High-grade stenoses of the internal carotid artery: Comparison of high-resolution contrast enhanced 3D MRA, duplex sonography and power Doppler imaging

Clevert, D.‐A.; Johnson, Thorsten R. C.; Michaely, Henrik J.; Jung, Enjae; Flach, Patricia M.; Strautz, T.; Reiser, Maximilian; Schoenberg, Stefan O.

doi:10.1016/j.ejrad.2006.07.012

Cited by 49 publications

(37 citation statements)

References 35 publications

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“…In ICAO, an overexaggeration of the MRA may implicate a subtotal stenosis of the proximal ICA [31], therefore possibly including it in the ICAO group. Flow stagnation proximal to occlusion or low poststenotic shear stress may promote the formation of subsequent fibrin- and RBC-rich clots [24].…”

Section: Discussionmentioning

confidence: 99%

Difference in Infarct Volume and Patterns between Cardioembolism and Internal Carotid Artery Disease: Focus on the Degree of Cardioembolic Risk and Carotid Stenosis

et al. 2010

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Background and Objective: Infarct volume and patterns may vary according to the stroke subtype. Within each stroke subtype, however, it is not clear if the infarct volume and patterns are affected by the risk of cardioembolism (CE) and the degree of arterial stenosis. Patients and Methods: We included consecutive patients with acute symptomatic ischemic lesions on diffusion-weighted imaging (DWI) performed within 48 h of symptom onset who had CE or internal carotid artery disease (ICAD). CE was divided into high-risk and medium-risk groups, and ICAD was divided into ICA occlusion (ICAO) and ICA stenosis (ICAS ≧50%) groups. DWI lesion patterns were classified as single versus multiple, and as large territorial versus perforating artery (large ≧2 cm, small <2 cm) versus pial artery versus border zone infarct. Infarct volumes and National Institutes of Health Stroke Scale (NIHSS) scores were obtained. Results: Of the 167 patients included, 120 had CE (98 high-risk, 22 medium-risk) and 47 had ICAD (25 ICAO, 22 ICAS). The infarct volume was largest in the high-risk CE group, followed by the ICAO group. The infarct volumes in the medium-risk CE and ICAS groups were similar. Infarct volumes correlated with NIHSS scores. Single and large territorial infarcts were more common in the high-risk CE group, while multiple lesions as well as pial and border zone infarcts were more frequent in the ICAD subgroups. The lesion patterns of the medium-risk CE and ICAD groups were relatively similar. Conclusions: CE and ICAD have heterogeneous radiologic characteristics depending on the risk of embolism and the degree of carotid stenosis.

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Section: Discussionmentioning

confidence: 99%

Difference in Infarct Volume and Patterns between Cardioembolism and Internal Carotid Artery Disease: Focus on the Degree of Cardioembolic Risk and Carotid Stenosis

et al. 2010

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“…Accurate differentiation of severe stenosis from occlusion of the internal carotid artery (ICA) is not always easy [1], and the diagnosis may influence the treatment strategies. Revascularization, either via carotid stenting or endarterectomy, can effectively reduce the risk of stroke recurrence in patients with severe carotid stenosis [2].…”

Section: Introductionmentioning

confidence: 99%

Distinguishing Critical Stenosis from Occlusion of the Internal Carotid Artery by Carotid Duplex in a Patient with Acute Ischemic Stroke

Chen

Chao

Tang

et al. 2012

Journal of Medical Ultrasound

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KEY WORDSacute ischemic stroke, carotid duplex, carotid stenosis Accurate distinction of internal carotid artery (ICA) severe stenosis from occlusion in patients with acute stroke is crucial because carotid revascularization may reduce the risk of recurrent stroke. We report a 68-year-old man who had acute onset of right hemiparesis and hemiparesthesia. Head magnetic resonance imaging (MRI) on the first day and computed tomography (CT) angiography the next day showed total occlusion or pseudo-occlusion of the left ICA. However, carotid ultrasonography at around the same time clearly demonstrated focal severe stenosis of the left ICA orifice and catheter carotid angiography later confirmed the findings. The patient received angioplasty and stenting of the left ICA 3 weeks after stroke, and his follow-up course was uneventful. The case report highlights the value of carotid ultrasonography in distinguishing critical stenosis from occlusion of the carotid artery in patients with acute ischemic stroke. ª

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“…Vascular ultrasound, computed tomographic angiography (CTA) and magnetic resonance angiography (MRA) comprise such alternatives [7][8][9][10][11][12][13]. While vascular ultrasound is limited by patient body habitus and operator dependency [14], CTA and MRA are both reliable, reproducible and non-invasive means of imaging the carotid arteries, [15]. CTA suffers from limitations such as a reliance on ionising radiation [16], lack of dynamic information and reduced accuracy in regions of heavily vascular calcification [17,18].…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance angiography of the carotid arteries: comparison of unenhanced and contrast enhanced techniques

et al. 2011

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High-grade stenoses of the internal carotid artery: Comparison of high-resolution contrast enhanced 3D MRA, duplex sonography and power Doppler imaging

Cited by 49 publications

References 35 publications

Difference in Infarct Volume and Patterns between Cardioembolism and Internal Carotid Artery Disease: Focus on the Degree of Cardioembolic Risk and Carotid Stenosis

Difference in Infarct Volume and Patterns between Cardioembolism and Internal Carotid Artery Disease: Focus on the Degree of Cardioembolic Risk and Carotid Stenosis

Distinguishing Critical Stenosis from Occlusion of the Internal Carotid Artery by Carotid Duplex in a Patient with Acute Ischemic Stroke

Magnetic resonance angiography of the carotid arteries: comparison of unenhanced and contrast enhanced techniques

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