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Head and Neck Imaging |
1 From the Department of Neuroradiology of Pr Marsault, Groupe Hospitalier Pitié-Salpêtrière, Bâtiment Babinski, 47-83 Boulevard de l’Hôpital, 75651 Paris Cedex 13, France. Received May 23, 2000; revision requested July 12; final revision received November 27; accepted December 21. Address correspondence to B.R. (e-mail: bruno.randoux@caramail.com).
PURPOSE: To prospectively compare gadolinium-enhanced magnetic resonance (MR) angiography and computed tomographic (CT) angiography with digital subtraction angiography (DSA) for use in detecting atheromatous stenosis and plaque morphology at the carotid bifurcation.
MATERIALS AND METHODS: Forty-four carotid arteries (in 22 patients) were analyzed by using CT angiography, enhanced MR angiography, and DSA. CT and enhanced MR angiograms were reconstructed with maximum intensity projection and multiplanar volume reconstruction. The following four features were analyzed: degree of stenosis on the basis of North American Symptomatic Carotid Endarterectomy Trial criteria, length of stenosis, luminal surface, and presence of ulcers.
RESULTS: There was significant correlation between CT angiography, enhanced MR angiography, and DSA for degree and length of stenosis. With enhanced MR angiography and CT angiography, degree of stenosis was underestimated in two of 44 cases. No case of overestimation with CT angiography was found. Severe internal carotid artery stenoses were detected with high sensitivity and specificity: 100% and 100%, respectively, with CT angiography; 93% and 100%, respectively, with enhanced MR angiography. Luminal surface irregularities were most frequently seen at CT angiography. With CT angiography and enhanced MR angiography, more ulceration was detected than with DSA.
CONCLUSION: There was a significant correlation between CT angiography, enhanced MR angiography, and DSA in evaluation of carotid artery stenosis. Enhanced MR angiography or CT angiography can be used to adequately evaluate carotid stenosis.
Index terms: Angiography, comparative studies, 172.124 • Carotid arteries, stenosis or obstruction, 172.721 • Computed tomography (CT), angiography, 172.12116 • Magnetic resonance (MR), contrast enhancement, 172.121419 • Magnetic resonance (MR), vascular studies, 172.12142, 172.12143
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