European Journal of Radiology

2003

DOI: 10.1016/s0720-048x(03)00200-6

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The diagnostic accuracy of computed tomography angiography for traumatic or atherosclerotic lesions of the carotid and vertebral arteries: a systematic review

William Hollingworth¹,

Avery B. Nathens²,

Jeffrey P. Kanne³

et al.

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Cited by 95 publications

(46 citation statements)

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“…Our estimates of the diagnostic accuracy of CTA are more conservative than in a similar recent meta-analysis that reported a pooled sensitivity of 91.6% and a specificity of 97.4% for detection of a 70% to 99% stenosis. 51 This difference may have several explanations. Although Hollingworth et al located more studies, their analysis comprised only 15 studies, whereas we included 28 studies.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review of Computed Tomographic Angiography for Assessment of Carotid Artery Disease

¹

,

²

,

³

et al. 2004

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Background and Purpose-To review the literature on the diagnostic accuracy of computed tomographic angiography (CTA) compared with arteriography/intra-arterial digital subtraction angiography as reference standard for assessment of symptomatic carotid artery disease. Methods-The PubMed, MEDLINE, PREMEDLINE, EMBASE, and CINAHL databases were searched to retrieve studies published between 1990 and July 2003, comparing CTA and intra-arterial digital subtraction angiography in patients with symptomatic carotid artery disease that presented raw data for detection of a Ͻ70% or 70% to 99% stenosis or an occlusion. Two observers independently assessed methodological quality and constructed 2ϫ2 tables for sensitivity and specificity of CTA for detection of a 70% to 99% stenosis versus Ͻ70% stenosis or an occlusion, and for Ͻ99% stenosis versus occlusion. A bivariate random effects model was used to calculate the pooled sensitivity and specificity of CTA for detection of these lesions. Results-Some 864 patients (66% male) with a mean age of 66 years were studied in the 28 studies included in the meta-analysis. In all studies, a single-slice CT-scan was used. Only 8 studies satisfied all methodological quality criteria. The pooled sensitivity and specificity for detection of a 70% to 99% stenosis were 85% (95% CI, 79% to 89%) and 93% (95% CI, 89% to 96%), respectively. For detection of an occlusion, the sensitivity and specificity were 97% (95% CI, 93% to 99%) and 99% (95% CI, 98% to 100%), respectively. Incomplete reporting of demographic characteristics and technical differences in the individual studies obstructed a meaningful subgroup analysis. Conclusions-CTA is an accurate modality for detection of severe carotid artery disease, especially for detection of occlusions. The fair methodological quality of the included studies must be taken into account when interpreting these results.

“…Our estimates of the diagnostic accuracy of CTA are more conservative than in a similar recent meta-analysis that reported a pooled sensitivity of 91.6% and a specificity of 97.4% for detection of a 70% to 99% stenosis. 51 This difference may have several explanations. Although Hollingworth et al located more studies, their analysis comprised only 15 studies, whereas we included 28 studies.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review of Computed Tomographic Angiography for Assessment of Carotid Artery Disease

¹

,

²

,

³

et al. 2004

View full text Add to dashboard Cite

Background and Purpose-To review the literature on the diagnostic accuracy of computed tomographic angiography (CTA) compared with arteriography/intra-arterial digital subtraction angiography as reference standard for assessment of symptomatic carotid artery disease. Methods-The PubMed, MEDLINE, PREMEDLINE, EMBASE, and CINAHL databases were searched to retrieve studies published between 1990 and July 2003, comparing CTA and intra-arterial digital subtraction angiography in patients with symptomatic carotid artery disease that presented raw data for detection of a Ͻ70% or 70% to 99% stenosis or an occlusion. Two observers independently assessed methodological quality and constructed 2ϫ2 tables for sensitivity and specificity of CTA for detection of a 70% to 99% stenosis versus Ͻ70% stenosis or an occlusion, and for Ͻ99% stenosis versus occlusion. A bivariate random effects model was used to calculate the pooled sensitivity and specificity of CTA for detection of these lesions. Results-Some 864 patients (66% male) with a mean age of 66 years were studied in the 28 studies included in the meta-analysis. In all studies, a single-slice CT-scan was used. Only 8 studies satisfied all methodological quality criteria. The pooled sensitivity and specificity for detection of a 70% to 99% stenosis were 85% (95% CI, 79% to 89%) and 93% (95% CI, 89% to 96%), respectively. For detection of an occlusion, the sensitivity and specificity were 97% (95% CI, 93% to 99%) and 99% (95% CI, 98% to 100%), respectively. Incomplete reporting of demographic characteristics and technical differences in the individual studies obstructed a meaningful subgroup analysis. Conclusions-CTA is an accurate modality for detection of severe carotid artery disease, especially for detection of occlusions. The fair methodological quality of the included studies must be taken into account when interpreting these results.

