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A Journal on Vascular and Endovascular Surgery

Official Journal of the Italian Society of Vascular and Endovascular Surgery
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Italian Journal of Vascular and Endovascular Surgery 2004 March;11(1):41-8

language: English

Perspective study on the use of spiral CT in evaluation of carotid stenosis of patients submitted to endo-arteriectomy

Pisacreta M. 1, Gornati R. 1, Porretta T. 1, Pelucchi A. 1, Bianchi M. 1, Ravini M. 1, Osio M. 2, Bertora P. 2

1 UOS Vascular Surgery, L. Sacco Hospital, Milan, Italy,
2 Department of Neurology, L. Sacco Hospital, Milan, Italy


Aim. For the pre­op­er­a­tive detec­tion of ath­e­ros­cle­rot­ic ­lesions of carot­id arter­ies ­echo col­or-Doppler (ECD) is an estab­lished oper­a­tor-depen­dent meth­od, where­as angio­gra­phy is asso­ciat­ed ­with a not-insig­nif­i­cant lev­el of com­pli­ca­tions; spi­ral CT is a prom­is­ing diag­nos­tic ­tool ­that ­allows non­in­va­sive, oper­a­tor-inde­pen­dent eval­u­a­tion of extra­cra­ni­al cere­bral arter­ies. The aim of our ­study was to eval­u­ate spi­ral CT reli­abil­ity by com­par­ing the ­degree of carot­id ­artery sten­o­sis meas­ured ­with pre­op­er­a­tive ECD and spi­ral CT ­with an intra­op­er­a­tive mea­sure­ment of cator­id sten­o­sis per­cent­age.
Methods. We stud­ied 50 ­patients due to under­go carot­id endo­ar­te­riec­to­my ­with pre­op­er­a­tive ECD and spi­ral CT and ­with intra­op­er­a­tive meas­ure­ment of carot­id sten­o­sis; as ­regards spi­ral CT, meas­ure­ments are car­ried out ­using the ­ECST meth­od.
Results. We con­sid­ered cor­re­la­tions ­among ECD, spi­ral CT and intra­op­er­a­tive meas­ure­ments ­using the Pearson Correlation Test: cor­re­la­tion ­ratios ­between Spiral CT and intra­op­er­a­tive meas­ure­ment (R=0.3768; p=0.007) and ­between ECD and intra­op­er­a­tive meas­ure­ment (R=0.2897, p=0.041) ­both ­proved sta­tis­ti­cal­ly sig­nif­i­cant. Correlation ­between spi­ral CT and ECG ­also ­proved con­sid­er­ably sig­nif­i­cant ­with an ­high R val­ue (R=0.7962, p=0.001), reveal­ing a sub­stan­tial ­data con­cor­dance ­between ­these 2 instru­men­tal ­exams. We ­also stud­ied spi­ral CT and ECD diag­nos­tic spec­i­fic­ity (93% and 95%) and sen­sibil­ity (58% and 44%) and Youden’s Index val­ues (0.51 and 0.39).
Conclusion. Spiral CT is extreme­ly reli­able in the pre­op­er­a­tive eval­u­a­tion of carot­id sten­o­sis per­cent­age, reach­ing the ­same ECD accu­ra­cy lev­el. Spiral Ct is oper­a­tor-non-depen­dent and pro­duc­es imag­es ­which are extreme­ly sim­i­lar to angio­gra­phy ­ones, ­quite use­ful, there­fore, in ­case of sur­gery, ­with no com­pli­ca­tions.

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