Carotid artery stenosis:a correlative analysis of imaging diagnosis and operative findings

Objective:To provide preliminary results of a correlative study of medical imaging and pathology in carotid stenosis.Methods:8 patients with severe carotid stenosis were performed Doppler US,MRA,CTA and received carotid endarterectomy.The imaging results were correlated to the surgical and pathological findings.Results:The severe stenosis of unilateral carotid artery was up to 70%～99%.More lesions of infarction were found in the area of the brain of the ipsilateral carotid narrowing than those in the normal side.Correlated to surgical findings,the location of stenosis agreed with that demonstrated by DUS,MRA and CTA,and the degree of stenosis was correctly evaluated by DUS in 6 cases,MRA in 7,and CTA in 8.Calcification and fibrous tissue proved pathologically appeared hyperdense on CTA,hyperechoic on DUS,and hypo intense on MRA.Necrotic materials and foam cells seen in histopathology appeared hypo or iso dense on CTA,hypo echoic on DUS,and heterogeneous intense on MRA.Conclusion:The combined use of DUS,MRA and CTA can improve the diagnostic accuracy of the carotid artery stenosis.CTA is more direct and accurate in the evaluation of the plaque.