“…Alternatively, CTA may be used in the assessment of carotid artery stenosis [11,12] . CTA also has high diagnostic accuracy for ICA disease with sensitivity and specificity as high as 85% and 93%, respectively, for detection of significant carotid stenoses [13,14] . However, the concordance between these two techniques has not been extensively explored.…”

Section: Research Articlementioning

confidence: 99%

Doppler-Ultrasound and computed tomography correlation for quantification of carotid stenosis

¹

,

²

,

³

et al. 2016

Med Imaging Interv Radiol

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Carotid disease is a major cause of cerebrovascular events. Risk is proportional to the extent and severity of atherosclerosis. Aim of this study was to assess the correlation between 64-multi-detector-row computed-tomography angiography (MDCTA) and Doppler ultrasound peak-systolic-velocity (DUS-PSV) in the quantification of stenosis. 116 consecutive patients were included; it was calculated the degree of carotid stenosis with the North American Symptomatic Carotid Endarterectomy Trial (NASCET) method using MDCTA and DUS-PSV. MDCTA measurements of stenosis ranged from 35% to 95% (mean 67±16%). DUS-PSV ranged from 102 to 600 cm/s (mean 262±112 cm/s). A moderate correlation (r 2 = 0.427) was found between MDCTA-NASCET stenosis and PSV values. At ROC curve analysis, PSV could significantly discriminate between stenoses ≥70% and <70% at MDCTA-NASCET measurement, with area under the curve of 0.807 (p<0.0001). PSV value ≥230 cm/s was identified as optimal cutoff to predict stenosis ≥70% at MDCTA, with a sensitivity of 71%, specificity of 83%, negative predictive value of 67% and positive predictive value of 82%. We found a reasonable concordance between MDCTA and DUS-PSV in quantifying carotid stenosis. PSV value of 230 cm/s is a reliable threshold to predict a >70% stenosis of MDCTA.Keywords: Carotid; Doppler; MDCTA; Ultrasound To cite this article: Giuseppe Di Gioia, et al. Doppler-Ultrasound and computed tomography correlation for quantification of carotid stenosis.

“…70 With CTA, the sensitivity and specificity for detecting carotid stenosis greater than 70% was 85% to 95% and 93% to 98%, respectively. 83,84 CTA sensitivity and accuracy can be increased by examining axial source images 83 and volume rendered projections, 85 and by use of faster high resolution multislice scanners. 86 …”

Section: Noninvasive Testingmentioning

confidence: 99%

ACCF/SCAI/SVMB/SIR/ASITN 2007 Clinical Expert Consensus Document on Carotid Stenting

Babb²,

et al. 2007

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This document has been developed by the American College of Cardiology Foundation (ACCF) Task Force on Clinical Expert Consensus Documents (CECD), and was cosponsored by the Society for Cardiovascular Angiography and Interventions (SCAI), the Society for Vascular Medicine and Biology (SVMB), the Society of Interventional Radiology (SIR), and the American Society of Interventional & Therapeutic Neuroradiology (ASITN). It is intended to provide a perspective on the current state of carotid artery stenting (CAS). The CECDs are intended to inform practitioners, payers, and other interested parties of the opinion of the ACCF and cosponsors concerning evolving areas of clinical practice and/or technologies that are widely available or new to the practice community. Topics chosen for coverage by expert consensus documents are so designed because the evidence base, the experience with technology, and/or the clinical practice are not considered sufficiently well developed to be evaluated by the formal American College of Cardiology/ American Heart Association (ACC/AHA) practice guidelines process. Often the topic is the subject of ongoing investigation. Thus, the reader should view the CECD as the best attempt of the ACCF and the cosponsors to inform and guide clinical practice in areas where rigorous evidence may not be available or the evidence to date is not widely accepted. When feasible, CECDs include indications or contraindications. Some topics covered by CECDs will be addressed subsequently by the ACC/AHA Practice Guidelines Committee.The Task Force on CECDs makes every effort to avoid any actual or potential conflicts of interest that might arise as a result of an outside relationship or personal interest of a member of the writing panel. Specifically, all members of the writing panel are asked to provide disclosure statements of all such relationships that might be perceived as real or potential conflicts of interest to inform the writing effort. These statements are reviewed by the parent task force, reported orally to all members of the writing panel at the first meeting, and updated as changes occur. The relationships with industry information for writing committee members and peer reviewers are published in the appendices of the document.

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