title: Time-Resolved 4-Dimensional Computed-Tomography Angiography Can Correctly Identify Carotid Pseudo-Occlusion.
abstract: Correct identification of symptomatic high-grade internal carotid artery stenosis from low-grade or total chronic occlusion is critical for patient selection for urgent carotid endarterectomy. Carotid pseudo-occlusion is a flow-related artifact on noninvasive imaging that can lead to an incorrect diagnosis of total internal carotid artery occlusion, thereby denying an eligible patient for appropriate surgical treatment. We present an 82-year-old man with a symptomatic critical internal carotid artery, which was detected on time-resolved 4-dimensional computed-tomography angiography, whereas single-phase computed-tomography angiography, magnetic resonance angiography, and Doppler ultrasonography suggested apparent occlusion. To our understanding, the use of 4-dimensional computed-tomography angiography to identify carotid pseudo-occlusion has not been previously reported.
authors.affiliation: Department of Neurosciences, Box Hill Hospital, Melbourne, Victoria, Australia. Electronic address: ng.fcffelix@gmail.com.
authors.forename: Felix C
authors.initials: FC
authors.lastname: Ng
authors.affiliation: Department of Medical Imaging, Box Hill Hospital, Melbourne, Victoria, Australia.
authors.forename: Mineesh
authors.initials: M
authors.lastname: Datta
authors.affiliation: Department of Neurosciences, Box Hill Hospital, Melbourne, Victoria, Australia; Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
authors.forename: Philip M C
authors.initials: PM
authors.lastname: Choi
mesh_terms: D000369:Aged, 80 and over; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging*; D000072226:Computed Tomography Angiography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013997:Time Factors; D018608:Ultrasonography, Doppler
keywords: 4D-CTA; Carotid pseudo-occlusion; carotid endarterectomy; carotid stenosis; transient ischemic attack