Angiographic Correlation of CT Calcification in the Carotid Siphon

Calcification in the coronary arteries has been correlated with significant vessel stenosis. The predictive value of calcification within the carotid siphon has not been characterized; however, stenosis in the carotid siphon is potentially important in determining management of patients with ipsilat...

Full description

Saved in:
Bibliographic Details
Published in:American journal of neuroradiology : AJNR 1999-03, Vol.20 (3), p.495-499
Main Authors: Woodcock, Richard J., Jr, Goldstein, Jonas H, Kallmes, David F, Cloft, Harry J, Phillips, C. Douglas
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Angiography
Biological and medical sciences
Brain
Calcinosis - classification
Calcinosis - diagnostic imaging
Carotid Artery Diseases - classification
Carotid Artery Diseases - diagnostic imaging
Carotid Artery, Internal - diagnostic imaging
Carotid Stenosis - classification
Carotid Stenosis - diagnostic imaging
Humans
Medical sciences
Middle Aged
Neurology
Predictive Value of Tests
Prognosis
Radiographic Image Enhancement - methods
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed - methods
Vascular diseases and vascular malformations of the nervous system
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Calcification in the coronary arteries has been correlated with significant vessel stenosis. The predictive value of calcification within the carotid siphon has not been characterized; however, stenosis in the carotid siphon is potentially important in determining management of patients with ipsilateral carotid bifurcation stenosis. The purpose of this study was to determine optimal parameters for assessing carotid siphon calcification on head CT scans and to compare the CT findings with angiographic results. We performed a retrospective review of patients referred for diagnostic carotid arteriography. Those patients who also had undergone a head CT study at our institution were selected. The CT scans and angiograms of 64 patients (128 vessels) were reviewed. Carotid siphon calcification on CT scans was characterized on brain and bone windows as mild, moderate, or severe. Comparison was then made with angiographic findings. The sensitivity and specificity of CT for depicting greater than 50% angiographic stenosis in the carotid siphon were 86% and 98%, respectively, for bone windows and 100% and 0%, respectively, for brain windows. The positive predictive value (PPV) for a stenosis of greater than 50% as evidenced by severe calcification was 86% on bone windows and 11% on brain windows. The PPV for mild and moderate calcification on bone windows was 2.5% and 0%, respectively. Severe CT calcification in the carotid siphon as characterized on bone windows correlates with a carotid siphon stenosis of greater than 50% as determined angiographically. Therefore, the identification of severe calcification offers a potential noninvasive method for identifying stenosis of the carotid siphon. This information may be essential in determining management and prognosis for patients with carotid bifurcation stenosis.
ISSN:0195-6108
1936-959X