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(Radiology. 1999;211:775-780.)
© RSNA, 1999

Head and Neck Imaging

Carotid Arterial Stenosis: Evaluation at CT Angiography with the Volume-rendering Technique1

Claude D. Marcus, MD, Viviane J. Ladam-Marcus, MD, Jean-Luc Bigot, MD, Claude Clement, MD, Bernard Baehrel, MD and Bernard P. Menanteau, MD

1 From the Departments of Radiology (C.D.M., V.J.L.M., J.L.B., B.P.M.), Vascular Surgery (C.C.), and Cardiothoracic Surgery (B.B.), Hôpital Robert Debré, C.H.U., Rue du Général Koenig, 51092 Reims, France. Received May 22, 1998; revision requested July 14; revision received September 9; accepted December 15. Address reprint requests to B.P.M.

PURPOSE: To determine whether computed tomographic (CT) angiography with the volume-rendering technique (VRT) can be used to accurately quantify carotid arterial stenosis and to identify occlusions.

MATERIALS AND METHODS: Spiral CT was performed in 23 patients who were referred for carotid stenosis evaluation. VRT images and shaded-surface display (SSD) images of 46 carotid arterial bifurcations were compared with findings from digital subtraction angiography (DSA).

RESULTS: Agreement on stenosis category between VRT CT angiography and DSA was found in 39 (85%) of the 46 carotid arteries studied. VRT CT angiography was 92% (49 of 53) sensitive and 96% (82 of 85) specific for the detection of grade 2–3 stenoses (>=70% stenosis). Agreement on stenosis category between SSD CT angiography and DSA was found in 38 (83%) of the 46 carotid arteries studied. SSD CT angiography was 91% (48 of 53) sensitive and 93% (79 of 85) specific for the detection of grade 2–3 stenoses. Calcified stenoses were correctly graded at VRT CT angiography in 10 of the 10 cases with heavy mural calcified plaques, while eight of the 10 stenoses were accurately quantified at SSD CT angiography.

CONCLUSION: These results indicate that VRT CT angiography is as accurate as SSD CT angiography in the evaluation of carotid arterial bifurcations.

Index terms: Carotid arteries, angiography, 172.124 • Carotid arteries, CT, 172.12115, 172.12116, 172.12117 • Carotid arteries, stenosis or obstruction, 172.721 • Computed tomography (CT), volume rendering, 172.12117 • Digital subtraction angiography, comparative studies, 172.1211




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