• Luca Saba, Eytan Raz, Roberto Grassi, Pier Luigi Di Paolo, Aniello Iacomino, Roberto Montisci, and Mario Piga.
• 1 Department of Radiology, Azienda Ospedaliero Universitaria di Cagliari, Polo di Monserrato s.s. 554, Monserrato, Cagliari 09045, Italy.
• AJR Am J Roentgenol. 2013 Nov 1;201(5):W747-52.

ObjectiveThe amount of cerebral white matter lesions (WMLs) and the severity of carotid artery disease are correlated in this study. The association between the severity of WMLs and the volume of the different components of carotid artery plaque is also evaluated.Materials And MethodsFifty consecutive patients (39 men, 11 women; mean [SD] age, 71 ± 9 years) with carotid artery stenosis who underwent carotid endarterectomy were included in this study. On admission, patients underwent head and neck CT angiography (CTA) and brain MRI. The CTA-based plaque volume and the percentages of the three main plaque components (fatty, mixed, and calcified) were calculated according to the attenuation values. Leukoaraiosis lesion volume on FLAIR images was determined using a semiautomated segmentation technique. Pearson correlation was conducted between the leukoaraiosis lesion volume on FLAIR images and the volumes of the different plaque components.ResultsPearson correlation analysis was performed to determine WML volume versus total carotid plaque volume (ρ = 0.2531; p = 0.0262), fatty plaque volume (ρ = 0.387; p = 0.0005), mixed plaque volume (ρ = 0.1709; p = 0.15), and calcified plaque volume (ρ = 0.0146; p = 0.899). The WML volume was also compared against fatty plaque percentage (ρ = 0.343; p = 0.0018), mixed plaque percentage (ρ = 0.181; p = 0.124), and calcified plaque percentage (ρ = -0.209; p = 0.068).ConclusionThe cerebral WML volume and the total volume of the plaque are correlated. The amount of fat within the plaque is an additional risk factor, whereas the calcified component seems to be protective.

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