CT angiography helps to differentiate acute from chronic carotid occlusion: "carotid ring sign".

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Serval ID
serval:BIB_C5D00F02F859
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
CT angiography helps to differentiate acute from chronic carotid occlusion: "carotid ring sign".
Journal
Neuroradiology
Author(s)
Michel P., Ntaios G., Delgado M.G., Bezerra D.C., Meuli R., Binaghi S.
ISSN
1432-1920 (Electronic)
ISSN-L
0028-3940
Publication state
Published
Issued date
2012
Peer-reviewed
Oui
Volume
54
Number
2
Pages
139-146
Language
english
Notes
Publication types: Journal Article
Abstract
INTRODUCTION: Currently, there is no reliable method to differentiate acute from chronic carotid occlusion. We propose a novel CTA-based method to differentiate acute from chronic carotid occlusions that could potentially aid clinical management of patients. METHODS: We examined 72 patients with 89 spontaneously occluded extracranial internal carotids with CT angiography (CTA). All occlusions were confirmed by another imaging modality and classified as acute (imaging <1 week of presumed occlusion) orchronic (imaging >4 weeks), based on circumstantial clinical and radiological evidence. A neuroradiologist and a neurologist blinded to clinical information determined the site of occlusion on axial sections of CTA. They also looked for (a) hypodensity in the carotid artery (thrombus), (b) contrast within the carotid wall (vasa vasorum), (c) the site of the occluded carotid, and (d) the "carotid ring sign" (defined as presence of a and/or b). RESULTS: Of 89 occluded carotids, 24 were excluded because of insufficient circumstantial evidence to determine timing of occlusion, 4 because of insufficient image quality, and 3 because of subacute timing of occlusion. Among the remaining 45 acute and 13 chronic occlusions, inter-rater agreement (kappa) for the site of proximal occlusion was 0.88, 0.45 for distal occlusion, 0.78 for luminal hypodensity, 0.82 for wall contrast, and 0.90 for carotid ring sign. The carotid ring sign had 88.9% sensitivity, 69.2% specificity, and 84.5% accuracy to diagnose acute occlusion. CONCLUSION: The carotid ring sign helps to differentiate acute from chronic carotid occlusion. If further confirmed, this information may be helpful in studying ischemic symptoms and selecting treatment strategies in patients with carotid occlusions.
Pubmed
Web of science
Open Access
Yes
Create date
06/09/2011 11:46
Last modification date
01/10/2019 7:19
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