Key result
Virtual intra-arterial angioscopy based on helical CT data demonstrated a sensitivity of 93.7% and specificity of 91.3% for the correct diagnosis of high-grade carotid stenosis compared to DSA.
Why the study?
Does virtual intra-arterial angioscopy (VIA) based on helical CT data accurately assess the degree of stenosis compared to digital subtraction angiography (DSA) in patients with symptomatic carotid disease?
Observational (n=20)
Does virtual intra-arterial angioscopy (VIA) based on helical CT data accurately assess the degree of stenosis compared to digital subtraction angiography (DSA) in patients with symptomatic carotid disease?
Virtual intra-arterial angioscopy based on helical CT data provides high sensitivity and specificity for diagnosing high-grade carotid stenosis when vessel wall and plaque structures are displayed simultaneously.
Answers are grounded in this paper and cite their sources.
May support noninvasive carotid stenosis assessment with VIA; leaves open prospective validation before clinical adoption.
The purpose of this study was to visualize both the vessel wall and atherosclerotic plaques in virtual intra-arterial angioscopy (VIA) based on helical CT data sets. To achieve this in vitro, the optimal reconstruction threshold of the vessel wall was determined to be 56.4% of the maximum enhancement. Using this threshold, 20 patients suffering from symptomatic carotid disease were examined in a helical CT scanner. The degree of stenosis was defined using the North American Symptomatic Endarterectomy Trial (NASCET) criteria and compared with results from digital substraction angiography (DSA). Grading of stenoses was only possible by adding the separately computed plaque geometry to the geometry of the vessel wall in a second step. Correlation between VIA and DSA in low grade, medium grade and high grade stenosis was 88%, 93% and 71%, respectively. Complete occlusions were diagnosed correctly in all patients. Sensitivity and specificity for the correct diagnosis of high grade stenosis was 93.7% and 91.3%, respectively. A realistic depiction of intraluminal structures in carotid arteries can only be generated by displaying both the vessel wall and plaque structures simultaneously.
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Rilinger et al. (2003) conducted an observational in symptomatic carotid disease (n=20). Virtual intra-arterial angioscopy (VIA) based on helical CT data vs. Digital subtraction angiography (DSA) was evaluated on Correct diagnosis of high grade stenosis (Sensitivity 93.7%, Specificity 91.3%). Virtual intra-arterial angioscopy based on helical CT data demonstrated a sensitivity of 93.7% and specificity of 91.3% for the correct diagnosis of high-grade carotid stenosis compared to DSA.
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