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Prevalence and distribution of calcified nodules in carotid arteries in correlation with clinical symptoms

  • HEAD, NECK AND DENTAL RADIOLOGY
  • Published:
La radiologia medica

Abstract

Purpose

Calcified nodules (“CN”) are responsible for up to 5% of coronary-infarcts and, therefore, classified as minor criteria of “vulnerable” atherosclerotic plaque. We sought to evaluate prevalence and distribution of CN in carotid arteries in correlation with clinical symptoms.

Methods

178 consecutive patients with unilateral ischemic stroke and carotid plaques ≥2 mm by duplex ultrasound underwent a carotid-black-blood-3T-MRI with fat-saturated pre- and post-contrast T1w-, PDw-, T2w- and TOF images using dedicated surface-coils. CN were defined as distinct calcification with an irregular, protruding, and convex luminal surface. Prevalence of CN was determined in common carotid artery (“CCA”) and internal carotid artery (“ICA”) in consensus by two reviewers blinded to clinical information.

Results

Thirty seven CN in 28 arteries of 26 patients were identified. Prevalence of CN in CCA compared to ICA was slightly higher (59 vs. 41%), but nearly similar in 66 arteries with ≥30% compared to 290 arteries with <30% stenosis (9.1 vs. 7.6%) and in the artery ipsilateral versus contralateral to stroke (7.9 vs. 7.9%; P values n.s.). Prevalence of CN was significantly higher in 40 symptomatic arteries with ≥30% stenosis compared to asymptomatic 26 arteries (15.6 vs. 0%; P = 0.04). There was a significantly higher prevalence of hypercholesterolemia and hypertension in patients with CN (57.7 vs. 36.0 and 88.5 vs. 66.7%; P values <0.05).

Conclusion

CN were found in 7.9% of arteries with carotid-plaques ≥2 mm by duplex-ultrasound; prevalence was significantly higher in symptomatic arteries with ≥30% stenosis compared to asymptomatic with <30% stenosis, suggesting that CN play a role in pathogenesis of ischemic stroke in a small subset of patients.

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Authors and Affiliations

  1. Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Nussbaumstr. 20, 80336, Munich, Germany

    Karolin Johanna Paprottka, Damiana Saam, Johannes Rübenthaler, Andreas Schindler, Nora Navina Sommer, Philipp Marius Paprottka, Dirk André Clevert, Maximilian Reiser, Tobias Saam & Andreas Helck

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  1. Karolin Johanna Paprottka
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  2. Damiana Saam
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  3. Johannes Rübenthaler
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  4. Andreas Schindler
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Correspondence to Karolin Johanna Paprottka.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Paprottka, K.J., Saam, D., Rübenthaler, J. et al. Prevalence and distribution of calcified nodules in carotid arteries in correlation with clinical symptoms. Radiol med 122, 449–457 (2017). https://doi.org/10.1007/s11547-017-0740-z

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  • DOI: https://doi.org/10.1007/s11547-017-0740-z

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