Diagnostic accuracy of colour Doppler ultrasonography, CT angiography and blood-pool-enhanced MR angiography in assessing carotid stenosis: a comparative study with DSA in 170 patients

Anzidei, Michele; Napoli, Alessandro; Zaccagna, Fulvio; Paolo, Pier Luigi Di; Saba, Luca; Marincola, Beatrice Cavallo; Zini, Chiara; Cartocci, Gaia; Mare, Luisa Di; Catalano, Carlo; Passariello, Roberto

doi:10.1007/s11547-011-0651-3

Cited by 89 publications

(76 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A previous comparative study of DSA evaluated the diagnostic accuracy of CDUS, CT angiography (CTA) and blood-pool-enhanced MRA in the assessment of 170 patients with CS. Consistent with the present study findings, it was observed that CTA was the most accurate technique for evaluating CS, with CTA exhibiting a marginally higher accuracy than MRA (97% for CTA vs. 95% for steady-state MRA and 92% for first-pass MRA) and a markedly greater accuracy than CDUS (97 vs. 76%, respectively) (25). In addition to the established contraindications of MRA such as cardiac pacemaker, cochlear implants, magnetic resonance imaging, brain pacemakers and false teeth, MRI motion artifacts arising from patient movements may limit the accuracy of enhanced MRA.…”

Section: Degree Of Degree Of Stenosis By Dsa Stenosis ---------------supporting

confidence: 91%

Comparative analysis of 3D time-resolved contrast-enhanced magnetic resonance angiography, color Doppler ultrasound and digital subtraction angiography in symptomatic carotid stenosis

et al. 2017

View full text Add to dashboard Cite

Abstract. The present study aimed to compare the diagnostic value of contrast-enhanced magnetic resonance angiography (CE MRA) with 3D time-resolved imaging of contrast kinetics, color Doppler ultrasound (CDUS) and digital subtraction angiography (DSA) in extracranial carotid stenosis (CS). A total of 54 patients with symptomatic CS were subjected to CDUS, CE MRA and DSA examination. Results of DSA were defined as the standard, and a total of 216 vessels were examined. In each patient four vessels were examined, namely the bilateral common carotid arteries and the bilateral internal carotid arteries. The sensitivities and specificities of CE MRA and CDUS for various degrees of CS were also determined. It was observed that the sensitivities to mild-level (1-49%), moderate-level (50-69%) and severe-level (70-99%) CS were 85.45, 100 and 100% for CE MRA, and 78.18, 50 and 100% for CDUS, respectively. The corresponding specificities were 95.27, 98.58 and 99.53% for CE MRA, and 79.05, 93.36 and 98.10% for CDUS, respectively. In addition, the carotid sinus plaque detection rate for CDUS was significantly higher than that of DSA and CE MRA (both P<0.001). Detection rates for common carotid artery plaques and internal carotid artery plaques did not significantly differ among the three examination methods (all P>0.05). These data demonstrate that CE MRA has higher sensitivity and specificity than CDUS for the diagnosis of CS, and that CDUS has a higher carotid sinus plaque detection rate than DSA and CE MRA. Therefore, the combination of MRI and CDUS may be a 'gold standard' diagnostic method for the detection of moderate and severe CS. IntroductionCarotid stenosis (CS) is a primary cause and risk factor of ischemic cerebrovascular disease. The most common location of CS is the carotid artery bifurcation, followed by the common carotid artery, the internal carotid artery siphon, middle cerebral artery and brain arteries (1). It is generally believed that carotid artery plaques are caused by one of two mechanisms: One is severe stenosis of the carotid artery causing hemodynamic changes and correspondingly low perfusion in parts of the brain. The other is that plaque in microemboli or patches on the surface of microthrombi fall off and cause cerebral embolism (2). Previous studies indicate that >60% of strokes are caused by carotid stenosis, and if serious these may lead to disability and even death in patients with cerebral apoplexy (3). The Society for Vascular Surgery recommends that, in patients with symptomatic CS, if noninvasive imaging identifies a stenosis degree of >70% (class I/level A), or if angiography identifies a stenosis degree of >50% (class I/level B), a carotid endarterectomy should be performed to reduce the risk of stroke (4). Thus, accurate assessment of the degree of CS is critical for the prevention of stroke (5). Digital subtraction angiography (DSA) is generally considered to be the gold standard for the diagnosis of CS. However, the rate of stroke induced by the invasive DSA procedure ranges from ...

