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Article: Evaluation of carotid stenosis using CT angiography in the initial evaluation of stroke and TIA
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TitleEvaluation of carotid stenosis using CT angiography in the initial evaluation of stroke and TIA
 
AuthorsJosephson, SA1
Bryant, SO1
Mak, HK2
Johnston, SC1
Dillon, WP1
Smith, WS1
 
Issue Date2004
 
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.neurology.org
 
CitationNeurology, 2004, v. 63 n. 3, p. 457-460 [How to Cite?]
 
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.
 
ISSN0028-3878
2013 Impact Factor: 8.303
 
ISI Accession Number IDWOS:000223229100010
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorJosephson, SA
 
dc.contributor.authorBryant, SO
 
dc.contributor.authorMak, HK
 
dc.contributor.authorJohnston, SC
 
dc.contributor.authorDillon, WP
 
dc.contributor.authorSmith, WS
 
dc.date.accessioned2012-06-26T06:14:08Z
 
dc.date.available2012-06-26T06:14:08Z
 
dc.date.issued2004
 
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.
 
dc.description.naturelink_to_subscribed_fulltext
 
dc.identifier.citationNeurology, 2004, v. 63 n. 3, p. 457-460 [How to Cite?]
 
dc.identifier.epage460
 
dc.identifier.isiWOS:000223229100010
 
dc.identifier.issn0028-3878
2013 Impact Factor: 8.303
 
dc.identifier.issue3
 
dc.identifier.pmid15304575
 
dc.identifier.scopuseid_2-s2.0-3543128871
 
dc.identifier.spage457
 
dc.identifier.urihttp://hdl.handle.net/10722/150899
 
dc.identifier.volume63
 
dc.languageeng
 
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.neurology.org
 
dc.publisher.placeUnited States
 
dc.relation.ispartofNeurology
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshAngiography - Methods
 
dc.subject.meshAngiography, Digital Subtraction
 
dc.subject.meshBrain Ischemia - Radiography
 
dc.subject.meshCarotid Artery, Internal - Radiography
 
dc.subject.meshCarotid Stenosis - Radiography
 
dc.subject.meshHumans
 
dc.subject.meshImage Processing, Computer-Assisted
 
dc.subject.meshIschemic Attack, Transient - Radiography
 
dc.subject.meshMass Screening
 
dc.subject.meshObserver Variation
 
dc.subject.meshPredictive Value Of Tests
 
dc.subject.meshRetrospective Studies
 
dc.subject.meshSingle-Blind Method
 
dc.subject.meshStroke - Radiography
 
dc.subject.meshTomography, Spiral Computed
 
dc.titleEvaluation of carotid stenosis using CT angiography in the initial evaluation of stroke and TIA
 
dc.typeArticle
 
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<contributor.author>Mak, HK</contributor.author>
<contributor.author>Johnston, SC</contributor.author>
<contributor.author>Dillon, WP</contributor.author>
<contributor.author>Smith, WS</contributor.author>
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<description.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 &lt;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.</description.abstract>
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Author Affiliations
  1. University of California, San Francisco
  2. Yan Chai Hospital - Hong Kong