Comparison of 64-Detector-Row Computed Tomography Angiography and Digital Substraction Angiography In The Diagnosis of Carotid and Vertebral Artery Stenosis
Abstract
Purpose: In this study, our aim is to investigate the efficiency of 64-detectorrow computed tomography CT angiography in the diagnosis of carotid and vertebral artery stenosis. Patients and Methods: In this prospective study, we evaluated 45 patients who were referred to our department with suspected diagnoses such as transient ischemic attack, stroke, hemiplegia, vertigo using 64-detectorrow CT angiography. Measurements of the stenoses were carried out on axial and maximum intensity projection MIP images, respectively, on the workstation. Subsequently, all patients were evaluated with digital substraction angiography DSA . Grades of the stenoses of carotid and vertebral arteries were determined by using North American Symptomatic Endarterectomy Trial NASCET criteria. Results of the 64-detector-row CT angiography were statistically compared with the findings of DSA. Results: A total of 83 stenosis in 42 carotid arteries 5 left common carotid artery, 18 right internal carotid artery, 19 left internal carotid artery and 41 vertebral arteries 18 right vertebral artery, 23 left vertebral artery were found using CT angiography. At DSA; two of these stenosis were evaluated as normal and a total of 81 stenosis 11 grade 2, 24 grade 3, 14 grade 4, 15 grade 5 and 17 grade 6 were detected. Consistency ratio between DSA and axial CT images and between DSA and MIP CT images were 84 % and 82 %, respectively. Conclusion: 64-detector-row CT angiography is an effective alternative imaging technique in the evaluation of carotid and vertebral artery stenosis.
Keywords
computed tomography angiography digital substraction angiography carotid stenosis vertebral artery stenosis
References
- Silvennoinen HM, Ikonen S, Soinne L, Railo M, Valanne L. CT angiographic analysis of carotid artery stenosis: comparison of manual assessment, semiautomatic vessel analysis, and digital subtraction angiography. AJNR Am J Neuroradiol. 2007; 28: 97-103.
- Masaryk TJ, Obuchowski NA. Noninvasive carotid imaging: caveat emptor. Radiology 1993; 186:325-31.
- Barnet HJ, Taylor DW, Eliasziw M, Fox AJ, Ferguson GG, Haynes RB. et al. Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators. N Eng J Med 1998; 339:1415-25.
- Wolpert SM, Caplan LR. Curent role of cerebral angiogragraphy in the diagnosis of cerebrovascular diseases. AJR 1992 ;159:191-7.
- Davies KN, Humphrey PR. Complications of cerebral angiography in patients with symptomatic carotid territory ischemia screened by carotid ultrasound. J Neurol Neurosurg Psychiatry 1993; 56: 967-72.
- Grossman RI, Yousem DM. Neuroradiology: the requisites. Cranial Anatomy. 2nd edition. Pennsylvania: Elsevier Inc (ABD) 2003; 88.
- McIvor J, Steiner TJ, Perkin GD, Greenhalgh RM, Rose FC. Neurological morbidity of arch and carotid arteriography in cerebrovascular disease. The influence of contrast medium and radiologist. BJR 1987; 60:117-22.
- Chen CJ, Lee TH, Hsu HL, Tseng YC, Lin SK, Wang LJ, et aL. Multislice CT angiography in diagnosing total versus near occlusions of the internal carotid artery: comparison with catheter angiography. Stroke 2004; 35: 83-5.
- Robinson ML, Sacks D, Perlmutter GS, Marinelli DL. Diagnostic criteria for carotid dupplex sonography. AJR 1988; 151:1045-9.
- Gil-Peralta A, Mayol A, Marcos JR, Gonzalez A, Ruano J, Boza F, et al. Percutaneous translüminal angioplasty of symptomatic atherosclerotic carotid arteries: results, complications, and follow- up. Stroke 1996; 27: 2271-3.
- Bhadelia RA, Bengoa F, Gesner L, Patel SK, Uzun G, Wolpert SM, et al. Efficacy of MR angiography in the detection and characterization of occlusive disease in the vertebrobasilar system. J Comput Assist Tomogr 2001; 25:458-65.
