Improved Imaging of Carotid Artery Bifurcation Using Helical Computed Tomographic Angiography

Cinat, Marianne; Pham, Hanh; Vo, David; Gordon, Ian L.; Wilson, Samuel E.

doi:10.1007/s100169900238

Cited by 20 publications

(10 citation statements)

References 12 publications

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“…To determine the level of the carotid bifurcation and the possible presence of calcification, a CT scan without contrast was obtained, in 5-mm sections, from C2 through C6. 30,31 Subsequently, the angiographic acquisition was obtained; arterial enhancement was provided by the intravenous administration in an antecubital vein, through an 18 -20 gauge intravenous catheter, of 130 mL of nonionic iodinated contrast material (iopromide [Ultravist 370], Berlex Pharmaceuticals, Richmond, Calif) at an injection speed of 4 mL/s with a power injector. The delay time was 14 -18 s, the table speed was 3 mm/s, and the collimation was 3 mm.…”

Section: Imaging: Us-ecd and Cta Techniquementioning

confidence: 99%

CT and Ultrasound in the Study of Ulcerated Carotid Plaque Compared with Surgical Results: Potentialities and Advantages of Multidetector Row CT Angiography

Saba

Caddeo²,

Sanfilippo³

et al. 2007

American Journal of Neuroradiology

198

120

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Section: Imaging: Us-ecd and Cta Techniquementioning

confidence: 99%

CT and Ultrasound in the Study of Ulcerated Carotid Plaque Compared with Surgical Results: Potentialities and Advantages of Multidetector Row CT Angiography

Saba

Caddeo²,

Sanfilippo³

et al. 2007

American Journal of Neuroradiology

198

120

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“…The use of contrast-infused CT scanning in the examination of carotid artery bifurcation was reported for the first time in the late 1980s. It can be also used alone, or in combination with US in the diagnostics of ICA stenoses (Castillo, 1993;Cumming and Morrow, 1994;Heiserman et al, 1994;Leclerc et al, 1995;Link et al, 1997;Mildenberger et al, 1997;Simeone et al, 1997;Magarelli et al, 1998;Sugahara et al, 1998;Cinat et al, 1999;Marcus et al, 1999;Sameshima et al, 1999;Binaghi et al, 2001;Randoux et al, 2001;Patel et al, 2002;Alvarez-Linera et al, 2003). According to some authors, it is more accurate than US (Link et al, 1997;Simeone et al, 1997;Magarelli et al, 1998;Sugahara et al, 1998;Cinat et al, 1999;Sameshima et al, 1999;Binaghi et al, 2001) and its findings are consistent with DSA examination results (Castillo, 1993;Cumming and Morrow, 1994;Heiserman et al, 1994;Link et al, 1997;Mildenberger et al, 1997;Simeone et al, 1997;Magarelli et al, 1998;Sugahara et al, 1998;Marcus et al, 1999;Sameshima et al, 1999;Binaghi et al, 2001;Randoux et al, 2001;Patel et al, 2002;Alvarez-Linera et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Comparison of ultrasonography, CT angiography, and digital subtraction angiography in severe carotid stenoses

Herzig¹,

Buřval

Křupka³

et al. 2004

Euro J of Neurology

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Digital subtraction angiography (DSA) is considered to be the 'gold standard' for confirmation of severe (70-99%) stenoses of internal carotid arteries (ICAs). However, it is associated with a risk of complications. The aim of this study was to assess the accuracy of ultrasonography (US), computed tomographic angiography (CTA), and their combined use for the detection and quantification of severe carotid stenoses, when compared with DSA. Severe ICA stenoses were diagnosed by US in a set of 29 patients. All patients also underwent CTA and DSA. Sensitivity, specificity, positive (PPV), negative predictive values (NPV), and Pearson's correlation coefficient were used in the evaluation of the percentage of stenosis results. Homogeneity chi2 test was applied when assessing statistical significance. Severe stenosis was diagnosed in 34 ICAs. Two ICAs with uninterpretable CTA finding were excluded. The number of ICAs with stenoses 70-99%/<70%- US 32/0; CTA 29/3; US + CTA 29/3; DSA 24/8. Pearson's correlation coefficient - US 0.601; CTA 0.725; US + CTA 0.773. Sensitivity/specificity/PPV/NPV - US 1.0/0.75/0.75/xxx; CTA 1.0/0.844/0.828/1.0; US + CTA 1.0/0.844/0.828/1.0. Homogeneity chi2 test results - US, P = 0.002; CTA, P = 0.098; US + CTAG, P = 0.098. US in combination with CTA can be used for relatively secure diagnostics of severe ICA stenoses. Thus, invasive DSA can be avoided in a substantial number of patients.

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“…Others, however, have obtained a 100% sensitivity and a 100% specificity with CTA of severe stenoses compared to digital subtraction angiography [16]. Because of the excellent post-processing capabilities of CTA, it is now used to corroborate the degree of stenosis when CFD and MRA results are ambiguous [2]. A number of other investigators have reported that MRA has overestimated the degree of stenosis when compared to conventional angiography [9,10,17,19,23].…”

Section: Discussionmentioning

confidence: 99%

“…Enlarged axial images furnish a cross-sectional view of the carotid artery and the plaque morphology [7]. Reconstructed images can be rotated 360°and viewed from any perspective, and closely resemble traditional angiograms [2].…”

Section: Introductionmentioning

confidence: 99%

Computed tomography in the decision for carotid endarterectomy

et al. 2011

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Computed tomographic angiography (CTA) is being used more frequently in the decision for the carotid endarterectomy. The accuracy of CTA to differentiate between moderate and severe occlusions of the internal carotid artery has been evaluated in this study. After color-flow 2 duplex (CFD) scanning to determine the severity of the stenosis, contrast-enhanced spiral CTA was performed in 60 carotid arteries of 30 patients. 2-D or 3-D time-of-flight MRA techniques and gadolinium enhancement were also used to measure stenosis. Accuracy for moderate, severe and occluded stenoses was calculated. Internal carotid artery stenosis was classified as completely occluded in four, severe in 27, moderate in 25 and mild in four by CFD. There were five total occlusions, and 19 severe, 30 moderate and six mild stenoses by CTA. The overall accuracy of CTA to CFD was 84%, and was 92% and 75% for moderate and severe stenoses, respectively. CTA has identified calcification and ulceration of the plaque. By MRA there were 2 total occlusions, and 33 severe, 19 moderate and six mild stenoses. The overall accuracy of MRA to CFD was 80%, and was 70% and 94% for moderate and severe stenoses, respectively. While MRA is now routinely used to confirm the results of CFD before surgery, the CTA may in time replace the MRA because it better identifies plaque morphology, ulceration and tight stenoses.

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Improved Imaging of Carotid Artery Bifurcation Using Helical Computed Tomographic Angiography

Cited by 20 publications

References 12 publications

CT and Ultrasound in the Study of Ulcerated Carotid Plaque Compared with Surgical Results: Potentialities and Advantages of Multidetector Row CT Angiography

CT and Ultrasound in the Study of Ulcerated Carotid Plaque Compared with Surgical Results: Potentialities and Advantages of Multidetector Row CT Angiography

Comparison of ultrasonography, CT angiography, and digital subtraction angiography in severe carotid stenoses

Computed tomography in the decision for carotid endarterectomy

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