Primary study on evaluation of severe carotid stenosis and occlusion disease by using multi-slice CT

Objective To evaluate the combination use of multi-slice CT angiography (CTA) and CT perfusion in patients with severe carotid stenosis disease. Methods All 23 symptomatic patients with severe carotid stenosis underwent CT plain scanning, CT perfusion and CTA examination. The degrees and locations of artery stenosis were assessed with CTA, and cerebral hemodynamic changes with CT perfusion. Ten normal persons underwent CT perfusion as did in control group. Results Eleven cases of severe carotid stenosis(70%) and 12 of carotid occlusion were found with CTA, and 16 cases were multiple arteries disease, including contralateral carotid stenosis, vertebral arteries stenosis and cerebral arteries stenosis or occlusion. CT perfusion demonstrated that there appeared cerebral hemodynamic impairment in 17 patients, showing no statistic differences between groups of occlusion (8 cases ) and stenosis (9 cases ),but the occurrence of hemodynamic impairment was higher in group of multiple arteries disease(14 cases) than in single arteries disease group (3 cases). Conclusions Cerebral hemodynamic impairment is common in severe carotid stenosis disease, with a higher incidence in patients with multiple arteries carotid disease than in those with single carotid disease. Severe carotid stenosis disease should be evaluated comprehensively by using combination of CTA and CT perfusion.