- Aschenbach R, Eger C, Basche S, Vogl TJ. Grading of carotid artery stenosis using high resolution dynamic magnetic resonance angiography in comparison to intraarterial digital subtraction angiography. Are stenosis over 70% reliably detectable? Rofo. 2004; 176: 357-62.
- Rubin GD, Shiau MC, Schimidt AJ, , Fleischmann D, Logan L, Leung AN, et al. Computed tomographic angiography: historical perspective and new state-of-the-art using multi detector-row helical computed tomography. J Comput Asist Tomogr 1999; 23: 83-90.
- Alvarez-Linera J, Benito-Leon J, Escribano J, Campollo J, Gesto R. Prospective evaIuation of carotid artery stenosis: elliptic centric contrast-enhanced MR angiography and spiral CT angiography compared with digital substraction angiography. AJNR Am J Neuroradiol. 2003; 24: 1012-9.
- Oliver TB, Lammie OA, Wright AR, Wardlaw J, Patel SG, Peek R, et al. Atherosclerotic plaque at the carotid bifurcation: CT angiographic appearance with histopathologic correlation. AJNR 1999; 20:897-901.
- Johnson PT, Heath DG, Bliss DF, Cabral B, Fishman EK. et al. Three- dimensional CT: real-time interactive. AJR 1996; 167:581-3.
- Farres MT, Grabenwoger F, Magometschnig H, Trattnig S, Heimberger K, Lammer J. et al. Spiral CT angiography: study of stenoses and calcification at the origin of the vertebral artery. Neuroradiology 1996; 38:738-43.
- Willinsky RA, Taylor SM, TerBrugge K, Farb RI, Tomlinson G, Montanera W. Neurologic complications of cerebral angiography: prospective analysis of 2,899 procedures and review of the literature. Radiology 2003; 227(2): 522-8.
- Napoli A, Fleischmann D, Chan FP, Catalano C, Hellinger
- JC, Passariello R, et al. Computed tomography angiography: state- of-the-art imaging using multidetector-row technology. J Comput Asist Tomogr. 2004; 28(suppl 1): 32-45.
- Chen CJ, Lee TH, Hsu HL, Tseng YC, Lin SK, Wang LJ, et al. Multi- slice CT angiography in diagnosing total versus near occlusions of the internal carotid artery: comparison with catheter angiography. Stroke 2004; 35: 83-5.
- Bartlett ES, Walters TD, Symons S, Fox AJ. Quantification of carotid stenosis on CT angiography. AJNR 2006; 27: 13-9.
- Moore WS, Krupski WC. Indications, surgical technique and results for repair of extracranial occlusive lesions. In Rutherford RB ed: Vascular Surgery, ed 5. Philadelphia, WB Saunders, 2000:1789-822.
- Streifler JY, Eliasziw M, Fox AJ, Benavente OR, Hachinski VC, Ferguson GG, et al. Angiographic detection of carotid plaque ulceration. Comparison with surgical observations in a multicenter study. North American Symptomatic Carotid Endarterectomy Trial. Stroke 1994; 25: 1130-2.
- Buerke B, Puesken M, Wittkamp G, Stehling C, Ditt H, Seidensticker P, et al. Bone subtraction CTA for transcranial arteries: intra-individual comparison with standard CTA without bone subtraction and TOF- MRA. Clin Radiol 2010; 65(6):440-6.
