The Clinical Application of Multi-Slice CT Angiography in Dilatation and Stenting of Carotid, Subclavian and Vertebral Artery Stenosis

Purpose: To discuss the diagnostic value of multi-slice CT angiography (MSCTA) in carotid stenosis and atherosclerosis plaques and the value in dilatation and stenting. Materials and Methods: 105 patients with symptomatic carotid stenosis were studied by MSCTA. 24 patients also underwent DSA within two weeks of MSCTA, and 49 patients underwent CFDS. The post-processing of image data including 3D reformation was performed after axial images were obtained. The degree of vascular stenosis and plaque density was analyzed by AVA software of GE AW 4.3 work station. The degree of stenosis was correlated with DSA to evaluate the accuracy of quantitative vascular measurement of MSCTA for carotid stenosis. The density analysis of atherosclerosis plaques was correlated with CFDS to evaluate the accuracy of Color Identification of MSCTA for classification of atherosclerosis plaques. Results: When DSA as golden standard, the sensitivity, specificity, negative and positive predictive value and accuracy to identify ≥70% stenosis with MSCTA were 96.4%, 91.0%, 97.6%, 86.9%, 93.1%, respectively. When CFDS as golden standard, the conformable rate of the density analysis with MSCTA was 80.3%, and the sensitivity, specificity, negative and positive predictive value and accuracy to identify calcium plaque with MSCTA were 83.3%, 98.2%, 98.2%, 83.3%, 96.7%, respectively. Conclusions: MSCTA permits the visualization of significant carotid stenosis (≥70%) and calcium plaque with high sensitivity, specificity and accuracy. It may help pre-procedure planning, interventional materials selecting and may help to evaluate the risk of shedding atheroma into distal circulation.