Cerebral circulation insufficiency – correlation of CTA-visualized atherosclerotic lesions in extra- and intracranial arteries
Katarzyna Gruszczyńska, Jan Baron, Zbigniew Zieliński, Jerzy Walecki, Jan Gniadek, Krzysztof Czernicki
Med Sci Monit 2004; 10(3): 71-79
Backghround: To analyze the co-occurrence of atherosclerotic lesions in CT angiograms of extra- and intracranial arteries in patients with cerebral circulation insufficiency.
Material and Methods: Extra- and intracranial CTA was performed in 70 patients with symptoms of cerebral circulation insufficiency. Co-occurrence of atherosclerotic lesions at both levels and correlation between the degree of atherosclerosis and sex, age, and clinical symptoms were evaluated. Intracranial CTA results were compared to those of the control group, which consisted of 34 subjects asymptomatic of cerebral circulation insufficiency. The usefulness of various data reconstruction techniques (MIP and MPR vs. MIP only) for the evaluation of intracranial stenosis was subjected to independent analysis by two radiologists.
Results: Concomitant occurrence of extra- and intracranial lesions was diagnosed in 56% of patients examined. A statistically significant correlation was found between the degree of stenosis at both levels under consideration (χ2=81.452; p<0.00001; contingency coefficient CC=0.733). A significant correlation was found between the development of clinical symptoms and the severity of extraand intracranial stenosis. The consistency between % representation of CTA-detected intracranial carotid stenosis, as independently analyzed by two radiologists, was higher in combined MIP & MPR than in MIP only (correlation coefficient R=0.9924, p<0.00001).
Conclusions: There was a statistically significant correlation found between extra- and intracranial arterial stenosis in patients with symptoms of cerebral circulation insufficiency indicating that cervical and cerebral stenosis tend to occur concomitantly. Combination of MIP & MPR seemed the optimum CTA post-processing technique when evaluating the intracranial arteries.
Keywords: carotid and cerebral arteries, atherosclerosis, CTA, Adult, Aged, Atherosclerosis - radiography, Brain - radiography, Brain Ischemia - radiography, Carotid Arteries - radiography, Carotid Stenosis - radiography, Case-Control Studies, Cerebral Angiography - methods, Cerebrovascular Circulation, Female, Humans, Male, Middle Aged, Radiographic Image Interpretation, Computer-Assisted - methods, Stroke - radiography, Tomography, X-Ray Computed - methods