Multidetector Spiral CT Was Used To Characterize And Quantify The Vulnerability Of Carotid Plaque

Acute cerebral infarction(ACI)is a kind of ischemic cerebrovascular disease.It is the second most common cause of death in the world after heart disease.It is also the most common cause of chronic disability in people over40 years old.It has caused significant harm to the physical and mental health of Chinese people.The primary cause of this incident was the formation of arterial plaques.In recent years,the research of multidetector spiral CT on carotid plaque is becoming mature,which can analyze carotid plaque from multiple angles.More and more studies have confirmed that MRI is the "gold standard" for the evaluation of carotid plaque.MRI can not only predict stroke and predict the prognosis of the heart,but also clearly display and measure the boundary,size and nature of the plaque.In addition,with the continuous development and improvement of CT examination technology,the use of it in the imaging and analysis of carotid plaque has gradually increased.Therefore,the components of carotid plaque can be characterized and quantified by high-resolution magnetic resonance imaging and multidetector spiral CT.Objectives:Multidetector spiral CT(MDCT)was used to characterize and quantify carotid plaque,and its application value in plaque vulnerability assessment was to study and discuss.Methods:A total of 56 patients with carotid plaque diagnosed by MDCT and MRI in our hospital from October 2018 to December 2020 were collected.MRI was used as the "gold standard" to diagnose and evaluate the plaque nature(plaque bleeding,lipid nuclei,fibrous tissue)of 56 patients,and the CT value and area of plaque components in corresponding CT images were measured.At the same time,the relationship between plaque vulnerability and clinical secondary disease was analyzed.Collect the clinical baseline data of patients,and obtain the influencing factors of plaque stability through corresponding statistical methods.Results:1 CT thresholds of carotid plaque components and correlation between MDCT and MRI: ANOVA analysis of variance showed that the CT thresholds of intraplaque hemorrhage,lipid nucleus and fibrous tissue in plaque were(20.84±11.12),(43.92±13.84),(82.32±18.66)Hu,and the difference was statistically significant(P<0.01);linear regression analysis showed that the area of intraplaque hemorrhage,lipid nucleus and fibrous tissue in plaque measured by MDCT was significantly different There was a good correlation between MRI and plaque area(R~2 =0.917 、 R~2 =0.949 、 R~2 =0.923 、 R~2=0.932).There is a significant correlation between carotid artery vulnerable plaque and clinical cerebrovascular events(P=0.001).2 Plaque stability imaging factors:Baseline data analysis:Age,TC,TG,LDL-C,HDL-C,HCY are related to plaque vulnerability,and their differences are significant(P<0.01);smoking,drinking patients had a higher incidence of carotid vulnerable plaque.Multivariate logistic regression analysis showed that HCY was independent influencing factors of carotid vulnerable plaque,and the difference is statistically significant(P=0.047).Conclusions:1 CT can accurately diagnose the vulnerability of carotid plaque,and can be used as a supplement of HR-MRI.2 HCY was independent risk factors of carotid vulnerable plaque.