ACCURACY OF ANGIOGRAPHY AND CT ANGIOGRAPH Y OF BIFURCATION OF THE CAROTID-ARTERY COMPARED WITH THE MACROMORPHOLOGICAL CORRELATE

Purpose: To compare the degree of carotid artery stenosis in angiograp hy and CT angiography with the degree of stenosis measured in an intac t eversion endarterectomy specimen. Methods: Preoperative angiograms ( intraarterial DSA, 512 x 512 matrix) and CT-angiograms (24 sec spiral scan, slice thickness 2 mm, pitch 1.5) were taken in 12 patients with symptomatic carotid stenosis. Evaluation of the degree of stenosis was performed according to the NASCET (''distal'' degree) and ECST (''loc al'' degree) methods. These data were compared with measurements of th e surgical specimens. Results. The median ''local'' degree of stenosis in angiograms was 81.5% (range: 70-99%), in CT angiograms 83% (59-94% ) and in specimens 85.5% (65-96%). The ''distal'' degree of stenosis w as 79% (50-99%) in angiograms, 85.5% (55-99%) in CT angiograms and 81% (52-95%) in specimens. CT angiography slightly overestimated the degr ee of stenosis compared with the specimen, whereas angiography slightl y underestimated the true degree of stenosis. However, these differenc es were not statistically significant. Conclusion: CT angiography is a ble to predict the degree of internal carotid stenosis when compared w ith an intact surgical specimen. It is as accurate as the ''gold stand ard'' of invasive angiography.