Purpose
To determine the accuracy of 16-slice multi-detector CT angiography (16-MDCTA) in the assessment of steno-occlusive disease of the carotid artery bifurcation and vertebral artery origin.
Methods and Materials
In 24 patients, 48 carotid arteries and 48 vertebral arteries were evaluated with 16-MDCTA and conventional digital subtraction angiography (DSA). Standardized 16-MDCTA acquired from the circle of Willis to the aortic arch.16-MDCTA data were displayed with maximum intensity projection (MIP) for carotid and vertebral arteries and with volume rendering (VR) for carotid artery.1111111111111111111111111111111111111111111111Please click the image!1111111111111111111111111111111111111111111111Please click the image!1111111111111111111111111111111111111111111111Please click the image!1111111111111111111111111111111111111111111111Please click the image!The percent diameter stenoses of the carotid artery bifurcation and vertebral artery origin were measured separately on MIP, and/or VR CT...
Results
All carotid and vertebral arteries were assessable on MIP and/or VR CT images. Large or encircling calcification prevents complete analysis on MDCTA. This ismain limiting factor on MIP. Somultiplanar reconstruction, VR andaxial image are needed. VR CT images had a tendency to overestimation inseverely stenotic vessels. Correlation between stenosis measured with 16-MDCTA and that measured with DSA were good (Pearson correlation: on carotid MIP images, c=0.983, <0.001; on carotid VR images, c=0.992, <0.001; on vertebral origin MIP images, c=0.984, <0.001). The aggrement rate of stenosis...
Conclusion
Non-invasive MIP and VR CT Angiographyenabled accurate evaluation of carotid and vertebral artery stenosis with multiplanar informations, rapid and exact scan with small contrast material . This standardized protocol of 16-MDCTA may play a major role in clinical decision making of Carotid endarterectomyor angioplasty, and will become a sole pre-operative vascular imaging method replacing DSA in a great part of cases.
References
Internal Carotid Arterial Stenosis: CT angiography with Volume Rendering ,Radiology 1999;210:673-682CT Angiography for the Dectection and Characterization of Carotid Artery Bifurcation Disease , Stroke 2000;31:2168-2174Computed Tomography Anigography in the Investigation of Carotid Stenosis , Clinical Radiology 2001;56:523-534Multi-slice CT angiography in the evaluation of patients with acute cerebrovascular disease - a promising new diagnostic tool , Journal of Neurology 2002;249:43-49Helical CT angiography in the preoperative evaluation of carotid artery stenosis , Journal of Vascular Surgery 1998;28:290-300Image Quality in a Standardized Algorithm for Minimally Invasive Coronary Anigography...
Personal Information
Lee Sung Hoon MD, Hong Gee Roh MD, Hong Sik Byun MDDepartment of Radiology, Stroke and Cerebrovascular Center Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul, Korea http://www.smc.samsung.co.kr
