Article Figures & Data
Figures
- FIG 1.
An example of multiple imaging biomarkers in a left carotid artery plaque. A mixed-density plaque involving the left origin (A) and proximal aspect (B) of the left ICA has adventitial calcifications (white arrows), a soft-tissue component measuring >2 mm (white star), and an ulceration (black arrows).
- FIG 2.
An example of bulky calcifications in a right carotid plaque. Axial (A) and coronal reformatted (B) images demonstrate near-complete occlusion of the proximal right ICA by a large calcified plaque (arrows show residual lumen).
- FIG 3.
Histologic examples of a hemorrhagic (A) and partially calcified (B) plaque. Intraplaque-hemorrhage is represented by red tissue staining on Movat Pentachrome (white circle, A); blood products are superimposed on a lipid-rich necrotic core (represented by clear cholesterol clefts, black arrows) and white-stained tissue (black circle, A). Multiple coarse calcifications are seen in the second plaque, some of which were fragmented during the endarterectomy (asterisks) (both images are original magnification, ×12.5).
Tables
Risk Factors No. (%) (BMI = Mean and SD) Ethnicity White = 66 (98.5%)Native American = 1 (1.5%) Tobacco use (current or prior) 45 (67.2%) Alcohol use 31 (46.3%) Hypertension 53 (79.1%) Diabetes mellitus 20 (30.0%) Average BMI (SD) 29.8 (SD = 6.3) Note:—BMI indicates body mass index
↵a Nearly all patients were White, likely influenced by the demographics at the institution at which this study was completed.
Findings No. (%) or Average (SD) Imaging features Rim sign 39 (58.2%) Ulceration 11 (16.4%) Any calcifications 64 (95.5%) Adventitial calcifications 53 (79.1%) Bulky calcifications 11 (16.4%) Soft tissue ≥2 mm 55 (82.0%) Maximum soft-tissue thickness (mean) (mm) 4.0 (SD, 2.0) Maximum overall plaque thickness (mean) (mm) 4.9 (SD, 1.5) Maximum stenosis (mean) (%) 77.4 (SD, 16.5) Histologic findings LRNC present 64 (95.5%) LRNC proportion (mean) 22.2% (SD , 19.2%) IPH present 52 (77.6%) IPH proportion (mean) 13.7% (SD , 17.2%) Calcification present 57 (85.1%) Calcification proportion (mean) 20.9% (SD, 20.7%) IPH(OR; 95% CI; P Value) LRNC(OR; 95% CI; P Value) IPH Proportion(RC; 95% CI; P Value) Lipid Proportion(RC; 95% CI; P Value) Rim sign OR = 2.695% CI, 0.8–8.9P value = .11 OR = 2.995% CI, 0.3–33.9P value = .39 RC = 4.295% CI, 0.02–8.3P value = .049b RC = 6.195% CI, 1.5–10.6P value = .01b Adventitial calcifications OR = 5.695% CI, 1.6–21.2P value = .01b OR = 6.795% CI, 0.8–195.7P value = .08 RC = 6.695% CI, 1.7–11.6P value = .009b RC = 6.695% CI, 1.0–12.1P value = .02 Ulceration OR = 1.495% CI, 0.3–7.1P value = .72 P value = .29c RC = 1.495% CI, −4.3–7.1P value = .6 RC = 5.695% CI, −0.6–11.9P value = .07 Note:—RC indicates regression coefficient.
↵a Univariate analyses between imaging features and IPH and LRNC were calculated with logistic regression analyses with odds ratios reported; imaging features and proportions of both IPH and LRNC were calculated with linear regression analyses with regression coefficients reported.
↵b Statistically significant.
↵c Odds ratio could not be calculated for ulceration and LRNC due to relatively sparse data spreads.
