CT angiography in the detection of carotid body enlargement in patients with hypertension and heart failure

Introduction: The carotid body (CB) has previously been found to be enlarged and hyperactive in various disease states such as heart failure (HF), hypertension (HTN), and respiratory disease. Evaluation of CB size in these disease states using imaging has not been performed. The purpose of this case-control study was to compare CB sizes in patients with HF and HTN with those of controls using CT angiography. Methods: A retrospective review was performed on 323 consecutive patients who had neck computed tomography angiography (CTA) exams in 2011. Following extensive review, 17 HF and HTN patients and 14 controls were identified. Two radiologists blinded to the patient disease status made consensus bilateral carotid body (CB) measurements on the CTA exams using a previously described standardized protocol. CB axial cross-sectional areas were compared between HF and HTN cases and controls using a paired t test. Results: The right CB demonstrated a mean cross-sectional area of 2.79 mm2 in HF and HTN patients vs. 1.40 mm2 in controls (p = 0.02). The left CB demonstrated a mean cross-sectional area of 3.13 mm2 in HF and HTN patients vs. 1.53 mm in controls (p = 0.03). Conclusion: Our results provide imaging evidence that the carotid bodies are enlarged in patients with HF and HTN. Our case-control series suggests that this enlargement can be detected on neck CTA. © 2013 Springer-Verlag Berlin Heidelberg.