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BackgroundIn the CT assessment of the carotid plaque, the analysis of the attenuation value is a fundamental parameter in order to classify the type of the tissue that composes the plaque. The purpose of this paper is to assess the intra-plaque attenuation variability in order to verify the potential reproducibility of HU measurements.MethodsIn this retrospective study, 68 consecutive patients (males 42; average age 64 ± 11 years) that underwent CT of carotid arteries were included. Exams were performed before and after administration of contrast medium and in each slice 4 different circular or elliptical ROIs (≥1 and ≤ 2 mm2) were traced and attenuation values were recorded. Wilcoxon and Mann-Whitney test were used to test the differences between the ROI.ResultsA total of 192 slices were analysed. The average value of attenuation before contrast medium was 41.591(SD 8.1) HU and 54.159 (SD 15.7) in post-contrast scan. Mann-Whitney test did not find statistically significant difference among the ROI in the pre-contrast scan whereas a statistically significant differences was found in post-contrast scan. Wilcoxon analysis showed a statistically significant difference (p value = 0.001) between pre and post-contrast attenuation.ConclusionIn conclusion, results of our study suggest that ROI sampling performed in the CT dataset acquired after administration of contrast medium show significant degree of heterogeneity and a statistically significant differences compared to the baseline measurement. This effect may be driven by a different amount of contrast acquisition in some areas of the carotid artery plaque.

Carotid artery intra-plaque attenuation variability using computed tomography