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Article: Evaluation of carotid stenosis using CT angiography in the initial evaluation of stroke and TIA

TitleEvaluation of carotid stenosis using CT angiography in the initial evaluation of stroke and TIA
Authors
Issue Date2004
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.neurology.org
Citation
Neurology, 2004, v. 63 n. 3, p. 457-460 How to Cite?
Abstract
Background: Imaging of the carotid arteries is important for the evaluation of patients with ischemic stroke or TIA. CT angiography (CTA) of the head and neck is readily available and can be part of the routine imaging of stroke patients. To evaluate the accuracy of CTA, the authors compared the degree of stenosis found using CTA with digital subtraction angiography (DSA) in consecutive patients during a 3-year period. Methods: The authors included all patients with interpretable CTA and DSA of the cervical carotid arteries from April 2000 to November 2002 at a single academic medical center. This yielded a total of 81 vessels. Stenosis on CTA of the internal carotid artery was measured in the axial plane at the point of maximum stenosis and referenced to the distal cervical internal carotid by two blinded readers. Two blinded readers measured stenosis from the DSA using the North American Symptomatic Carotid Endarterectomy Trial method. Results: Using a 70% cutoff value for stenosis, CTA and DSA were in agreement in 78 of 81 (96%; 95% CI, 90 to 99%) vessels. CTA was 100% sensitive (n = 5) and 63% specific (95% CI, 25 to 88%), and the negative predictive value of a CTA demonstrating <70% stenosis was 100% (n = 73). Conclusions: In this consecutive series of patients with CT angiography of the neck and digital subtraction angiography, the authors found that CT angiography has a high sensitivity and high negative predictive value for carotid disease. CT angiography appears to be an excellent screening test for internal carotid artery stenosis, and the authors advocate its use for the initial imaging of patients with suspected stroke or TIA.
Persistent Identifierhttp://hdl.handle.net/10722/150899
ISSN
2013 Impact Factor: 8.303
ISI Accession Number ID
References

 

Author Affiliations
  1. University of California, San Francisco
  2. Yan Chai Hospital - Hong Kong
DC FieldValueLanguage
dc.contributor.authorJosephson, SAen_US
dc.contributor.authorBryant, SOen_US
dc.contributor.authorMak, HKen_US
dc.contributor.authorJohnston, SCen_US
dc.contributor.authorDillon, WPen_US
dc.contributor.authorSmith, WSen_US
dc.date.accessioned2012-06-26T06:14:08Z-
dc.date.available2012-06-26T06:14:08Z-
dc.date.issued2004en_US
dc.identifier.citationNeurology, 2004, v. 63 n. 3, p. 457-460en_US
dc.identifier.issn0028-3878en_US
dc.identifier.urihttp://hdl.handle.net/10722/150899-
dc.description.abstractBackground: Imaging of the carotid arteries is important for the evaluation of patients with ischemic stroke or TIA. CT angiography (CTA) of the head and neck is readily available and can be part of the routine imaging of stroke patients. To evaluate the accuracy of CTA, the authors compared the degree of stenosis found using CTA with digital subtraction angiography (DSA) in consecutive patients during a 3-year period. Methods: The authors included all patients with interpretable CTA and DSA of the cervical carotid arteries from April 2000 to November 2002 at a single academic medical center. This yielded a total of 81 vessels. Stenosis on CTA of the internal carotid artery was measured in the axial plane at the point of maximum stenosis and referenced to the distal cervical internal carotid by two blinded readers. Two blinded readers measured stenosis from the DSA using the North American Symptomatic Carotid Endarterectomy Trial method. Results: Using a 70% cutoff value for stenosis, CTA and DSA were in agreement in 78 of 81 (96%; 95% CI, 90 to 99%) vessels. CTA was 100% sensitive (n = 5) and 63% specific (95% CI, 25 to 88%), and the negative predictive value of a CTA demonstrating <70% stenosis was 100% (n = 73). Conclusions: In this consecutive series of patients with CT angiography of the neck and digital subtraction angiography, the authors found that CT angiography has a high sensitivity and high negative predictive value for carotid disease. CT angiography appears to be an excellent screening test for internal carotid artery stenosis, and the authors advocate its use for the initial imaging of patients with suspected stroke or TIA.en_US
dc.languageengen_US
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.neurology.orgen_US
dc.relation.ispartofNeurologyen_US
dc.subject.meshAngiography - Methodsen_US
dc.subject.meshAngiography, Digital Subtractionen_US
dc.subject.meshBrain Ischemia - Radiographyen_US
dc.subject.meshCarotid Artery, Internal - Radiographyen_US
dc.subject.meshCarotid Stenosis - Radiographyen_US
dc.subject.meshHumansen_US
dc.subject.meshImage Processing, Computer-Assisteden_US
dc.subject.meshIschemic Attack, Transient - Radiographyen_US
dc.subject.meshMass Screeningen_US
dc.subject.meshObserver Variationen_US
dc.subject.meshPredictive Value Of Testsen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshSingle-Blind Methoden_US
dc.subject.meshStroke - Radiographyen_US
dc.subject.meshTomography, Spiral Computeden_US
dc.titleEvaluation of carotid stenosis using CT angiography in the initial evaluation of stroke and TIAen_US
dc.typeArticleen_US
dc.identifier.emailMak, HK:makkf@hkucc.hku.hken_US
dc.identifier.authorityMak, HK=rp00533en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid15304575en_US
dc.identifier.scopuseid_2-s2.0-3543128871en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-3543128871&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume63en_US
dc.identifier.issue3en_US
dc.identifier.spage457en_US
dc.identifier.epage460en_US
dc.identifier.isiWOS:000223229100010-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridJosephson, SA=8328578900en_US
dc.identifier.scopusauthoridBryant, SO=7202782192en_US
dc.identifier.scopusauthoridMak, HK=7004699149en_US
dc.identifier.scopusauthoridJohnston, SC=23497260700en_US
dc.identifier.scopusauthoridDillon, WP=14059733400en_US
dc.identifier.scopusauthoridSmith, WS=7406471224en_US

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