Comparative evaluation of 64-slice CT angiography and digital subtraction angiography in assessing the cervicocranial vasculature.
BACKGROUND
Noninvasive 64-slice computed tomography angiography (64-MSCTA) closely approximates conventional catheter angiography (DSA) in terms of detail resolution.


OBJECTIVE
Retrospective evaluation of cervicocranial (cc) 64-MSCTA in comparison with DSA in patients with presumptive cc vascular disorders.


METHODS
Twenty-four 64-MSCTA studies (32 mm detector width, slice thickness 0.5 mm, 120 kv, 150 mAs, pitch 0.75) of patients with presumptive cc vascular pathology (13 men, 11 women, mean age 38.3 +/- 11.3 yrs, range 19-54 yrs) were assessed in comparison with DSA studies without abnormal findings in age-matched patients (11 men, 13 women, mean age 39.7 +/- 11.9 yrs, range 18-54 yrs). Study readings were performed in a blinded manner by two neuroradiologists with respect to image quality and assessibility of various cc vascular segments by using a five-point scale. Radiation exposure was calculated for 64-MSCTA.


RESULTS
Each reader assessed 384/528 different vessel segments (64-MSCTA/DSA). Superior image quality was attributed to DSA with respect to the C1 ICA-C6 ICA, A3 ACA, and P3 PCA segments as well the AICA and SCA. 64-MSCTA was scored superior for C7 ICA and V4 VA segments. A significantly increased number ofnonassessable V2- and V3 VA segments in DSA studies was noted. The effective dose for 64-MSCTA amounted to 2.2 mSv.


CONCLUSIONS
64-MSCTA provides near-equivalent diagnostic information of the cc vasculature as compared with DSA. According to our results, DSA should be considered primarily when peripheral vessels (A3/P3) or ICA segments close to the skull base (C2-5) are of interest, such as in primary angiitis or stenoocclusive ICA disease, respectively.
Klingebiel
Randolf
R
Department of Neuroradiology, Universitary Medicine Berlin, Germany. randolf.klingebiel@charite.de
Kentenich
Max
M
Bauknecht
Hans-Christian
HC
Masuhr
Florian
F
Siebert
Eberhard
E
Busch
Markus
M
Bohner
Georg
G
D000328:Adult; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography / Q000379:methods*; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult