T.Belšan F.Charvát D.Netuka V.Mandys J.Vrána

Accuracy of preoperative carotid artery stenosis

measurementcomparison of MRA, DSA and histological

specimens

T.BelšanF.CharvátD.NetukaV.Mandys J.Vrána

Central Military Hospital Prague Czech Republic

XIX. Symposium Neuroradiologicum, Bologna, October 7th, 2010

Purpose of study

We compare the preciseness of carotid artery stenosis measurement based on different imaging modalities (DSA, CE

MRA) with histological specimens obtained by endarterectomy.

Extend of carotid artery stenosis is one of the most important factor in decision about the

method of stenosis treatment (medical, surgical, intravascular)

Material and method• 103 patients with carotid

artery stenosis

• Digital subtraction angiography (DSA)

• CE magnetic resonance angiography (CE MRA)

• Carotid endarterectomy (CEA)

• Processing of the whole atherosclerotic plaque specimen

Material and method• 103 patients with carotid

artery stenosis

• Digital subtraction angiography (DSA)

• CE magnetic resonance angiography (CE MRA)

• Carotid endarterectomy (CEA)

• Processing of the whole atherosclerotic plaque specimen

Material and method

NASCET=N - E

N

ESCT= C - E

C

Results

Results DSA MRA

Mean differences -14,4% +0,7%

Mild stenosis 30-49% -24,7% -7,6%

Moderate stenosis 50-69% -12,3% +0,2%

High grade stenosis ≥ 70% -2,3% +12,2%

Results

- 25

- 20

- 15

- 10

- 5

0

5

10

15

Mild stenosis 30- 49%

Moderate stenosis50- 69%

High grade stenosis ≥70%

DSAMRA

ConclusionDSA is the most accurate in high grade stenosis(underestimates moderate and mild stenosis)

MRA is the most precise in moderate stenosis(underestimates mild, overestimates high grade stenosis)These discrepancies should be

aware in decision between medical and

surgical/intravascular treatment of carotid artery

stenoses