Preliminary application of multislice spiral CT angiography in detection of carotid artery stenosis

Objective To evaluate primarily the accuracy of multislice spiral CT (MSCT) angiography in detecting carotid artery stenosis. Methods A total of 24 consecutive patients with suspected or confirmed carotid artery disease were studied by MSCT (0.6 or 0.5 s rotation time; 1.25 mm thickness; 13.5 mm/s table speed; intravenous contrast agent). The results were compared with quantitative carotid angiography. Results In the 168 carotid arteries of 24 patients, 19 of 21 carotid arteries with significant stenosis (≥30% reduction of vessel diameter) were correctly detected by MSCT; 139 of 147 normal or slightly stenosed carotid arteries (30% reduction of vessel diameter) were correctly detected by MSCT. These values correspond to a sensitivity of 90.5 %, specificity of 94.6 %, positive predictive value of 70.1 %, and negative predictive value of 98.6% for the detection of significant carotid artery stenosis by MSCT. In the 168 carotid arteries of 24 patients, 12 of 12 carotid arteries with high-grade stenosis (≥ 70% reduction of vessel diameter) were correctly detected by MSCT, 154 of 156 carotid arteries without or with low-grade stenosis (70% reduction of vessel diameter) were correctly detected by MSCT. These values correspond to a sensitivity of 100 %, specificity of 98.7 %, positive predictive value of 85.7 %, and negative predictive value of 100 % for the detection of high-grade carotid arteries stenosis by MSCT. Conclusion MSCT angiography permits the visualization of significant carotid artery stenosis with high accuracy. It may be used as an alternative for carotid angiography in detecting carotid artery stenosis.