Marianne Cinat, MD, Christopher T

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Presentation transcript:

Helical CT angiography in the preoperative evaluation of carotid artery stenosis Marianne Cinat, MD, Christopher T. Lane, MD, Hanh Pham, MD, Andrew Lee, MD, Samuel Eric Wilson, MD, Ian Gordon, MD Journal of Vascular Surgery Volume 28, Issue 2, Pages 290-300 (August 1998) DOI: 10.1016/S0741-5214(98)70165-X Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Severe stenosis of the left internal carotid artery shown by standard arteriography A, and an MIP image on CTA, B. Journal of Vascular Surgery 1998 28, 290-300DOI: (10.1016/S0741-5214(98)70165-X) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Percentage of area reduction was calculated by electronically outlining the residual lumen and the normal vessel lumen at the level of greatest stenosis. In this example, the area of the residual lumen is 11 mm2, and the area of the normal lumen is 71 mm2, resulting in an 86% area reduction. Calcifications are also seen within the plaque. Journal of Vascular Surgery 1998 28, 290-300DOI: (10.1016/S0741-5214(98)70165-X) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 The expected curvilinear relationship between diameter reduction (as measured by arteriography) and area reduction (as measured by CTA). Journal of Vascular Surgery 1998 28, 290-300DOI: (10.1016/S0741-5214(98)70165-X) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 XY plots and correlation of CTA to arteriogram using NASCET criteria (R = 0.87, p < 0.001) A, and CTA to arteriogram using ECST criteria (R = 0.87, p < 0.001), B Journal of Vascular Surgery 1998 28, 290-300DOI: (10.1016/S0741-5214(98)70165-X) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 MIP images show severe narrowing of the right internal carotid artery, A. Calcifications are seen within the plaque. B, Magnified axial images with measurement of pixel density illustrate a fatty plaque (arrow) within the internal carotid artery (b). The internal jugular vein (a) and the external carotid artery are also shown (c). Journal of Vascular Surgery 1998 28, 290-300DOI: (10.1016/S0741-5214(98)70165-X) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 A, MIP images show severe narrowing of the right internal carotid artery. B and C, Axial images confirm intimal hyperplasia and fibrosis after a carotid endarterectomy. The residual lumen measures 3 mm2, and the normal vessel measures 27 mm2, resulting in an area reduction of 89%. Journal of Vascular Surgery 1998 28, 290-300DOI: (10.1016/S0741-5214(98)70165-X) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions