Keywords:
Interventional vascular, Abdomen, Neuroradiology brain, MR, CT, Fluoroscopy, Diagnostic procedure, Intraoperative, Imaging sequences, Neoplasia, Arteriovenous malformations, Seizure disorders
Authors:
P. Watal, N. Bahri, R. Gupta; Jamnagar/IN
DOI:
10.1594/ecr2013/C-1451
Results
CLINICAL AND EPIDEMIOLOGICAL RISK FACTOR CORRELATION
WITH CT BRAIN LESION
|
With CT brain lesion
(23)
|
Symptoms
|
23 (100)
|
Mean age (yrs)
|
63
|
Male
|
13 (56)
|
Female
|
10 (43)
|
Ischemic heart disease (IHD)
|
4 (17)
|
Tobacco use
|
14 (61)
|
Hypertension
|
11 (48)
|
Diabetes Mellitus
|
15 (65)
|
Dyslipidemia
|
10 (43)
|
ASSOCIATION WITH DEGREE OF STENOSIS
Studied
(28 patients)
|
Patients with >70% stenosis (minimum one vessel) (n=7)
|
Patients with <70% stenosis (both vessels)
(n=17)
|
Normal angiography
(n=4)
|
Chi squre
=0.201
P=0.9046
|
CT brain lesions (23)
|
6 (86)
|
14 (82)
|
3 (75)
|
No lesions on CT brain (5)
|
1 (14)
|
3 (18)
|
1 (25)
|
ASSOCIATION WITH FATTY PLAQUE
Studied
|
Patients with fatty plaques
(minimum one vessel) (n=16)
|
Patients without Fatty plaques (mixed and calcified)
(n=8)
|
Chi squre=3.725
P=0.1553
|
CT brain lesions
|
15 (94)
|
5 (67)
|
No lesion on CT brain
|
1 (6)
|
3 (33)
|
Stenosis degree
<70%
|
9 (56)
|
5 (63)
|
Stenosis degree
>70%
|
7 (44)
|
0
|
|
- All patients except one with fatty plaque had associated brain lesion.
Only patient with fatty plaque with no brain lesion had NEAR STENOSIS in ipsilateral vessel.
ASSOCIATION WITH MIXED PLAQUE
Studied
|
Patients with mixed plaques (n=6)
|
Patients without mixed plaques (fatty + calcified)
(n=18)
|
Chi squre=0.3294
P=0.3485
|
CT brain lesions
|
5 (83)
|
15 (83)
|
No brain lesions on CT
|
1 (17)
|
3 (17)
|
Stenosis degree
<70%
|
6 (100)
|
11 (61)
|
Stenosis degree
>70%
|
0
|
7 (39)
|
ASSOCIATION WITH CALCIFIED PLAQUE
Studied (n=28)
|
Patients with calcified plaques in vessels
(n=2)
|
Patients without calcified plaques in vessels
(n=22)
|
CHI SQURE=11.807
P=0.0081
|
CT brain lesions
|
0 (0)
|
20 (91)
|
No brain lesions on CT
|
2 (100)
|
2 (9)
|
Stenosis degree
<70%
|
2 (100)
|
15 (68)
|
Stenosis degree
>70%
|
0 (0)
|
7 (32)
|
- None of patient with calcified plaque had an associated brain lesion on CT.
- None of patient with calcified plaque had an association with >70% stenosis.
ASSOCIATION WITH BOTH FATTY PLAQUE AND STENOSIS
Studied
(n=28)
|
Fatty plaques and >70% stenosis
(n=7)
|
Fatty plaques and <70% stenosis
(n=9)
|
Non fatty plaque and >70% stenosis
(n=0)
|
Non -Fatty plaques and <70% stenosis
(n=8)
|
Associated with normal CTA
(n=4)
|
Chi squre=4.261
P=0.2346
|
CT brain lesions
|
6 (86)
|
9 (100)
|
0
|
5 (62)
|
3 (75)
|
No brain lesions on CT
|
1 (14)
|
0 (0)
|
0
|
3 (38)
|
1 (25)
|
- Patients with both fatty plaques and >70% stenosis,
all except one patient had associated brain lesions on CT.
This is important to note because this patient had ‘NEAR STENOSIS ’,
and previous studies have shown that near stenosis has protective effect compared to carotid stenosis or fatty plaque alone.
ASSOCIATION WITH BOTH MIXED PLAQUE AND STENOSIS
Studied
(n=28)
|
mixed plaques and >70% stenosis
(n=0)
|
mixed plaques and <70% stenosis
(n=6)
|
Non-mixed plaques and >70% stenosis (n=7)
|
Non-mixed plaques and <70% stenosis
(n=11)
|
Associated with normal CTA
(n=4)
|
Chi sqyre=0.207
P=0.9765
|
CT brain lesions
|
0
|
5 (83)
|
6 (86)
|
9 (81)
|
3 (75)
|
No brain lesions on CT
|
0
|
1 (17)
|
1 (14)
|
2 (19)
|
1 (25)
|
ASSOCIATION WITH CALCIFIED PLAQUE AND STENOSIS
Studied
|
calcified plaques and >70% stenosis
(n=0)
|
calcified plaques and <70% stenosis
(n=2)
|
Non-calcified plaques and >70% stenosis
(n=7)
|
Non- calcified plaques and <70% stenosis
(n=15)
|
Associated with normal CTA
(n=4)
|
Chi squre=10.681
P=0.0136
|
CT brain lesions
|
0
|
0 (0)
|
6 (86)
|
14 (93)
|
3 (75)
|
No brain lesions on CT
|
0
|
2 (100)
|
1 (14)
|
1 (7)
|
1 (25)
|
- No patient with calcified plaque had >70% stenosis on CTA.
RELATIONSHIP BETWEEN NASCET-STYLE RATIOS AND MILLIMETER STENOSIS MEASUREMENT DEFINING PRESENCE OF INTERNAL CAROTID STENOSIS
IN PRESENT STUDY
(ASSESSMENT OF 20 VESSELS OUT OF TOTAL OF 56)
Stenosis
Measurement (Narrowed segment)
|
<50%
(n=7)
|
50–69%
(n=6)
|
>70%
(n=7)
|
2.3mm or more
|
6
|
0
|
0
|
1.4 to 2.2 mm
|
1
|
5
|
1
|
1.3 mm or less
|
0
|
1
|
6
|
- 24 vessels out of 56 were normal including 8 vessels in 4 patients (4 bilateral completely normal angiography studies).
In 12 vessels (common carotid artery,
bifurcation lesions) although stenosis was measurable however,
percent ratios were not calculable because NASCET criteria defined percent ratios are applicable only for internal carotid artery.
CORRELATION BETWEEN DOMINANT SIDE OF VASCULAR PATHOLOGY AND SYMPTOMATIC SIDE OF CEREBRAL ISCHEMIA
Studied (n=28)
|
Right side dominant vascular pathology
|
Left side dominant vascular pathology
|
Normal CTA angiography
|
Right cerebral
Hemispheric lesion
|
10
|
1
|
3
|
Left cerebral
Hemispheric lesion
|
0
|
9
|
0
|
Normal CT brain
|
2
|
2
|
1
|