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DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
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Multimodal Optical Imaging Platform for Studying Cellular Metabolism
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Multimodality Imaging in Carotid Web.

Thomas P Madaelil1, Jonathan A Grossberg1, Raul G Nogueira1

  • 1Departments of Neurology and Neurosurgery, Marcus Stroke and Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA, United States.

Frontiers in Neurology
|March 28, 2019
PubMed
Summary
This summary is machine-generated.

Carotid web (CaW) diagnosis is improved by CT angiogram (CTA) and digital subtraction angiogram (DSA), which show higher accuracy than ultrasound (US). These findings help optimize imaging for cryptogenic stroke patients.

Keywords:
carotid webdiagnostic imagingfibromuscular dysplasianeuroradiologystroke

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Area of Science:

  • Neuroimaging
  • Vascular Neurology
  • Radiology

Background:

  • Carotid web (CaW) is an underdiagnosed cause of stroke in younger individuals.
  • The optimal imaging technique for diagnosing CaW remains unclear.

Purpose of the Study:

  • To evaluate and compare the diagnostic accuracy of various imaging modalities for Carotid web (CaW).

Main Methods:

  • Retrospective analysis of patients with multimodal imaging (CT angiogram-CTA, digital subtraction angiogram-DSA, ultrasound-US) for CaW or atherosclerosis.
  • Blinded analysis of imaging by separate readers, with discrepancies resolved by consensus.
  • Cohen's Kappa (κ) coefficient used to assess inter-rater agreement and modality comparison.

Main Results:

  • CTA and DSA showed high inter-rater agreement (κ = 0.88 and κ = 0.86, respectively).
  • Agreement between CTA and DSA was very high (κ = 0.92), significantly stronger than between US and CTA (κ = 0.553).
  • Patients with symptomatic CaW were younger, more commonly female, and had fewer vascular risk factors than those with atherosclerosis.

Conclusions:

  • CT angiogram (CTA) and digital subtraction angiogram (DSA) demonstrate comparable and superior diagnostic performance for Carotid web (CaW) compared to ultrasound (US).
  • CTA and DSA are recommended for accurate CaW diagnosis, aiding in the evaluation of cryptogenic stroke.