Dual-Energy Computed Tomography Analysis of Carotid Calcified Plaques in Stroke Patients

Background: Vascular calcification represents ectopic deposition of calcium phosphate in the arterial wall. Component analysis of calcifications using dual-energy computed tomography (DECT) has helped to elucidate arteriosclerosis, but reports examining carotid calcified plaque remain lacking. The present study qualitatively evaluated calcifications using DECT in patients with stroke in our institution. Methods: We performed a single-center, retrospective cohort study based on data obtained from the medical charts of inpatients admitted to Tokyo Metropolitan Hiroo Hospital between March 1 and August 31, 2024. We focused on calcified lesions of carotid plaques on plain CT. Patients were divided into two groups based on the presence or absence of monosodium urate (MSU) in carotid plaques, and in cases where MSU was present, they were further divided into unilateral or bilateral cases. We then analyzed associations between patient background and MSU in carotid plaque. Results: During the study period, 55 patients were admitted to our facility. Among these, 26 patients with calcified carotid plaque who underwent neck CT were included in this study. Median age was 79 years (interquartile range, 72-85 years) and 17 patients (65.4%) were male. Twenty-three patients (88.7%) were positive for MSU, comprising 10 patients (38.5%) with bilateral lesions and 13 (50%) with unilateral lesions. Patients with hypertension were more likely to show MSU-positive calcified plaque (p = 0.034). Conclusions: We qualitatively evaluated carotid plaques using DECT in patients with stroke. These findings suggest a potential role of MSU in carotid plaque formation among stroke patients. Future studies should investigate the clinical significance of these findings and potential therapeutic implications.