title: Carotid bifurcation imaging model for more accurately comparing imaging techniques.
abstract: For comparing current and presubably forthcoming imaging modalities, a carotid bifurcation model was made from cadaveric specimens. Perfusing and pulsing the immersed common carotid artery and its proximal branches via a Harvard pump simulated clinical imaging conditions. Film-screen (F-S) and digital subtraction (DS) angiography, computed tomography (CT), ultrasound and magnetic resonance imaging (MRI) were compared. For CT and MRI, scanning parameters such as slice thickness, degree of overlapping, amount of contrast medium needed, scanning mode and multiplanar and three-dimensional techniques enabled enhancing the capacity for CT in the clinical setting. Direct axial CT proved to be most accurate for assessing the contours and magnitude of carotid narrowing. Nonetheless, these serial segments were not readily compared with F-S and DS angiographic full length images. The use of multiplanar reconstruction (MPR) and three-dimensional (3-D) CT achieved this and furthermore showed the external contour of the diseased segment. Concerning carotid ulceration, our carotid model study showed CT to be equally accurate with DS and superior to F-S angiography. However, in our clinical study of 34 carotid arteries in 17 patients ulcerations were equally well identified by CT and angiography but DS angiography proved superior in identifying ulcers not seen with CT. Perhaps this discrepancy is explained by the clinical routine of attaining multiple fluoroscopically positioned views of the common carotid bifurcations in DS catheter angiography unlike the complexity of attaining optimal views of tortuous vessels on CT.
authors.affiliation: Neuroradiology Division, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: S J
authors.initials: SJ
authors.lastname: Zinreich
authors.forename: H
authors.initials: H
authors.lastname: Wang
authors.forename: J I
authors.initials: JI
authors.lastname: Epstein
authors.forename: W S
authors.initials: WS
authors.lastname: Kim
authors.forename: H
authors.initials: H
authors.lastname: Brem
authors.forename: J H
authors.initials: JH
authors.lastname: Anderson
authors.forename: H S
authors.initials: HS
authors.lastname: Ahn
authors.forename: A E
authors.initials: AE
authors.lastname: Rosenbaum
mesh_terms: D000792:Angiography; D015901:Angiography, Digital Subtraction; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D002340:Carotid Artery Diseases / Q000175:diagnosis; D003952:Diagnostic Imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D066298:In Vitro Techniques; D008279:Magnetic Resonance Imaging; D008955:Models, Cardiovascular; D008961:Models, Structural; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography