Calcium at the carotid siphon as an indicator of internal carotid artery stenosis
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Carotid siphon calcification is often visible on unenhanced head CT (UCT), but the relation to proximal carotid artery stenosis (CAS) is unclear. We investigated the association of carotid siphon calcification with the presence of CAS.
This IRB-waived retrospective study included 160 consecutive patients suspected of stroke (age 64 ± 14 years, 63 female) who underwent head UCT and CTA of the head and neck. CAS was rated on CTA as not present or present with non-significant (<50 %), moderate (50–69 %) or significant (≥70 %) stenosis. Presence, shape (on UCT) and volume (on CTA) of carotid siphon calcifications were related to CAS.
Carotid siphon calcification was absent in 41 % of patients and bilateral in 94 % of those with calcifications. Presence, shape and volume of calcification resulted in odds ratios for having significant CAS of 10.1, 3.9 and 8.4, with 95 % CIs of 1.3–79.6, 1.1–14.1 and 2.6–26.8, respectively. Corresponding NPVs were 0.98, 0.98 and 0.96, while PPVs were 0.14, 0.07 and 0.29, respectively.
Absence of calcification in the carotid artery siphon on UCT has high negative predictive value for carotid artery stenosis in patients with suspected stroke. However, siphon calcification is not a reliable indicator of significant carotid artery stenosis.
• Many stroke patients do not have calcification in the carotid artery siphon.
• Carotid stenosis ≥50 % is unlikely in stroke patients without siphon calcification.
• Carotid siphon calcium is a poor indicator of significant carotid artery stenosis.
- Calcium at the carotid siphon as an indicator of internal carotid artery stenosis
Volume 23, Issue 6 , pp 1478-1486
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- Intracranial atherosclerosis
- Internal carotid artery
- Vascular calcification
- Carotid stenosis
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- Author Affiliations
- 1. Department of Radiology, County hospital Požega, Osječka 107, 34000, Požega, Croatia
- 2. Image Sciences Institute, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- 3. Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
- 4. Department of Surgery, County hospital Požega, Osječka 107, 34000, Požega, Croatia
- 5. Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- 6. Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands