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RT Journal Article
SR Electronic
T1 Multi-Detector Row CT Angiography in the Assessment of Carotid Artery Disease in Symptomatic Patients: Comparison with Rotational Angiography and Digital Subtraction Angiography
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1022
OP 1034
VO 26
IS 5
A1 Berg, Marja
A1 Zhang, Zishu
A1 Ikonen, Aki
A1 Sipola, Petri
A1 Kälviäinen, Reetta
A1 Manninen, Hannu
A1 Vanninen, Ritva
YR 2005
UL http://www.ajnr.org/content/26/5/1022.abstract
AB BACKGROUND AND PURPOSE: Compared with the single-detector technique, multi-detector row CT angiography permits larger anatomic coverage that includes both the epiaortic and entire carotid circulations. We evaluated the accuracy of multi-detector row CT angiography by using multiplanar reformation (MPR) for measuring carotid artery diameters compared with that of rotational angiography. We also evaluated the diagnostic performance of CT angiography compared with digital subtraction angiography (DSA).METHODS: In 35 patients, CT angiograms of 70 carotid arteries were compared with DSA images, and CT angiograms of 33 carotid arteries were compared with rotational angiograms. CT angiographic interpretation was performed first interactively at a workstation. Diameter measurements of normal and stenosed carotid arteries were performed on cross-sectional and oblique sagittal MPRs. Degree of stenosis was calculated per North American Symptomatic Carotid Endarterectomy Trial criteria independently by two observers for each technique.RESULTS: Degree of stenosis was slightly underestimated with CT angiography, with mean differences (± SD) per observer of 6.9 ± 17.6% and 10.7 ± 16.1% for cross-sectional and 2.8 ± 19.2% and 9.1 ± 16.8% for oblique sagittal MPRs compared with rotational angiography. CT angiography was somewhat inaccurate for measuring the absolute minimal diameter of high-grade stenoses. On symptomatic sides (n = 35), interactive CT angiographic interpretation combined with MPR measurements for lesions with a visual estimate of 50% or greater stenosis achieved a sensitivity of 95% (20/21) and specificity of 93% (13/14) in the detection of carotid stenosis (≥ 50%) verified with DSA.CONCLUSION: Regardless of slight underestimation of carotid stenosis with CT angiography compared with rotational angiography, diagnostic performance of CT angiography with interactive interpretation proved to be good. Also, the method is highly sensitive for detection of carotid artery stenosis, indicating the suitability of CT angiography as a screening method for symptomatic patients. For hemodynamically significant stenoses revealed by CT angiographic screening, conventional angiography still seems to be necessary.