Abstract

Calcification of the carotid artery

posted by Martin Heuschmid, M.D. | Jan 28, 2008

Case history

A 63-year-old hypertensive patient is presenting with transient amaurosis fugax and aphasia for 8 hours. MRI angiography was not possible because a cardiac pacemaker is present.

Questions

Abnormal anatomy of the carotid vessels?
Severe carotid artery stenosis?
Plaques of the carotid arteries?

Diagnosis / Differential diagnosis

Arteriosclerosis of the internal carotid artery
Occlusion of carotid artery due to thrombosis/ embolism
Soft or calcified plaque of the carotid artery
Vascular abnormalities

Findings

Abnormal anatomic finding of the carotid arteries could be excluded. Fused dual energy images show calcified plaques at both carotid bifurcations. Severe vascular stenosis due to calcified or soft plaque was not found.

Comments

Dual energy CTA enables a differentiation of iodine-filled vessel lumina from calcified vessel plaques, making a more accurate quantification of carotid stenosis possible. Color-coded visualization further simplifies diagnosis and presentation.

[1] Axial dual energy image of a calcified plaque at the bifurcation of the left carotid artery (arrow). Note the differentiation of iodine (blue) and calcium (red).	[2] Coronar dual energy image (MPR) of the same plaque (arrow).
[3] Sagital dual energy image (MPR) of the same plaque (arrow)	[4] Application of dual energy bone/plaque removal: All voxels containing calcium (hard plaques and bones) have automatically been removed from the images.