Multichannel tomography and color doppler ultrasonography in evaluation of carotid plaque

Between January 2012-April 2013, at Gaziantep University Department of Radiology total 58 patients and 86 plaques taken COLOR DOPPLER ULTRASONOGRAPHY and MULTICHANNEL TOMOGRAPHY examinations, detected plaque in their extracranial carotid systems other than ECA were evaluated in terms of plaque morphology and stenosis rate by being analyzed. Comparison of two methods was performed by being used grey scala images in COLOR DOPPLER ULTRASONOGRAPHY in the evaluation of plaque morphology, by being used ROI measurement values and color mapping in MULTICHANNEL TOMOGRAPHY examination. In COLOR DOPPLER ULTRASONOGRAPHY examination the classification of plaque was made by being modified Gray Weale classification. In MULTICHANNEL TOMOGRAPHY examination after being considered plaques between 20-60 (HU) to be low-attenution plaque, between 60-130 (HU) to be moderate-attenution plaque, 130 and over (HU) to be high-attenution plaque, plaques were classified by being divided into 4 types. Consequently, we found the kappa value of compliance between two classifications as 0,929 and we saw that there was a near perfect correlation between these two methods. But it puts an emphasis on follow up examination of the plaque that MULTICHANNEL TOMOGRAPHY examination has advantages such as demonsrating a fibrous cap in comparison with COLOR DOPPLER ULTRASONOGRAPHY, being able to calculate content of plaques as a percentage and being able to evaluate calsified plaques more clearly. From the patients in the study group file information, it was noted whether there were ipsilateral hemispheric symptoms. In these cases, the relationship of plaque morphology and surface characteristics with symptomatology was calculated using logistic regression analysis. Accordingly, it was seen that soft plaque increased 13.5 times the possibility of being symptomatic, ulcerated and irregular plaque surface increased 21 times the possibility of being symptomatic. In addition to this study, on comparison of the two studies was performed by being used 2003 Consensus criteria for COLOR DOPPLER ULTRASONOGRAPHY imaging and NASCET for MULTICHANNEL TOMOGRAPHY analysis. DSA was performed in 25 patients included in this study.Their compliance with the DSA was evaluated on the basis of DSA stenosis rates of these patients.As a result of this study, the kappa value between DSA and COLOR DOPPLER ULTRASONOGRAPHY compliance was found O.965, the kappa value between MULTICHANNEL TOMOGRAPHY and DSA was found 0.951 and the kappa value between MULTICHANNEL TOMOGRAPHY and COLOR DOPPLER ULTRASONOGRAPHY compliance was found 0.950. A near-perfect correlation was determined among all the methods for the calculation of stenosis rate. Keywords: Extracranial carotid stenosis, plaque morphology, Color Map