CT ANGIOGRAPHY - APPLICATION TO THE EVALUATION OF CAROTID-ARTERY STENOSIS

PURPOSE: To determine whether computed tomographic (CT) angiography ca n be used to accurately quantify carotid stenoses and differentiate se vere stenoses from occlusions. MATERIALS AND METHODS: CT angiography w as used to evaluate 50 carotid arteries in 27 patients who were referr ed for surgical evaluation after diagnosis of carotid stenosis and who had undergone standard angiography. Four observers read each study se parately in a blinded fashion, then all four observers together review ed those studies in which the individual readings differed to reach a consensus reading. RESULTS: The consensus readings for the two modalit ies were in agreement on stenosis category in 41 (82%) of the 50 carot id arteries (kappa(w) = 0.852 +/- 0.114). The consensus readings in th e other nine arteries differed by only one category; seven had less se vere stenosis at CT angiography and two had more severe stenosis. The CT angiograms also depicted a variety of additional abnormalities, inc luding loops (n = 6), aneurysms (n = 2), and ulcers (n = 4). CONCLUSIO N: These results indicate that CT angiography can non-invasively provi de most of the information needed before carotid endarterectomy.