Dual-energy computed tomography iodine maps for visualizing enhancement and estimating characteristics in plaques

Distal embolism causing acute ischemic events due to rupture of vulnerable plaques can occur during endovascular therapy, necessitating careful treatment and technique selection. Intraplaque neovascularization (IPN) is a key factor in plaque instability. Detecting intraplaque neovascularization (IPN) greatly aids early screening and diagnosis of vulnerable plaques. Contrast-enhanced dynamic magnetic resonance imaging has shown a rapidly enhancing component indicating neovascularization and a slowly enhancing component indicating fibrous tissue. To our knowledge, no reports have described visualizing plaque contrast effects using dual-energy computed tomography. The rapid enhancement and washout pattern likely reflected neovascularization, whereas the gradual enhancement suggested fibrous components. Reviewing arterial and delayed phase iodine maps from dual-energy computed tomography may help estimate plaque characteristics.