- Buerke B, Wittkamp G, Seifarth H, Heindel W, Kloska SP. Dual-energy CTA with bone removal for transcranial arteries: intraindividual comparison with standard CTA without bone removal and TOF- MRA. Acad Radiol 2009; 16(11):1348-55
Ekstrakraniyal Karotis ve Vertebral Arter Darlıklarında 64 Kesitli BT Anjiyografi ile DSA Bulgularının Karşılaştırılması
Abstract
Amaç: Bu çalışmada ekstrakraniyal karotis ve vertebral arter VA darlıklarının tanısında 64 kesitli bilgisayarlı tomografik anjiyografinin BTA ’nin etkinliği araştırılmıştır. Hastalar ve Yöntem: Bu prospektif çalışmada merkezimize geçici iskemik atak, inme, hemipleji, baş dönmesi, hareket bozukluğu gibi sebeplerle refere edilen 45 hastaya ana karotid arter AKA , internal karotid arter İKA ve vertebral arterlere yönelik BTA incelemeleri yapıldı. İş istasyonunda gerek aksiyel kesitlerden gerekse de maksimum intensite projeksiyonu MİP ile elde edilen görüntüler üzerinden darlık ölçümleri yapıldı. Daha sonra tüm hastalara dijital substraksiyon anjiyografisi DSA yapıldı. Olguların karotid ve VA darlıklarının dereceleri NASCET North American Symptomatic Endarterectomy Trial kriterlerine göre belirlendi. BTA ile elde edilen sonuçlar DSA bulguları ile istatistiksel olarak karşılaştırıldı. Bulgular: BTA ile 42’si karotid 5 sol AKA, 18 sağ İKA, 19 sol İKA ve 41’i VA 18 sağ VA, 23 sol VA olmak üzere toplam 83 darlık saptandı. DSA ile bu olguların ikisi normal olarak değerlendirildi; 11’i evre 2, 24’ü evre 3, 14’ü evre 4, 15’i evre 5, ve 17’si evre 6 olmak üzere toplam 81 darlık tanısı kondu. DSA ile aksiyel-BTA sonuçları arasında %84, MİP-BTA sonuçları arasında ise %82 oranında uyum saptandı. Sonuç: 64 kesitli BTA, ekstrakraniyal karotis ve vertebral arter darlıklarının değerlendirilmesinde etkili bir alternatif görüntüleme yöntemidir.
Keywords
bilgisayarlı tomografik anjiyografi dijital substraksiyon anjiyografisi karotis darlığı vertebral arter darlığı
References
- Silvennoinen HM, Ikonen S, Soinne L, Railo M, Valanne L. CT angiographic analysis of carotid artery stenosis: comparison of manual assessment, semiautomatic vessel analysis, and digital subtraction angiography. AJNR Am J Neuroradiol. 2007; 28: 97-103.
- Masaryk TJ, Obuchowski NA. Noninvasive carotid imaging: caveat emptor. Radiology 1993; 186:325-31.
- Barnet HJ, Taylor DW, Eliasziw M, Fox AJ, Ferguson GG, Haynes RB. et al. Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators. N Eng J Med 1998; 339:1415-25.
- Wolpert SM, Caplan LR. Curent role of cerebral angiogragraphy in the diagnosis of cerebrovascular diseases. AJR 1992 ;159:191-7.
- Davies KN, Humphrey PR. Complications of cerebral angiography in patients with symptomatic carotid territory ischemia screened by carotid ultrasound. J Neurol Neurosurg Psychiatry 1993; 56: 967-72.
- Grossman RI, Yousem DM. Neuroradiology: the requisites. Cranial Anatomy. 2nd edition. Pennsylvania: Elsevier Inc (ABD) 2003; 88.
- McIvor J, Steiner TJ, Perkin GD, Greenhalgh RM, Rose FC. Neurological morbidity of arch and carotid arteriography in cerebrovascular disease. The influence of contrast medium and radiologist. BJR 1987; 60:117-22.
- Chen CJ, Lee TH, Hsu HL, Tseng YC, Lin SK, Wang LJ, et aL. Multislice CT angiography in diagnosing total versus near occlusions of the internal carotid artery: comparison with catheter angiography. Stroke 2004; 35: 83-5.
- Robinson ML, Sacks D, Perlmutter GS, Marinelli DL. Diagnostic criteria for carotid dupplex sonography. AJR 1988; 151:1045-9.
- Gil-Peralta A, Mayol A, Marcos JR, Gonzalez A, Ruano J, Boza F, et al. Percutaneous translüminal angioplasty of symptomatic atherosclerotic carotid arteries: results, complications, and follow- up. Stroke 1996; 27: 2271-3.
