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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleExtracranial Vascular

Carotid Artery Plaque Characterization Using CT Multienergy Imaging

L. Saba, G.M. Argiolas, P. Siotto and M. Piga
American Journal of Neuroradiology April 2013, 34 (4) 855-859; DOI: https://doi.org/10.3174/ajnr.A3285
L. Saba
aFrom the Department of Radiology (L.S., M.P.), Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari-Polo di Monserrato, Monserrato, Cagliari, Italy
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G.M. Argiolas
bDepartment of Radiology (G.M.A., P.S.), Azienda Ospedaliera Brotzu-Cagliari, Cagliari, Italy.
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P. Siotto
bDepartment of Radiology (G.M.A., P.S.), Azienda Ospedaliera Brotzu-Cagliari, Cagliari, Italy.
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M. Piga
aFrom the Department of Radiology (L.S., M.P.), Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari-Polo di Monserrato, Monserrato, Cagliari, Italy
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Figures

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    Fig. 1.

    An 83-year-old male patient. In the 4 panels, the HU value (white arrows) is visible at the different monochromatic energy levels (gray arrowheads): 66 (A), 70 (B), 77 (C), and 86 keV (D). This plaque is in the fatty category by using all 4 energy levels.

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    Fig. 2.

    A 76-year-old male patient. In the 4 panels, the HU value (white arrows) is visible at the different monochromatic energy levels (gray arrowheads): 66 (A), 70 (B), 77 (C), and 86 keV (D). This plaque is in the mixed category for 66 (A), 70 (B), and 77 keV (C) but is in the fatty category with 86 keV (D) energy.

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    Fig. 3.

    Box-and-whisker plot of the attenuation values according to the different kiloelectron volt levels.

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    Fig. 4.

    Graph shows the HU values of the plaque. The attenuation value of 60 HU, which is considered the threshold between mixed and fatty plaques, is visible (the HU values >60 are visible in the shaded area of the graph). The dotted rectangle indicates the plaques in which a classification shift occurred according to the energy level.

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    Fig. 5.

    Bland-Altman plot analysis at 66 (A), 70 (B), 77 (C), and 86 keV (D).

Tables

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    Table 1:

    Summary table of HU values at different kiloelectron volts

    Energy (keV)Mean HU95% CISDMedian95% CI2.5–97.5 PNormal Distribution
    6660,3951,598–69,18227,8545644,000–65,17121,525–129,475.028a
    7055,65947,591–63,72625,55845241,000–60,17121,050–118,425.028a
    7749,17141,969–56,37222,81554937,000–52,28518,000–105,950.036a
    8643,04936,483–49,61520,80264332,943–47,05713,575–96,750.04a
    • Note:—P indicates percentiles.

    • ↵a Statistically significant P value: normality rejected.

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    Table 2:

    Wilcoxon analysis (P values)

    Energy (keV)66 keV70 keV77 keV86 keV
    66x.001a.001a.001a
    70.001ax.001a.001a
    77.001a.001ax.001a
    86.001a.001a.001ax
    • Note:—x indicates not calculable.

    • ↵a Statistically significant P value.

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    Table 3:

    Plaque type according to the energy (n = 53)

    Energy (keV)Fatty PlaquesMixed Plaques
    662330
    702825
    773122
    863419
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    Table 4:

    χ2 test to assess the variation in plaque type according to the kiloelectron volts used

    Energy (keV)66 keV70 keV77 keV86 keV
    66x0,3310,12.032a
    700,331x0,557.236
    770,120,557x.549
    860,032a0,2360,549x
    • Note:—x indicates not calculable.

    • ↵a Statistically significant P value.

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American Journal of Neuroradiology: 34 (4)
American Journal of Neuroradiology
Vol. 34, Issue 4
1 Apr 2013
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Cite this article
L. Saba, G.M. Argiolas, P. Siotto, M. Piga
Carotid Artery Plaque Characterization Using CT Multienergy Imaging
American Journal of Neuroradiology Apr 2013, 34 (4) 855-859; DOI: 10.3174/ajnr.A3285

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Carotid Artery Plaque Characterization Using CT Multienergy Imaging
L. Saba, G.M. Argiolas, P. Siotto, M. Piga
American Journal of Neuroradiology Apr 2013, 34 (4) 855-859; DOI: 10.3174/ajnr.A3285
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