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British Journal of Radiology (2003) 76, 792-797
© 2003 British Institute of Radiology
doi: 10.1259/bjr/52679856
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Full Paper

Virtual intra-arterial angioscopy (VIA) of the carotid artery based on helical CT data

N Rilinger, MD 1 H Seifarth, MD 5 R Sokiranski, MD 2 S Krämer, MD 5 F Liewald, MD 4 J Goerich, MD 2 A Tomzcak, MD 3 and C E E Nierhoff, MD 1

1 Institute of Diagnostic and Interventional Radiology, Klinikum Offenbach, Starkenburgring 66, 63069 Offenbach, 2 Department of Diagnostic Radiology, University of Ulm, Steinhövelstrasse 9, D-89075 Ulm, 3 Department of Diagnostic Radiology, Kreiskrankenhaus am Plattenwald, Am Plattenwald 1, D-74177 Bad Friedrichshall, 4 Department for Thoracic and Vascular Surgery, University of Ulm, Steinhövelstrasse 9, D-89075 Ulm and 5 Department of Clinical Radiology, University of Münster, A. Schweitzer Straße 33, D-48129 Münster, Germany

The purpose of this study was to visualize both the vessel wall and atherosclerotic plaques in virtual intra-arterial angioscopy (VIA) based on helical CT data sets. To achieve this in vitro, the optimal reconstruction threshold of the vessel wall was determined to be 56.4% of the maximum enhancement. Using this threshold, 20 patients suffering from symptomatic carotid disease were examined in a helical CT scanner. The degree of stenosis was defined using the North American Symptomatic Endarterectomy Trial (NASCET) criteria and compared with results from digital substraction angiography (DSA). Grading of stenoses was only possible by adding the separately computed plaque geometry to the geometry of the vessel wall in a second step. Correlation between VIA and DSA in low grade, medium grade and high grade stenosis was 88%, 93% and 71%, respectively. Complete occlusions were diagnosed correctly in all patients. Sensitivity and specificity for the correct diagnosis of high grade stenosis was 93.7% and 91.3%, respectively. A realistic depiction of intraluminal structures in carotid arteries can only be generated by displaying both the vessel wall and plaque structures simultaneously.




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[Abstract] [Full Text] [PDF]


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