1. Application of Dual‐Layer Spectral‐Detector Computed Tomography Angiography in Identifying Symptomatic Carotid Atherosclerosis: A Prospective Observational Study
- Author
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Jia Zhang, Sijia Li, Lei Wu, Haoyuan Wang, Chuanying Wang, Yinan Zhou, Binbin Sui, and Xingquan Zhao
- Subjects
carotid plaque ,computed tomography angiography ,dual‐layer spectral‐detector dual‐energy computed tomography ,symptomatic carotid atherosclerosis ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Dual‐layer spectral‐detector dual‐energy computed tomography angiography (DLCTA) can distinguish components of carotid plaques. Data on identifying symptomatic carotid plaques in patients using DLCTA are not available. Methods and Results In this prospective observational study, patients with carotid plaques were enrolled and received DLCTA. The attenuation for both polyenergetic image and virtual monoenergetic images (40, 70, 100, and 140 keV), as well as Z‐effective value, were recorded in the noncalcified regions of plaques. Logistic regression models were used to assess the association between attenuations of DLCTA and the presence of symptomatic carotid plaques. In total, 100 participants (mean±SD age, 64.37±8.31 years; 82.0% were men) were included, and 36% of the cases were identified with the symptomatic group. DLCTA parameters were different between 2 groups (symptomatic versus asymptomatic: computed tomography [CT] 40 keV, 152.63 [interquartile range (IQR), 70.22–259.78] versus 256.78 [IQR, 150.34–408.13]; CT 70 keV, 81.28 [IQR, 50.13–119.33] versus 108.87 [IQR, 77.01–165.88]; slope40–140 keV, 0.91 [IQR, 0.35–1.87] versus 1.92 [IQR, 0.96–3.00]; Z‐effective value, 7.92 [IQR, 7.53–8.46] versus 8.41 [IQR, 7.94–8.92]), whereas no difference was found in conventional polyenergetic images. The risk of symptomatic plaque was lower in the highest tertiles of attenuations in CT 40 keV (adjusted odds ratio [OR], 0.243 [95% CI, 0.078–0.754]), CT 70 keV (adjusted OR, 0.313 [95% CI, 0.104–0.940]), Z‐effective values (adjusted OR, 0.138 [95% CI, 0.039–0.490]), and slope40–140 keV (adjusted OR, 0.157 [95% CI, 0.046–0.539]), with all P values and P trends
- Published
- 2024
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