Evaluation of Stenotic Lesions in the Carotid Arteries using Ultrasonography and Three-demension CT Angiography

摘要

Indications for carotid endarterectomy (CEA) depend on the severity of carotid stenosis, as well as the surface characteristics of the stenotic lesion. The purpose of this study was to evaluate a diagnostic validity of three-dimensional CT angiography (3D-CTA) in patients with carotid stenosis, and to assess its applicability before CEA. Sixty-four patients with carotid artery stenosis were investigated pre-operatively by ultrasonography (US), 3D-CTA and digital subtraction angiography (DSA). The evaluation of the degree of carotid artery stenosis and its surface characteristics was done separately by each diagnostic modality. Thereafter, the data obtained by 3D-CTA were compared with those of US, DSA and pathological findings. The degree of carotid artery stenosis defined by 3D-CTA correlated well with those seen on DSA. However, arterial wall irregularity, ulceration and calcifications were visualized more precisely on 3D-CTA. Assessment of surface properties of the stenotic lesion by 3D-CTA significantly correlated with data obtained by US. Comparing with other diagnostic modalities 3D-CTA provides much more precise information about the degree of the carotid artery stenosis and its surface properties. Therefore, 3D-CTA may be considered as a new alternative diagnostic tool for determination of indications for CEA.