Spiral CT angiography: study of stenoses and calcification at the origin of the vertebral artery

Farrés, Maria Teresa; F, Grabenwöger; Magometschnig, H.; Trattnig, Siegfried; Heimberger, K.; Lämmer, Johannes

doi:10.1007/s002340050339

Cited by 27 publications

(29 citation statements)

References 8 publications

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“…This was done for pragmatic reasons, most stroke patients do not routinely undergo DSA (i.e., because of complication risks). In addition, previous studies show that CTA is adequately capable of detecting vertebral artery stenosis (Farres et al, 1996;Khan et al, 2009). Third, the cause of posterior circulation stroke or TIA might be thrombo-embolic instead of hemodynamic.…”

Section: Discussionmentioning

confidence: 96%

Duplex ultrasonography for the detection of vertebral artery stenosis

et al. 2017

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Objectives: Vertebrobasilar stenosis is frequent in patients with posterior circulation stroke and it increases risk of recurrence. We investigated feasibility of duplex ultrasonography (DUS) for screening for extracranial vertebral artery stenosis and compared it with CT angiography (CTA). Materials and Methods:We gathered data on 337 consecutive patients who had DUS because of posterior circulation stroke or TIA. Matching CTA studies were retrieved and used as reference. Stenosis on CTA was considered "significant" if >50%, at DUS if Peak Systolic Velocity (PSV) > 140 cm/s for the V1 segment and PSV > 125 cm/s for the V2 segment. We determined the area under the ROC curve (AUROC). In addition, we calculated which PSV cut-off value resulted in highest sensitivity with acceptable specificity.Results: DUS was able to make an adequate measurement in 378 of 674 V1 segments and 673 of 674 V2 segments. DUS detected a significant stenosis in 52 of 378 V1 segments; 12 were confirmed by CTA (AUROC 0.73, 95% Confidence Interval 0.63-0.83).The optimal DUS PSV cut-off value for this segment was 90 cm/s. For the V2 segment there were too few stenoses to allow reliable assessment of diagnostic characteristics of DUS. Conclusions:Although DUS has a fair AUROC for detecting significant stenosis, adequate assessment of the V1 segment is often not possible due to anatomic difficulties.Assessment of the V2 segment is feasible but yielded few stenoses. Hence, we consider usefulness of DUS for screening of extracranial vertebral artery stenosis limited. K E Y W O R D SCT angiography, duplex ultrasonography, vertebral artery, vertebrobasilar stroke

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Section: Discussionmentioning

confidence: 96%

Duplex ultrasonography for the detection of vertebral artery stenosis

et al. 2017

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“…Other studies reported 94% sensitivity and 88% specificity for multi-detector CT angiography in VA stenoses ≥ 50%. Calcified stenoses in the VA origin can be found by CTA even more easily than by DSA (18). In an investigation, Puchner et al emphasized the high quality and feasibility of multi-detector CTA for diagnosis of vertebral stenoses; however, the correlation value between CTA and DUS was moderate (kappa 0.56).…”

Section: Discussionmentioning

confidence: 99%

The Comparison between Digital Subtraction Angiography, CT Angiography, and Doppler Ultrasonography in Evaluation and Assessment of Carotid Artery Stenosis

Banaei

2017

Ann Mil Health Sci Res

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Background: Common angiography or digital subtraction angiography (DSA) is the gold standard protocol for diagnosis of carotid artery stenosis. However, this method has very high delivered X-ray doses to patient and personnel as an invasive diagnostic protocol. The progress of noninvasive or minimally invasive diagnostic techniques like Doppler ultrasonography (DUS), CT angiography (CTA), and MR angiography (MRA) has improved the detection and evaluation of stenosis lesions. The aim of this study was to evaluate the usefulness and accuracy of non-invasive DUS and CTA, attempting in this way to restrict DSA only for final proof of high-grade stenosis. Methods: 25 male patients with carotid artery stenosis were examined with CTA, DUS, and DSA. The lumen diameter of carotid artery was measured and compared with CTA and DUS. The results of CTA and DUS were compared and correlated with DSA results as a reference. Results: Data of lumen diameter measurements in ultrasonography and CTA (for internal and common carotid artery) showed no significant differences between the two methods. Mean internal/common lumen artery in stenosis region was 3.745/5.114 and

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“…They used continuous-wave Doppler sonography [13, 21]and Duplex scanning [10, 11, 12, 14, 15, 18, 19]without color Doppler. Only 5 recent papers have used color-coded Doppler for examination of the vertebral arteries [16, 17, 20, 22, 23]. A previous study [22]reported color-coded Doppler of the vertebral artery in 85 normal individuals and in 166 patients with atheromatous diseases.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies concerning the quantification of proximal VA stenosis by ultrasound are not recent and are limited in number [10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23]. They used continuous-wave Doppler sonography [13, 21]and Duplex scanning [10, 11, 12, 14, 15, 18, 19]without color Doppler.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Color-Doppler in the Quantification of Proximal Vertebral Artery Stenoses

Bray

Pasco²,

Tranquart

et al. 2001

Cerebrovasc Dis

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Background: Vertebrobasilar (VB) strokes appear to have the same causes as carotid strokes. Obstructive lesions of proximal vertebral arteries probably occur in about 30% of stroke patients. Purpose: Our aim was to assess the validity of color Doppler sonography compared to selective intra-arterial angiography in the quantification of proximal vertebral artery stenoses. Materials and Methods: A prospective blind study of 316 vertebral arteries was undertaken between 1996 and 1998. One hundred and fifty-eight patients with cerebrovascular disorders without cerebral hemorrhage were studied consecutively by frequency or amplitude color Doppler flow imaging and intra-arterial angiography. The lesions were quantified by morphological and hemodynamic criteria and classified into 6 groups: 0% 207 arteries; 1–29% 32 arteries; 30–49% 29 arteries; 50–69% 13 arteries; 70–99% 23 arteries; 100% 12 arteries. Results: Ten of the 12 occlusions were identified, the 2 false-negatives were due to 2 revascularized vessels. Moderate stenoses (<50%) were differentiated from tight stenoses (>50%) using hemodynamic criteria. The majority of false-negative stenoses (38) in the different groups were related to intrathoracic or very deep origin of the artery, anechogenic stenosis or a tortuous vessel. Stenoses greater than 70% were diagnosed in 71% of cases with a specificity of 99%. The ĸ value was 0.80. Conclusion: Duplex sonography should be proposed first in VB attacks or stroke to detect and quantify vertebral artery stenoses for surgery and angioplasty.

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Spiral CT angiography: study of stenoses and calcification at the origin of the vertebral artery

Cited by 27 publications

References 8 publications

Duplex ultrasonography for the detection of vertebral artery stenosis

Duplex ultrasonography for the detection of vertebral artery stenosis

The Comparison between Digital Subtraction Angiography, CT Angiography, and Doppler Ultrasonography in Evaluation and Assessment of Carotid Artery Stenosis

Accuracy of Color-Doppler in the Quantification of Proximal Vertebral Artery Stenoses

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