Diagnosis of disease of the common carotid artery bifurcation: CT angiography vs catheter angiography.
OBJECTIVE
The purpose of this prospective study was to compare CT angiography with conventional catheter angiography for imaging the bifurcation of the common carotid artery in patients with signs and symptoms of atherosclerotic disease.


METHODS
Ten symptomatic patients (20 bifurcations of the common carotid artery) underwent contrast-enhanced spiral CT of the neck. The images were preprocessed and postprocessed by using a commercially available volume-rendering technique and a maximum-intensity-projection algorithm. All patients subsequently underwent conventional catheter angiography.


RESULTS
CT angiographic findings matched those on conventional angiograms in only 50% of cases. Two nearly occluded internal carotid arteries were missed with CT angiography. Four internal carotid arteries were interpreted as occluded on the basis of CT angiograms but were shown as patent on catheter angiograms. Of five severe stenoses shown by CT angiography, only two were confirmed by conventional angiography.


CONCLUSIONS
The results indicate that CT angiography as used in this study cannot replace catheter angiography. With CT angiography, both overestimation and underestimation of stenoses occur.
Castillo
M
M
Department of Radiology, University of North Carolina, Chapel Hill 27599-7510.
D000792:Angiography / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D017536:Carotid Artery, Common; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D006801:Humans; D007089:Image Enhancement; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed