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Dual-Source CT-Angiographie von Karotisstenosen im Vergleich zu MR-Angiographie und Duplexsonographie

Dual source CT angiography of carotid stenoses in comparison to MR angiography and duplex sonography

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Zusammenfassung

Ziel

Das Ziel unserer Studie war die Evaluierung der Dual-Source CT-Angiographie von Karotisstenosen im Vergleich zur MR-Angiographie und farbkodierten Duplexsonographie.

Material und Methode

Bei 15 symptomatischen Patienten wurden insgesamt 30 Karotiden hinsichtlich ihres Stenosegrades evaluiert. Dabei wurden für die angiographischen Methoden die NASCET-Kriterien und für die Sonographie die DEGUM-Kriterien angewendet. Jeder Patient wurde mit Farbduplex, der kontrastverstärkten 3T-MR-Angiographie und der kontrastverstärkten Dual-Source CT-Angiographie: (Röhre A: 140 kV, 55 mAs; Röhre B: 80 kV, 230 mAs; 64×0,6 mm coll., pitch 0,65 rot. 0,33 s) untersucht. Die CT-Bilder wurden in 1 mm dicken Schichten rekonstruiert. Dabei wurde eine sofortige Knochensubtraktion durchgeführt. Alle Dual-Source CT- und MR-Angiographien wurden durch denselben, erfahrenen Radiologen, alle Ultraschalluntersuchungen durch dieselbe, erfahrene Neurologin befundet. Die einzelnen Ergebnisse wurden miteinander verglichen und korreliert.

Ergebnisse

Der durchschnittliche Stenosegrad wurde im CT mit 48%, im MRT mit 49% und im Ultraschall mit 47% angegeben. Es gab keinen statistisch signifikanten Unterschied hinsichtlich der Stenosegradbestimmung zwischen CT und MRT (p=0,83), oder zwischen CT und Ultraschall (p=0,75). Die Korrelationskoeffizienten wurden zwischen CT und MRT mit r=0,8327 und zwischen CT und Ultraschall mit r=0,8260 errechnet.

Schlussfolgerung

Die Diagnostik von Karotisstenosen mit Hilfe der Dual-Source CT-Angiographie erlaubt eine sichere Bestimmung des Stenosegrades. Die Ergebnisse sind mit denen der MR-Angiographie und der farbkodierten Duplexsonographie vergleichbar.

Abstract

Aim

The aim of this study was to evaluate the accuracy of dual source CT angiography of the carotid artery in comparison with MR angiography and color-coded duplex ultrasound (US).

Material and methods

From 15 symptomatic patients 30 carotid arteries were evaluated for the degree of stenosis following the NASCET criteria for angiography and the DEGUM criteria for sonography. Each patient was examined using duplex ultrasound, 3T MR angiography and contrast-enhanced dual source CT angiography (DSCT) (tube A 140 kV, 55 mA, tube B 80 kV, 230 mA; 64×0.6 mm coll, pitch 0.65 rot. 0.33 s) of the extracranial carotid artery. Images were reconstructed in 1 mm section thickness and direct bone removal was performed for optimal visualization after the scan. All dual source CT and MR angiography images were evaluated and measured by the same experienced radiologist and all duplex ultrasound results by the same neurologist. Measurement results were compared and correlated.

Results

The mean degree of stenosis was 48% by CT (SD 35%), 49% by MR (SD 38%) and 47% by US (SD 41%). There was no statistically significant difference in stenosis evaluation between CT and MR (p=0.83) or between CT and US (p=0.75). The correlation coefficient between CT and MR was r=0.8327, between CT and US r=0.8424 and between US and MR r=0.8260.

Conclusion

Dual source CT evaluation of the carotid arteries allows a reliable measurement of carotid artery stenosis. Results are comparable to MR angiography and US.

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Authors and Affiliations

  1. Klinik für Radiologische Diagnostik, RWTH Aachen, Aachen, Deutschland

    M. Das, G. Mühlenbruch, A.H. Mahnken & R.W. Günther

  2. Klinik für Neuroradiologie, RWTH Aachen, Aachen, Deutschland

    T. Krings & M. Schaaf

  3. Europäisches Gefäßzentrum Aachen-Maastricht, RWTH Aachen - AZ Maastricht, AZ Maastricht, Niederlande

    S. Langer & M.J. Jacobs

  4. Klinik für Neurologie, RWTH Aachen, Aachen, Deutschland

    J. Harrer-Haag

  5. Klinik für Gefäßchirurgie, Helios-Klinikum Siegburg, Ringstr. 49, 53721, Siegburg, Deutschland

    G. Mommertz

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  1. M. Das
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  2. G. Mühlenbruch
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  3. A.H. Mahnken
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  4. T. Krings
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  5. S. Langer
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  7. J. Harrer-Haag
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  8. R.W. Günther
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  9. M.J. Jacobs
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  10. G. Mommertz
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Correspondence to G. Mommertz.

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Das, M., Mühlenbruch, G., Mahnken, A. et al. Dual-Source CT-Angiographie von Karotisstenosen im Vergleich zu MR-Angiographie und Duplexsonographie. Gefässchirurgie 14, 500–504 (2009). https://doi.org/10.1007/s00772-009-0743-8

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  • DOI: https://doi.org/10.1007/s00772-009-0743-8

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