1. T.Belšan F.Charvát D.Netuka V.Mandys J.Vrána
Accuracy of preoperative carotid artery stenosis measurement comparison of MRA, DSA and histological specimens
Central Military Hospital
Prague Czech Republic
T.Belšan
F.Charvát
D.Netuka
V.Mandys
J.Vrána
XIX. Symposium Neuroradiologicum, Bologna, October 7th, 2010

2. Purpose of study
Extend of carotid artery stenosis is one of the most important factor in decision about the method of stenosis treatment (medical, surgical, intravascular)
We compare the preciseness of carotid artery stenosis measurement based on different imaging modalities (DSA, CE MRA) with histological specimens obtained by endarterectomy.

3. Material and method 103 patients with carotid artery stenosis
Digital subtraction angiography (DSA)
CE magnetic resonance angiography (CE MRA)
Carotid endarterectomy (CEA)
Processing of the whole atherosclerotic plaque specimen

4. Material and method 103 patients with carotid artery stenosis
Digital subtraction angiography (DSA)
CE magnetic resonance angiography (CE MRA)
Carotid endarterectomy (CEA)
Processing of the whole atherosclerotic plaque specimen

5. Material and method
C - E
ESCT=
N - E C
NASCET= N

8. Results Results DSA MRA Mean differences -14,4% +0,7% -24,7% -7,6%
Mild stenosis %
-24,7%
-7,6%
Moderate stenosis %
-12,3%
+0,2%
High grade stenosis ≥ 70%
-2,3%
+12,2%

9. Results

10. Conclusion DSA is the most accurate in high grade stenosis
(underestimates moderate and mild stenosis)
MRA is the most precise in moderate stenosis
(underestimates mild, overestimates high grade stenosis)
These discrepancies should be aware in decision between medical and surgical/intravascular treatment of carotid artery stenoses