Association of Carotid Plaque Calcification Attenuation With Intraplaque Hemorrhage Volume: 3D-Segmentation Analysis

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging Pub Date : 2025-07-14 DOI:10.1111/jon.70071

Jeremy Rubin, Quy Cao, Yu Sakai, Nathan Arnett, Huy Q. Phi, Andrew C. Hu, Brett L. Cucchiara, Daniel Bos, Luca Saba, Elias Johannson, Jarcy Zee, Jae W. Song

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引用次数: 0

Abstract

Background and Purpose

Despite the high prevalence of plaque calcifications in carotid atherosclerosis, the association between morphologic and attenuation features of calcifications and intraplaque hemorrhage (IPH) remains unclear.

Methods

Calcific carotid plaques were identified on neck computed tomography angiographies (CTAs) from patients meeting criteria for embolic stroke of undetermined source. Plaque calcifications were manually segmented using 3D-Slicer to quantify features, including volume and attenuation (Hounsfield Units [HU]). IPH volume (IPHvol) was quantified using a semi-automated software. A linear mixed regression model evaluated associations between calcification features and IPHvol, adjusting for sex, age, and cardiovascular risk factors. An interaction term between calcification volume and attenuation was included after dichotomizing attenuation (>924HU) and volume (>30 millimeter [mm]³) as high versus low on the basis of median values.

Results

From 70 patients (median age 68 years, 50% female), 116 calcific plaques containing 269 plaque calcifications were analyzed. Adjusting for age, cardiovascular risk factors, and plaque calcification features, being female showed lower IPHvols compared to males (mean ratio 0.34, p = 0.002). A significant interaction between calcification volume and attenuation emerged (p = 0.042). Among plaques with low plaque calcification volumes, plaques with low-attenuation (<924HU) calcifications showed 5.53 times higher IPHvols than plaques with high-attenuation calcifications (p = 0.003). Among plaques with high-attenuation calcifications, plaques with high volumes of these calcifications showed 4.40 times higher IPHvols compared to low-volumes of high-attenuation calcifications (p = 0.011).

Conclusions

Plaque calcification attenuation characteristics are associated with IPHvols. Understanding calcification patterns that correlate with IPH could enable clinicians to infer plaque instability from readily visible calcifications on CTA.

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颈动脉斑块钙化衰减与斑块内出血量的关系：3d分割分析

背景和目的尽管颈动脉粥样硬化中斑块钙化的发生率很高，但钙化的形态学和衰减特征与斑块内出血（IPH）之间的关系尚不清楚。方法对符合来源不明的栓塞性卒中标准的患者进行颈动脉钙化斑块的ct血管造影检查。使用3d切片机对斑块钙化进行手动分割，量化特征，包括体积和衰减（Hounsfield单位[HU]）。使用半自动软件定量IPH体积（IPHvol）。线性混合回归模型评估钙化特征与IPHvol之间的关系，调整性别、年龄和心血管危险因素。在对衰减（>924HU）和体积（>；30毫米[mm]3）进行二分类后，在中位数的基础上纳入了钙化体积与衰减之间的相互作用项。结果70例患者（中位年龄68岁，女性50%），116个钙化斑块，其中269个斑块钙化。调整年龄、心血管危险因素和斑块钙化特征后，女性的iphol比男性低（平均比值0.34,p = 0.002）。钙化体积和衰减之间存在显著的相互作用（p = 0.042）。在低斑块钙化体积斑块中，低衰减（<924HU）钙化斑块的IPHvols是高衰减钙化斑块的5.53倍（p = 0.003）。在高衰减钙化斑块中，高体积钙化斑块的IPHvols是低体积高衰减钙化斑块的4.40倍（p = 0.011）。结论斑块钙化衰减特征与ivos有关。了解与IPH相关的钙化模式可以使临床医生从CTA上容易看到的钙化推断斑块的不稳定性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neuroimaging 医学-核医学

CiteScore

4.70

自引率

0.00%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!