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1Abteilung für Röntgendiagnostik, Chirurgische Universitätsklinik Würzburg, Germany.
Insights
Digital subtraction angiography (DSA), CT angiography (CTA), and color flow Doppler (CFD) accurately detect carotid artery occlusions. CTA excels in plaque morphology, while CFD and DSA better identify ulcerations for effective stenosis assessment.
Area of Science:
- Vascular Surgery
- Diagnostic Imaging
- Neurology
Context:
- Carotid stenosis diagnosis is crucial for effective patient therapy.
- Accurate assessment of stenosis degree and plaque morphology is essential.
- Fast, reliable, and cost-effective diagnostic methods are needed.
Purpose:
- To compare the sensitivity and specificity of digital subtraction angiography (DSA), color flow Doppler (CFD), and CT angiography (CTA) in diagnosing carotid stenosis.
- To evaluate the capability of each imaging modality in assessing plaque morphology and ulcerations.
Summary:
- 159 patients with cerebrovascular disease were assessed using DSA, CFD, and CTA.
- All methods achieved 100% sensitivity for detecting carotid occlusions.
- CTA demonstrated superior plaque morphology assessment, while CFD and DSA were more precise for ulcerations.
Impact:
- CFD provides the most comprehensive initial assessment for carotid stenosis.
- CTA and DSA offer valuable supplementary information for complex cases.
- Optimizing diagnostic strategies improves patient management for cerebrovascular disease.
Abstract:
Clinical findings and the correct assessment of the morphology and degree of stenosis is a decidant point in the conservative and operative therapy of carotid stenosis. Diagnosis should be reached fast, sure and cost-effective with a high sensitivity and specifity.One hundred and fifty-nine patients with cerebrovascular disease underwent digital subtraction angiography (DSA), color flow Doppler (CFD) and CT angiography (CTA).We detected 213 severe (> 80%) stenoses (ICA: 151, ECA: 45, CCA: 17), and 32 occlusions (ICA: 27, ECA: 3, CCA: 2). The 3 methods showed all occlusions (sensitivity: 100%). D SA failed in 7 stenosis (sensitivity 96.7%), CTA in 3 cases (98.6%), CFD in 19 stenoses (sensitivity: 92.2%).Morphology of plaques were detected by CTA, which was superior to CFD or DSA. Ulcerations were demonstrated more exactly by CFD and DSA; CTA needs the reformation. Most questions can be answered by CFD, special information should be got by CTA and DSA.
