Accuracy of CT angiography in the assessment of a fetal origin of the posterior cerebral artery.
An uncommon cause of cerebral ischemia in the territory of the posterior cerebral artery (PCA) is the combination of a fetal origin of the PCA and atherosclerotic disease in the internal carotid artery. This study compared the accuracy of CTA with DSA in the assessment of a fetal origin of the PCA. Patients in whom an intracranial DSA and CTA had been performed were reviewed. A fetal origin was defined as a normal-sized patent posterior communicating artery (PCoA) with hypoplasia or aplasia of the ipsilateral P1 segment. One hundred PCAs in 51 patients were analyzed. A fetal origin was present in ten vessels (10%, eight patients). CTA revealed all of them. CTA considered an additional three vessels as having a fetal origin, while DSA revealed a PCoA with the same diameter as the P1 segment of the PCA. Sensitivity and specificity of CTA in the assessment of a fetal origin could be estimated at 100 and 97%, respectively. Positive and negative predictive values were 77 and 100%, respectively. CTA can be considered a valid diagnostic tool for the assessment of a fetal origin of the PCA in patients with a cerebral ischemic event in the territory of the PCA.
van der Lugt
A
A
Department of Radiology, Erasmus MC, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. a.vanderlugt@erasmusmc.nl
Buter
T C
TC
Govaere
F
F
Siepman
D A M
DA
Tanghe
H L J
HL
Dippel
D W J
DW
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography; D002941:Circle of Willis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D020762:Infarction, Posterior Cerebral Artery / Q000000981:diagnostic imaging* / Q000209:etiology; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D020769:Posterior Cerebral Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed; D014057:Tomography, X-Ray Computed