CT angiography is highly accurate in detecting high-grade artery stenosis

MD-CTA (64-slice CT angiography) is highly accurate in detecting and grading extracranial internal carotid artery (ICA) stenoses in which the artery is closed between 70-90% when compared to color-coded Doppler sonography, power Doppler and B-flow ultrasound, according to a new study by researchers from the University of Munich-Grosshadern in Munich, Germany.

For the study, the researchers analyzed 37 patients with 43 known or suspected extracranial ICA stenoses who underwent MDCTA and vascular ultrasound. The researchers found that "excellent" visualization of vessels was achieved on MD-CTA in all cases. Of the 43 stenoses, 28 were closed between 70-80%, 10 were closed between 80-90% and all were correctly identified with MD-CTA and vascular ultrasound.

According to the researchers, it is important to be able to identify high-grade ICA stenosis to plan the appropriate surgery and therapy. "Studies have shown that symptomatic patients with high-grade stenoses of the extracranial ICA profit from thromboendarterectomy, an operation that involves opening the artery and removing the occlusion. In addition, the morphology of the stenosis, especially the detection of ulcerated plaques and thrombi, is crucial for the planning of interventional treatment," said Dirk Andre Clevert, MD, lead author of the study.

"The diagnostic investigation of stenoses for surgical planning should include a combination of MD-CTA and vascular ultrasound, because ultrasound has also gained a high importance as a generally available non-invasive imaging method. For the depiction of ICA segments within the skull, MD-CTA is especially necessary for preoperative planning," said Dr. Clevert.

The full results of the study were presented during the American Roentgen Ray Society Annual Meeting in Vancouver, BC.

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