[Spiral CT angiography versus DSA in detection of carotid stenoses]

To determine the value of spiral CT angiography for evaluation of internal carotid artery stenosis.

Spiral CT angiography was compared with selective intraarterial DSA in 40 patients with 72 internal carotid artery stenoses. Quantification of stenoses was performed according to the NASCET-study and categorized in mild (0-29%), moderate (30-69%), severe (70-99%) and occlusion (100%).

The total agreement of spiral CT angiography with DSA in all stenoses was 78% (r = 0.933; p < 0.0001). In the mild stenoses group there was an agreement of 56% (r = 0.598; p = 138), in the moderate stenosis group there was an agreement of 59% (0.623; p = 0.0128) and in the group with severe stenosis the agreement was 97% (0.944; p < 0.0001). All occlusions were correctly interpreted by spiral CT angiography (r = 1; p = 0.0082).

The agreement of spiral CT angiography with DSA is good. Especially SCTA allows a good correlation in the severe stenosis group and in the occlusion group. DSA remains the standard of reference, because of its ability to demonstrate tandem lesions and collateral flow.