[CT angiography in carotid stenosis. Diagnostic value compared to color-coded duplex ultrasonography and MR angiography].

PURPOSE: To evaluate the accuracy of different diagnostic methods for the visualization of the carotid arteries and their pathological changes in order to avoid invasive angiography whenever surgery was considered.

MATERIAL AND

METHODS

24 patients with clinically suspected stenosis or occlusion of the carotid arteries were prospectively examined via CT angiography. MR angiography and colour-coded duplex sonography (ccds) to evaluate the degree of stenosis and the extent of calcification.

RESULTS

In 36 cases stenoses of different extent could be documented with CT angiography, 33 cases were found using colour-coded duplex sonography and MRA. Sonography could not prove mild stenoses (< 30%), and in two patients with sonographically suspected total occlusion vessel perfusion was documented via CT angiography. MR angiography led to a overestimation in patients with high-grade stenosis compared to the degree of stenosis obtained via ccds and CTA. With regard to the diagnosis of calcification MIP, reconstructions after CT examination showed best correlation to the plain CT slices referring to length (94.6%) and thickness (89.2%).

CONCLUSION

CTA with MIP reconstructions is an excellent screening method and, in combination with ccds, CT angiography may replace DSA before surgery or intervention.