Purpose: To investigate CT angiographic area assessment of carotid artery stenosis.
Methods and Materials: Seventy-two vessels in 36 patients with symptomatic carotid stenosis were evaluated by automated 3D CT-angiography (CTA) analysis method and digital subtraction angiography (DSA). Multiple planar reconstruction (MPR) rotational DSA (rDSA) was conducted in thirty-one patients. Two observers independently performed the measurements on 3D CTA and on MPR rDSA. Correlation, agreement and diagnostic performance were assessed on area assessments. Maximal /minimal (L/S) diameter ratio at the level of stenosis was used to evaluate the impact of morphological changes on measurements.
Results: The interobserver and intraobserver correlation coefficients of area stenosis degree (ASD) on CTA were 0.81 and 0.91, respectively. The intertechnique correlation coefficient of ASD between CTA and MPR rDSA was 0.78. Diameter stenosis degree (DSD) and lumen area at the level of stenosis were poorly correlated with residual deviation of 0.89 when L/S ratio was greater than 1.5. Satisfactory diagnostic performance was obtained in area stenosis assessment of carotid stenosis with reference to DSD of DSA.
Conclusion: Area stenosis assessment in carotid stenosis with advanced 3D CT angiography analysis was reproducible and correlated well with MPR rDSA. ASD gives often less severe estimate of the hemodynamic significance of the carotid stenosis than DSD.
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