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Carotid Artery Abnormalities and Leukoaraiosis in Elderly Patients: Evaluation with MDCT

¹ Department of Radiology, Policlinico Universitario, University of Cagliari, Cagliari, Italy.
² Department of Vascular Surgery, Policlinico Universitario, Cagliari, Italy.
³ Division of Internal Medicine, Ospedale San Giovanni di Dio, Cagliari, Italy.
⁴ Institute of Radiology, Ospedale San Giovanni di Dio, Via Tola 7, Cagliari 09128, Italy.

OBJECTIVE. Several studies have shown that leukoaraiosis is a clinically relevant condition. Patients with leukoaraiosis have a negative prognosis in terms of death, stroke, and myocardial infarction. The aim of this study was to evaluate whether the presence and severity of leukoaraiosis correlate with degree of carotid stenosis and the presence of specific types of plaque (fatty, mixed, calcified) in a group of elderly patients with clinical indications for MDCT.

MATERIALS AND METHODS. From January 2004 to March 2007, 147 consecutively registered patients 65 years and older underwent MDCT. All patients enrolled in the study cohort were assessed for the presence and severity of leukoaraiosis. Degree of carotid artery stenosis according to the North American Symptomatic Carotid Endarterectomy Trial criteria and type of plaque were evaluated. Statistical analysis was performed to determine whether an independent interaction existed among the presence of leukoaraiosis, severity of leukoaraiosis, and degree of carotid artery stenosis associated with plaque type.

RESULTS. A correlation was observed between the presence of leukoaraiosis and degree of carotid stenosis (Pearson correlation, 0.23; p < 0.001). A statistically significant correlation between advanced patient age and presence of leukoaraiosis (Pearson correlation, 0.32; p < 0.0001) and severity of leukoaraiosis (Pearson correlation, 0.55; p < 0.0001) was recorded. The data obtained showed a trend toward increased risk of development of leukoaraiosis (p = 0.08) in carotid arteries with fatty plaques.

CONCLUSION. The results of this study showed a statistically significant correlation between the presence and severity of leukoaraiosis and degree of carotid stenosis. A trend toward increased risk of development of leukoaraiosis in carotids with fatty plaques also was observed. The data confirmed that the development of leukoaraiosis is strongly correlated with age.

Keywords: carotid artery • leukoaraiosis • MDCT angiography • stroke

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