Accuracy of Computed Tomography Angiography for Diagnosing Extracranial Mural Lesions in Patients with Acute Internal Carotid Artery Occlusion: Correlation with Digital Subtraction Angiography
Extracranial carotid mural lesions (CML), caused by atherosclerosis or dissection, are frequently observed in acute internal carotid artery (ICA) occlusion, often requiring angioplasty or stenting. This study aimed to assess the diagnostic accuracy of computed tomography angiography (CTA) in differe...
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MDPI AG
2023-07-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/13/7/1169 |
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| author | Miriam Fernández-Gómez Félix Gallo-Pineda Carlos Hidalgo-Barranco Gracia Castro-Luna Patricia Martínez-Sánchez |
| author_facet | Miriam Fernández-Gómez Félix Gallo-Pineda Carlos Hidalgo-Barranco Gracia Castro-Luna Patricia Martínez-Sánchez |
| author_sort | Miriam Fernández-Gómez |
| collection | DOAJ |
| description | Extracranial carotid mural lesions (CML), caused by atherosclerosis or dissection, are frequently observed in acute internal carotid artery (ICA) occlusion, often requiring angioplasty or stenting. This study aimed to assess the diagnostic accuracy of computed tomography angiography (CTA) in differentiating extracranial CML from thromboembolic etiology in acute ICA occlusion in patients eligible for endovascular treatment. Two neuroradiologists retrospectively studied patients with apparent extracranial ICA occlusion on CTA. Patients were divided into two groups: thromboembolism and CML, based on findings from CTA and digital subtraction angiography (DSA). CTA sensitivity and specificity were calculated using DSA as the gold standard. Occlusive patterns and cervical segment widening were evaluated for atherosclerosis, dissection, and thromboembolism etiologies. CTA had a sensitivity of 84.91% (74.32–95.49%) and a specificity of 95.12% (87.31–100%) in detecting extracranial CML. Atherosclerosis was the most common cause, distinguishable with high accuracy using CTA (<i>p</i> < 0.001). No significant differences were found in occlusive patterns between dissection and thromboembolism (<i>p</i> = 0.568). Cervical segment widening was only observed in dissection cases due to mural hematoma. Conclusions: CTA accurately differentiates extracranial CML from thromboembolic etiology in acute ICA occlusion. The pattern of the occlusion and the artery widening help to establish the location and the etiology of the occlusion. |
| first_indexed | 2024-03-11T00:55:41Z |
| format | Article |
| id | doaj.art-5b8957f96fd84be3abcc4ab297b21767 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-11T00:55:41Z |
| publishDate | 2023-07-01 |
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| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-5b8957f96fd84be3abcc4ab297b217672023-11-18T20:04:39ZengMDPI AGJournal of Personalized Medicine2075-44262023-07-01137116910.3390/jpm13071169Accuracy of Computed Tomography Angiography for Diagnosing Extracranial Mural Lesions in Patients with Acute Internal Carotid Artery Occlusion: Correlation with Digital Subtraction AngiographyMiriam Fernández-Gómez0Félix Gallo-Pineda1Carlos Hidalgo-Barranco2Gracia Castro-Luna3Patricia Martínez-Sánchez4Interventional Neuroradiology, Torrecardenas University Hospital, University of Almería, 04009 Almería, SpainInterventional Neuroradiology, Torrecardenas University Hospital, University of Almería, 04009 Almería, SpainInterventional Neuroradiology, Torrecardenas University Hospital, University of Almería, 04009 Almería, SpainFaculty of Health Sciences, University of Almería, 04120 Almería, SpainStroke Centre, Department of Neurology, Torrecardenas University Hospital, University of Almería, 04009 Almería, SpainExtracranial carotid mural lesions (CML), caused by atherosclerosis or dissection, are frequently observed in acute internal carotid artery (ICA) occlusion, often requiring angioplasty or stenting. This study aimed to assess the diagnostic accuracy of computed tomography angiography (CTA) in differentiating extracranial CML from thromboembolic etiology in acute ICA occlusion in patients eligible for endovascular treatment. Two neuroradiologists retrospectively studied patients with apparent extracranial ICA occlusion on CTA. Patients were divided into two groups: thromboembolism and CML, based on findings from CTA and digital subtraction angiography (DSA). CTA sensitivity and specificity were calculated using DSA as the gold standard. Occlusive patterns and cervical segment widening were evaluated for atherosclerosis, dissection, and thromboembolism etiologies. CTA had a sensitivity of 84.91% (74.32–95.49%) and a specificity of 95.12% (87.31–100%) in detecting extracranial CML. Atherosclerosis was the most common cause, distinguishable with high accuracy using CTA (<i>p</i> < 0.001). No significant differences were found in occlusive patterns between dissection and thromboembolism (<i>p</i> = 0.568). Cervical segment widening was only observed in dissection cases due to mural hematoma. Conclusions: CTA accurately differentiates extracranial CML from thromboembolic etiology in acute ICA occlusion. The pattern of the occlusion and the artery widening help to establish the location and the etiology of the occlusion.https://www.mdpi.com/2075-4426/13/7/1169internal carotid arteryocclusionangiographyetiologydissectiontandem |
| spellingShingle | Miriam Fernández-Gómez Félix Gallo-Pineda Carlos Hidalgo-Barranco Gracia Castro-Luna Patricia Martínez-Sánchez Accuracy of Computed Tomography Angiography for Diagnosing Extracranial Mural Lesions in Patients with Acute Internal Carotid Artery Occlusion: Correlation with Digital Subtraction Angiography Journal of Personalized Medicine internal carotid artery occlusion angiography etiology dissection tandem |
| title | Accuracy of Computed Tomography Angiography for Diagnosing Extracranial Mural Lesions in Patients with Acute Internal Carotid Artery Occlusion: Correlation with Digital Subtraction Angiography |
| title_full | Accuracy of Computed Tomography Angiography for Diagnosing Extracranial Mural Lesions in Patients with Acute Internal Carotid Artery Occlusion: Correlation with Digital Subtraction Angiography |
| title_fullStr | Accuracy of Computed Tomography Angiography for Diagnosing Extracranial Mural Lesions in Patients with Acute Internal Carotid Artery Occlusion: Correlation with Digital Subtraction Angiography |
| title_full_unstemmed | Accuracy of Computed Tomography Angiography for Diagnosing Extracranial Mural Lesions in Patients with Acute Internal Carotid Artery Occlusion: Correlation with Digital Subtraction Angiography |
| title_short | Accuracy of Computed Tomography Angiography for Diagnosing Extracranial Mural Lesions in Patients with Acute Internal Carotid Artery Occlusion: Correlation with Digital Subtraction Angiography |
| title_sort | accuracy of computed tomography angiography for diagnosing extracranial mural lesions in patients with acute internal carotid artery occlusion correlation with digital subtraction angiography |
| topic | internal carotid artery occlusion angiography etiology dissection tandem |
| url | https://www.mdpi.com/2075-4426/13/7/1169 |
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