Carotid artery stenosis: optimization of CT angiography with a combination of shaded surface display and source images.

PURPOSE To evaluate the accuracy of CT angiography of occlusive disease of the carotid arteries using three-dimensional surface-rendered images alone and in conjunction with display of axial source images. METHODS Forty-eight symptomatic patients had conventional angiography followed by CT angiography within 24 hours. Images of 96 carotid arteries were acquired using contrast-enhanced spiral CT. Image postprocessing was performed on a free-standing workstation to produce 3-D shaded surface display (SSD) images. Two readers independently evaluated the CT angiographic (SSD) images and then reevaluated each case while simultaneously reviewing the SSD and axial source images. Digital subtraction angiograms were evaluated in a separate session and eventually compared with CT angiograms. All evaluations were performed under blinded conditions to control for reader bias. RESULTS SSD images alone underestimated stenosis relative to angiograms whereas combined SSD and axial images did not. CONCLUSION SSD angiograms in conjunction with the source images are better than SSD images alone in estimating the degree of stenosis in carotid artery disease.

[1]  K. Johnston,et al.  The difficulty of quantifying the severity of carotid stenosis. , 1982, Surgery.

[2]  P. Chikos,et al.  Observer variability in evaluating extracranial carotid artery stenosis. , 1983, Stroke.

[3]  C. Zee,et al.  Variability in Arteriographic Assessment of the Carotid Bifurcation , 1987, Angiology.

[4]  Reiner Lenz,et al.  Evaluation of methods for shaded surface display of CT-volumes , 1988, [1988 Proceedings] 9th International Conference on Pattern Recognition.

[5]  Karkow Ws,et al.  Variations in interpretation of arterial stenosis. , 1989 .

[6]  J. Cranley,et al.  Variations in interpretation of arterial stenosis. , 1989, The Journal of cardiovascular surgery.

[7]  W. Kalender,et al.  Spiral volumetric CT with single-breath-hold technique, continuous transport, and continuous scanner rotation. , 1990, Radiology.

[8]  W A Kalender,et al.  Physical performance characteristics of spiral CT scanning. , 1991, Medical physics.

[9]  R Kikinis,et al.  Common carotid artery bifurcation: evaluation with spiral CT. Work in progress. , 1992, Radiology.

[10]  G D Rubin,et al.  CT angiography with spiral CT and maximum intensity projection. , 1992, Radiology.

[11]  A. Fox,et al.  How to measure carotid stenosis. , 1993, Radiology.

[12]  S Napel,et al.  Diagnosis of carotid artery disease: preliminary experience with maximum-intensity-projection spiral CT angiography. , 1993, AJR. American journal of roentgenology.

[13]  M. Castillo,et al.  Diagnosis of disease of the common carotid artery bifurcation: CT angiography vs catheter angiography. , 1993, AJR. American journal of roentgenology.

[14]  M S van Leeuwen,et al.  CT angiography: application to the evaluation of carotid artery stenosis. , 1993, Radiology.

[15]  M S van Leeuwen,et al.  Spiral CT angiography. , 1993, AJR. American journal of roentgenology.

[16]  M. Cumming,et al.  Carotid artery stenosis: a prospective comparison of CT angiography and conventional angiography. , 1994, AJR. American journal of roentgenology.