ArticlemedRxiv : the preprint server for health sciences2025
Carotid Plaque Calcification Attenuation Characteristics are Associated with Intraplaque Hemorrhage Volumes: A 3D Segmentation-Based Analysis.
Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and Purpose: Despite the high prevalence of plaque calcifications in carotid atherosclerosis, the association between morphologic and attenuation features of calcifications and intraplaque hemorrhage (IPH) remains unclear. Methods: Carotid bifurcation calcific plaques were identified on neck CTAs from patients with unilateral anterior circulation ischemic stroke consistent with embolic stroke of undetermined source. Plaque calcifications were manually segmented using 3D Slicer to measure volume, surface area, shape, and attenuation (Hounsfield Units (HU)) characteristics. IPH volume (IPHvol) was quantified using a semi-automated software. A linear mixed regression model evaluated associations between calcification features and IPHvol, adjusting for sex, age, and cardiovascular risk factors. An interaction term between calcification volume and attenuation was included after dichotomizing attenuation (>924HU) and volume (>30mm Results: From 70 patients (median age 68 years, 50% female), 116 calcific plaques containing 269 plaque calcifications were analyzed. Adjusting for age, cardiovascular risk factors and plaque calcification features, being female showed lower IPHvols compared to males (mean ratio 0.34, p=0.002). A significant interaction between calcification volume and attenuation emerged (p=0.042). Among plaques with low volumes (<30mm Conclusions: Plaque calcification attenuation characteristics are associated with IPHvols. Beyond presence or volumes of plaque calcifications, calcification attenuation characteristics should be considered when evaluating unstable plaque components.
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