Three-dimensional computed tomography angiography and magnetic resonance angiography of carotid bifurcation stenosis

Purpose: To evaluate the role of computed tomography angiography (CTA) and magnetic resonance angiography (MRA) in the quantification of atherosclerot ic stenosis of carotid artery bifurcation in comparison with digital substr action angiography (DSA) and Doppler sonography (DS). Materials and Methods : Twenty-five patients with atherosclerotic disease of the carotid arteries with proven stenosis by DSA, had spiral CTA, MRA using two-and three-dimen sional time-of-flight gradient echo techniques, and DS using Doppler flow s ignal recording (total 47 carotid artery bifurcations). The degree of steno sis was measured according to the North American Symptomatic Carotid Endart erectomy Trial criteria: total occlusion (100%), severe (70-99%), moderate (30-69%) and mild (0-29%). The degree of stenosis measured by CTA, MRA and DS was compared to DSA, used as the gold standard. Results: Ninety-seven pe rcent of MRA measures were equivalent to DSA, and 3% were underestimated; 9 6% of CTA measures were equivalent to DSA, and 4% were underestimated; 77% of DS measures were equivalent to DSA, 21% were overestimated and 2% were u nderestimated. Conclusions: CTA and MRA are equally accurate methods in qua ntifying the degree of carotid bifurcation stenosis. Copyright (C) 2001 S.K arger AG, Basel.