CT angiography: application to the evaluation of carotid artery stenosis.
OBJECTIVE
To determine whether computed tomographic (CT) angiography can be used to accurately quantify carotid stenoses and differentiate severe stenoses from occlusions.


METHODS
CT angiography was used to evaluate 50 carotid arteries in 27 patients who were referred for surgical evaluation after diagnosis of carotid stenosis and who had undergone standard angiography. Four observers read each study separately in a blinded fashion, then all four observers together reviewed those studies in which the individual readings differed to reach a consensus reading.


RESULTS
The consensus readings for the two modalities were in agreement on stenosis category in 41 (82%) of the 50 carotid arteries (kappa W = 0.852 +/- 0.114). The consensus readings in the other nine arteries differed by only one category; seven had less severe stenosis at CT angiography and two had more severe stenosis. The CT angiograms also depicted a variety of additional abnormalities, including loops (n = 6), aneurysms (n = 2), and ulcers (n = 4).


CONCLUSIONS
These results indicate that CT angiography can non-invasively provide most of the information needed before carotid endarterectomy.
Dillon
E H
EH
Department of Diagnostic Radiology, University Hospital Utrecht, The Netherlands.
van Leeuwen
M S
MS
Fernandez
M A
MA
Eikelboom
B C
BC
Mali
W P
WP
D000328:Adult; D000368:Aged; D000792:Angiography; D015901:Angiography, Digital Subtraction; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging; D002342:Carotid Artery, External / Q000000981:diagnostic imaging; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D014057:Tomography, X-Ray Computed / Q000379:methods; D014654:Vascular Patency