid plaques from 50 patients operated for carotid artery stenosis were analyzed. Carotid endarterectomy was performed within one week of diagnostic evaluation. Results of multidetector-row computed tomography and duplex Doppler ultrasonography diagnostic evaluation were compared with results of histological analysis of the same plaque areas. American Heart Association classification of atherosclerotic plaques was applied for histological classification. Median tissue density of carotid plaques complicated with intraplaque hemorrhage was 14.7 Hounsfield units. Median tissue density of noncalcified segments of uncomplicated plaques was 54.3 Hounsfield units (p = 0.00003). The highest tissue density observed for complicated plaques was 31.8 Hounsfield units. Multidetector-row computed tomography detected plaques complicated with hemorrhage with sensitivity of 100% and specificity of 70.4%, with tissue density of 33.8 Hounsfield units as a threshold value. Duplex Doppler ultrasonography plaque analysis based on visual in-line classification showed sensitivity of 21.7% and specificity of 89.6% in detecting plaques complicated with intraplaque hemorrhage. Multidetector-row computed tomography showed a very high level of sensitivity and a moderate level of specificity in detecting atherosclerotic carotid plaques complicated with hemorrhage. Duplex Doppler ultrasonography plaque analysis based on visual in-line classification showed a low level of sensitivity and a moderate-high level of specificity in detecting atherosclerotic carotid plaques complicated with hemorrhage.

Abstract in Croatian

Cilj ove studije bio je usporediti osjetljivost i specifičnost višeslojne kompjuterizirane tomografije i duplex Doppler ultrazvuka u otkrivanju krvarenja u aterosklerotski karotidni plak. U studiji je analizirano 50 karotidnih plakova uzetih nakon karotidne endarterektomije. Uspoređeni su rezultati prijeoperacijske analize višeslojnom kompjuteriziranom tomografijom i duplex-om sa nalazima histološke analize istih područja plakova. Karotidna endarterektomija radila se unutar tjedan dana od analize višeslojnom kompjuteriziranom tomografijom. Prilikom histološke analize koristila se klasifikacija aterosklerotskih plakova predložena od American Heart Association. Median tkivne gustoće karotidnih plakova kompliciranih krvarenjem bio je 14,7 Hounsfieldovih jedinica. Median tkivne gustoće nekalcificiranih dijelova plakova bez krvarenja bio je 54,3 Hounsfieldove jedinica (p=0,00003). Najveća izmjerena tkivna gustoća plakova kompliciranih krvarenjem bila je 31,8 Hounsfieldove jedinice. Višeslojna kompjuterizirana tomografija pokazala je osjetljivost od 100% i specifičnost od 70,4% u otkrivanju plakova kompliciranih krvarenjem pri graničnoj vrijednosti od 33,8 Hounsfieldove jedinice. Koristeći vizuelnu klasifikaciju plakova, duplex je pokazao osjetljivost od 21,7% i specifičnost od 89,7% u otkrivanju plakova kompliciranim krvarenjem. Rezultati ove studije pokazali su vrlo visoku osjetljivost i umjerenu specifičnost višeslojne kompjuterizirane tomografije, te nisku osjetljivost i umjereno visoku specifičnost duplex-a u otkrivanju plakova kompliciranih krvarenjem.

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