ABSTRACT
BACKGROUND AND PURPOSE: Atherosclerotic arterial remodeling has been described in the coronary circulation but has not been studied extensively for carotid atherosclerosis. The purpose of our study was to examine the association between carotid artery remodeling and clinical presentation in patients with significant stenosis by using multidetector row CT (MDCT). MATERIALS AND METHODS: One hundred eight patients with >or=50% stenosis (North American Symptomatic Carotid Endarterectomy Trial criteria) by MDCT angiography between January 2004 and June 2006 were identified. The study group included 37 symptomatic (65.9 +/- 13.0 years; 12 women; stenosis, 81.5 +/- 12.2%; 17 with stroke; 15 with transient ischemic attack; 5 with amaurosis fugax) and 71 asymptomatic patients (70.5 +/- 10.5 years; 28 women; stenosis, 78.8 +/- 11.1%). Remodeling ratio (RR) was calculated by dividing the outer vessel circumference at the site of greatest stenosis by a normal reference-segment vessel circumference. Maximum vessel thickness (MxVT) and eccentricity index (EI) of the plaque, defined as maximal thickness/minimal thickness at the site of greatest luminal narrowing, were also determined. Data were analyzed by using an independent t test. RESULTS: The RR was significantly higher in symptomatic patients (1.64 +/- 0.44) than in asymptomatic patients (1.41 +/- 0.5) (P=.02). There was no significant difference in MxVT in symptomatic (5.9 +/- 2.1 mm) and asymptomatic patients (5.6 +/- 2.4 mm) (P=.45) and no significant difference in EI (symptomatic, 4.7 +/- 2.7; asymptomatic, 4.3 +/- 2.2; P=.38). CONCLUSION: In this series of subjects with significant internal carotid artery stenosis, expansive carotid remodeling was significantly greater in patients with cerebral ischemic symptoms than in asymptomatic patients. The extent of expansive remodeling may indicate underlying atherosclerotic plaque vulnerability. MDCT has a role in the evaluation of carotid artery disease beyond examining luminal stenosis.
Subject(s)
Carotid Artery Diseases/diagnostic imaging , Cerebral Angiography/methods , Tomography, X-Ray Computed/methods , Aged , Cerebral Angiography/instrumentation , Female , Humans , Male , Radiographic Image Enhancement/instrumentation , Radiographic Image Enhancement/methods , Reproducibility of Results , Sensitivity and Specificity , Tomography, X-Ray Computed/instrumentationABSTRACT
Extramedullary hematopoiesis is a complication of a number of myeloproliferative disorders. MR imaging of the orbits was performed in a patient with bilateral orbital swelling with known myeloproliferative disorder and myelofibrosis. The study revealed symmetric, bilateral enhancing masses in the lacrimal fossae extending into the nasolacrimal ducts. Biopsy demonstrated sclerotic extramedullary hematopoietic tumor.
Subject(s)
Hematopoiesis, Extramedullary , Lacrimal Apparatus , Humans , Male , Middle Aged , OrbitABSTRACT
We present a case report of a patient on long-term dialysis who underwent percutaneous vertebroplasty to treat a painful intrabody vertebral cleft and who subsequently experienced a refracture of the posterior portion of the same vertebral body, resulting in anterior displacement of the cement through the anterior cortex. The case raises the question whether, in some patients, the marrow space should be filled with cement in addition to the cleft.
