Multi-Detector Row CT Angiography in the Assessment of Carotid Artery Disease in Symptomatic Patients: Comparison with Rotational Angiography and Digital Subtraction Angiography

tor row CT angiography permits larger anatomic coverage that includes both the epiaortic and entire carotid circulations. We evaluated the accuracy of multi-detector row CT angiography by using multiplanar reformation (MPR) for measuring carotid artery diameters compared with that of rotational angiography. We also evaluated the diagnostic performance of CT angiogra-phy compared with digital subtraction angiography (DSA). METHODS: In 35 patients, CT angiograms of 70 carotid arteries were compared with DSA images, and CT angiograms of 33 carotid arteries were compared with rotational angiograms. CT angiographic interpretation was performed first interactively at a workstation. Diameter measurements of normal and stenosed carotid arteries were performed on cross-sectional and oblique sagittal MPRs. Degree of stenosis was calculated per North American Symptomatic Carotid Endarterectomy Trial criteria independently by two observers for each technique. RESULTS: Degree of stenosis was slightly underestimated with CT angiography, with mean differences ( SD) per observer of 6.9 17.6 % and 10.7 16.1 % for cross-sectional and 2.8 19.2 % and 9.1 16.8 % for oblique sagittal MPRs compared with rotational angiography. CT angiography was somewhat inaccurate for measuring the absolute minimal diameter of high