Carotid artery plaque characteristics: current reporting practices on CT angiography.
Carotid artery plaque characteristics: current reporting practices on CT angiography.
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DOI：
10.1007/s00234-020-02610-w
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发表时间：
2021-07
期刊：
影响因子：
2.8
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中科院分区：
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颅外ICA成像主要集中于管腔狭窄的程度，但最近的进展表明，特定的斑块特征在卒中风险评估中至关重要。我们评估了一家学术机构颈动脉CTA报告颈动脉斑块特征的现状。在这项回顾性观察研究中，我们对50岁以上有颈动脉斑块的患者进行了颈部CTA。我们评估了提及以下内容的报告：管腔狭窄程度、软斑块、钙化斑块、斑块厚度、软斑块和钙化斑块的量化、斑块溃烂以及与特定特征相关的风险增加。我们使用费舍尔的精确测试来比较每个功能被提及的频率。我们纳入了651例患者的报告(平均年龄68.1±13.3岁)。根据NASCET标准，共有639份报告(98.1%)明确提及狭窄程度。斑块的特殊特征较少见：软斑块116例(17.8%)；钙化斑块166例(25.5%)；软斑块和钙化斑块的数量分别为24例(3.7%)和16例(2.5%)；斑块厚度12例(1.8%)；斑块溃烂476例(73.1%)；与斑块相关的风险增加2例(0.3%)。统计学上，狭窄程度比任何其他斑块特征更有可能被提及(p<；0.001)。目前，几乎所有的报告都提到了颈部CTA的管腔狭窄程度，而相当少的报告提到了特定的斑块特征。尽管越来越多的证据表明颈动脉斑块特征在卒中风险评估中的重要性，但放射学报告并不常规地报告这些发现。
Extracranial ICA imaging has largely focused on the degree of luminal stenosis, but recent advances suggest specific plaque features are crucial in stroke risk assessment. We evaluated the current state of reporting carotid plaque features on neck CTAs at an academic institution. In this retrospective observational study, we included neck CTAs performed on patients over age 50 with any reported carotid plaque. We evaluated reports for mention of the following: degree of luminal stenosis, soft plaque, calcified plaque, plaque thickness, quantification of soft and calcified plaque, plaque ulceration, and increased risk associated with specific features. We used Fisher’s exact test to compare how often each feature was mentioned. We included a total of 651 reports from unique patients (mean age, 68.1 ± 13.3 years). A total of 639 reports (98.1%) explicitly mentioned degree of stenosis per NASCET criteria. Specific plaque features were less frequently characterized: soft plaque in 116 (17.8%); calcified plaque in 166 (25.5%); quantification of the amount of soft plaque and calcified plaque in 24 (3.7%) and 16 (2.5%) reports, respectively; plaque thickness in 12 (1.8%); plaque ulceration in 476 (73.1%); and increased risk associated with plaque in 2 (0.3%). Degree of stenosis was statistically more likely to be mentioned than any other plaque feature (p < 0.001). Currently, nearly all reports mention the degree of luminal stenosis on neck CTAs while a significant minority mention specific plaque features. Despite mounting evidence of the importance of carotid plaque features in stroke risk assessment, radiology reports do not routinely report these findings.