- Bhadelia RA, Bengoa F, Gesner L, Patel SK, Uzun G, Wolpert SM, et al. Efficacy of MR angiography in the detection and characterization of occlusive disease in the vertebrobasilar system. J Comput Assist Tomogr 2001; 25:458-65.
- Aschenbach R, Eger C, Basche S, Vogl TJ. Grading of carotid artery stenosis using high resolution dynamic magnetic resonance angiography in comparison to intraarterial digital subtraction angiography. Are stenosis over 70% reliably detectable? Rofo. 2004; 176: 357-62.
- Rubin GD, Shiau MC, Schimidt AJ, , Fleischmann D, Logan L, Leung AN, et al. Computed tomographic angiography: historical perspective and new state-of-the-art using multi detector-row helical computed tomography. J Comput Asist Tomogr 1999; 23: 83-90.
- Alvarez-Linera J, Benito-Leon J, Escribano J, Campollo J, Gesto R. Prospective evaIuation of carotid artery stenosis: elliptic centric contrast-enhanced MR angiography and spiral CT angiography compared with digital substraction angiography. AJNR Am J Neuroradiol. 2003; 24: 1012-9.
- Oliver TB, Lammie OA, Wright AR, Wardlaw J, Patel SG, Peek R, et al. Atherosclerotic plaque at the carotid bifurcation: CT angiographic appearance with histopathologic correlation. AJNR 1999; 20:897-901.
- Johnson PT, Heath DG, Bliss DF, Cabral B, Fishman EK. et al. Three- dimensional CT: real-time interactive. AJR 1996; 167:581-3.
- Farres MT, Grabenwoger F, Magometschnig H, Trattnig S, Heimberger K, Lammer J. et al. Spiral CT angiography: study of stenoses and calcification at the origin of the vertebral artery. Neuroradiology 1996; 38:738-43.
- Willinsky RA, Taylor SM, TerBrugge K, Farb RI, Tomlinson G, Montanera W. Neurologic complications of cerebral angiography: prospective analysis of 2,899 procedures and review of the literature. Radiology 2003; 227(2): 522-8.
- Napoli A, Fleischmann D, Chan FP, Catalano C, Hellinger
- JC, Passariello R, et al. Computed tomography angiography: state- of-the-art imaging using multidetector-row technology. J Comput Asist Tomogr. 2004; 28(suppl 1): 32-45.
- Chen CJ, Lee TH, Hsu HL, Tseng YC, Lin SK, Wang LJ, et al. Multi- slice CT angiography in diagnosing total versus near occlusions of the internal carotid artery: comparison with catheter angiography. Stroke 2004; 35: 83-5.
- Bartlett ES, Walters TD, Symons S, Fox AJ. Quantification of carotid stenosis on CT angiography. AJNR 2006; 27: 13-9.
- Moore WS, Krupski WC. Indications, surgical technique and results for repair of extracranial occlusive lesions. In Rutherford RB ed: Vascular Surgery, ed 5. Philadelphia, WB Saunders, 2000:1789-822.
- Streifler JY, Eliasziw M, Fox AJ, Benavente OR, Hachinski VC, Ferguson GG, et al. Angiographic detection of carotid plaque ulceration. Comparison with surgical observations in a multicenter study. North American Symptomatic Carotid Endarterectomy Trial. Stroke 1994; 25: 1130-2.
- Buerke B, Puesken M, Wittkamp G, Stehling C, Ditt H, Seidensticker P, et al. Bone subtraction CTA for transcranial arteries: intra-individual comparison with standard CTA without bone subtraction and TOF- MRA. Clin Radiol 2010; 65(6):440-6.
- Buerke B, Wittkamp G, Seifarth H, Heindel W, Kloska SP. Dual-energy CTA with bone removal for transcranial arteries: intraindividual comparison with standard CTA without bone removal and TOF- MRA. Acad Radiol 2009; 16(11):1348-55
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | September 1, 2014 |
| Published in Issue | Year 2014Issue: 3 |