show abstract

Section: Degree Of Degree Of Stenosis By Dsa Stenosis ---------------supporting

confidence: 91%

Comparative analysis of 3D time-resolved contrast-enhanced magnetic resonance angiography, color Doppler ultrasound and digital subtraction angiography in symptomatic carotid stenosis

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Although CTA has a higher resolution than MRA, both detect lumen stenosis with a similar, high accuracy compared with DSA. 6 In addition, plaque density on CTA is a poor IPH predictor. 15 It is clear from this research that stroke source workup is incomplete if one uses only lumen information from CTA or MRA without IPH-sensitive sequences, such as MPRAGE.…”

Section: Discussionmentioning

confidence: 99%

“…Computed tomographic angiography (CTA) and magnetic resonance angiography (MRA) are as accurate as digital subtraction angiography (DSA) in determining lumen stenosis and both much more accurate than duplex ultrasound. 6 Carotid plaque ulceration has long been an indicator for surgery but can be difficult to detect with DSA. 7 Ulceration can be detected with CTA at a threshold of ≥2 mm with high sensitivity (87%) and specificity (99%) compared with histology.…”

mentioning

confidence: 99%

Intraluminal Thrombus, Intraplaque Hemorrhage, Plaque Thickness, and Current Smoking Optimally Predict Carotid Stroke

McNally

McLaughlin

Hinckley

et al. 2015

Stroke

View full text Add to dashboard Cite

Background and Purpose-Intraplaque hemorrhage (IPH) is associated with acute and future stroke. IPH is also associated with lumen markers of stroke risk including stenosis, plaque thickness, and ulceration. Whether IPH adds further predictive value to these other variables is unknown. The purpose of this study was to determine whether IPH improves carotid-source stroke prediction. Methods-In this retrospective cross-sectional study, patients undergoing stroke workup were imaged with MRI and IPH detection. Seven hundred twenty-six carotid-brain image pairs were analyzed after excluding vessels with noncarotid plaque stroke sources (420) and occlusions (7)

show abstract

“…30 Anzidei et al 31 reported that CTA was the most accurate technique for evaluating carotid stenosis in a large study group (n ϭ 170 patients), with a slightly better performance than MRA (97% versus 95% for steady-state MRA and 92% for first-pass MRA) and a greater accuracy than color Doppler ultrasonography (97% versus 76%). Although patients scheduled for carotid artery imaging are predominantly in the higher age group and radiation exposure is thought to be less critical, the ALARA (as low as reasonably achievable) concept should still be followed, and a variety of dose-reduction techniques in CT imaging have become available in recent years.…”

Section: Discussionmentioning

confidence: 99%

Carotid CTA: Radiation Exposure and Image Quality with the Use of Attenuation-Based, Automated Kilovolt Selection

Eller¹,

Wuest²,

Kramer³

et al. 2013

American Journal of Neuroradiology

View full text Add to dashboard Cite

show abstract

Diagnostic accuracy of colour Doppler ultrasonography, CT angiography and blood-pool-enhanced MR angiography in assessing carotid stenosis: a comparative study with DSA in 170 patients

Cited by 89 publications

References 33 publications

Comparative analysis of 3D time-resolved contrast-enhanced magnetic resonance angiography, color Doppler ultrasound and digital subtraction angiography in symptomatic carotid stenosis

Comparative analysis of 3D time-resolved contrast-enhanced magnetic resonance angiography, color Doppler ultrasound and digital subtraction angiography in symptomatic carotid stenosis

Intraluminal Thrombus, Intraplaque Hemorrhage, Plaque Thickness, and Current Smoking Optimally Predict Carotid Stroke

Carotid CTA: Radiation Exposure and Image Quality with the Use of Attenuation-Based, Automated Kilovolt Selection

Contact Info

Product

Resources

About