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. 2013 Feb 26;5(1):9.
doi: 10.1186/1758-5996-5-9.

Noninvasive assessment of the carotid and cerebrovascular atherosclerotic plaques by multidetector CT in type-2 diabetes mellitus patients with transient ischemic attack or stroke

Ci He  1 , Ming Gu, Rui Jiang, Jian-Hao Li
Affiliations

Noninvasive assessment of the carotid and cerebrovascular atherosclerotic plaques by multidetector CT in type-2 diabetes mellitus patients with transient ischemic attack or stroke

Ci He et al. Diabetol Metab Syndr. .

Abstract

Background: The cerebrovasuclar artery disease as a common complication of type-2 diabetes mellitus (T2DM) caused huge economic burden and lives threatening to patients. We evaluated the prevalence and morphology of carotid and cerebrovascular atherosclerotic plaques in T2DM patients with transient ischemic attack (TIA) or stroke using multidetector CT (MDCT).

Methods: 64-MDCT and dual-source CT (DSCT) angiographies were performed in 195 T2DM patients with TIA or stroke (mean age 65.7+/-12.8 years; 118 men) between January 2009 to August 2011. During the process, plaque type, its distribution, extensive and obstructive natures were determined for each segment derived from the patients.

Results: Atherosclerotic plaques were detected in 183 (93.8%) patients. A total of 1056 segments with plaque were identified, of which 450 (42.6%) were non-calcified, 192 (18.2%) were mixed and 414 (39.2%) calcified ones. Among them, 562 (53.2%) resulted in mild stenosis, 291 (27.6%) moderate stenosis, 170 (16.1%) severe stenosis and 33 (3.1%) occlusion. Non-calcified plaques contributed 91.8% to non-obstructive lumen narrowing, while mixed and calcified plaques contributed 89.0% and 65.0% respectively.

Conclusions: MDCT angiography detected a high prevalence of plaques in T2DM patients with TIA or stroke. A relatively high proportion of plaques were non-calcified, as well as with non-obstructive stenosis. MDCT angiography might further enhance the detection and management of carotid and cerebrovascular atherosclerosis in T2DM patients with TIA and stroke.

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Figures

Figure 1
Figure 1
CPR images show different plaques and stenosis. A severe stenosis caused by a noncalcified plaque. B moderate stenosis caused by a mixed plaque. C mild stenosis caused by a calcified plaque.
Figure 2
Figure 2
Constitution of atherosclerosis plaques in T2DM patients with TIA or stroke.
Figure 3
Figure 3
Bar graph demonstrating the difference of stenosis between plaques.
Figure 4
Figure 4
Bar graph showing the distributions of plaques.
See this image and copyright information in PMC

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