Congress:
ECR25
Poster Number:
C-14320
Type:
Poster: EPOS Radiologist (scientific)
DOI:
10.26044/ecr2025/C-14320
Authorblock:
D. Bachhuka1, A. Papalkar2, S. Ahmed1; 1Preston/UK, 2Secunderabad/IN
Disclosures:
Deepti Bachhuka:
Nothing to disclose
Amber Papalkar:
Nothing to disclose
Saba Ahmed:
Nothing to disclose
Keywords:
Head and neck, Vascular, CT-Angiography, Ultrasound, Ultrasound-Spectral Doppler, Computer Applications-Detection, diagnosis, Contrast agent-intravenous, Stents, Arteriosclerosis, Embolism / Thrombosis, Hypertension
- CTA yields good detection of carotid stenosis and hence should be carefully analyzed and quantified. Though automatic methods of computation are available, a manual check of the software is always necessary. Quantification on post-processed images helps save time but axial images should be carefully examined in cases of eccentric plaques and false readings.
- CTA being a fast technique, images could be acquired in few seconds with direct and accurate millimeter stenosis measurement. 3D reconstruction abilities from the high resolution axial source images are an added advantage. Our study tried to correlate single millimeter stenosis value to grade NASCET standard percent stenosis. A linear relationship between millimeter stenosis and derived NASCET style percentage was established. With a negative predictive value of 97.36%, a millimeter measurement of stenosis is an excellent tool to rule out severe carotid disease, at a threshold value of 1.3mm.
Fig 5: CTA and DUS images of 67-year-old male showing less than 50% carotid stenosis on right side. A) Volume rendered CTA image, B) MPR CTA image with millimetre stenosis, C) DUS image of right ICA showing PSV 73cm/sec and D) DUS image of right CCA showing EDV of 14cm/sec. Thus, amounting to St. Mary’s Ratio of 5.2. Percent stenosis of 54%.
Fig 6: CTA and DUS images of 54-year-old male showing 50-59 % carotid stenosis on right side. A) Volume rendered CTA image, B) MPR CTA image with millimetre stenosis, C) DUS image of right ICA showing PSV 140 cm/sec and D) DUS image of right CCA showing EDV of 15 cm/sec. Thus, amounting to St. Mary’s Ratio of 9.33. Percent stenosis of 54%.
Fig 7: CTA and DUS images of 87-year-old male showing 60-69 % carotid stenosis on right side. A) MPR CTA image with millimetre stenosis, B) Volume rendered CTA image, C) DUS image of right ICA showing PSV 178 cm/sec and D) DUS image of right CCA showing EDV of 15 cm/sec. Thus, amounting to St. Mary’s Ratio of 11.8. Percent stenosis of 63.8 %.
Fig 8: CTA and DUS images of 67-year-old male showing 70-79 % carotid stenosis on right side. A) Volume rendered CTA image, B) MPR CTA image with millimeter stenosis, C) DUS image of right ICA showing PSV 258 cm/sec and D) DUS image of right CCA showing EDV of 15 cm/sec. Thus, amounting to St. Mary’s Ratio of 17.2. Percent stenosis of 75.4 %.
Fig 9: CTA and DUS images of 46-year-old male showing 80-89 % carotid stenosis on left side. A) Volume rendered CTA image, B) MPR CTA image with millimeter stenosis, C) DUS image of right ICA showing PSV 304 cm/sec and D) DUS image of right CCA showing EDV of 12 cm/sec. Thus, amounting to St. Mary’s Ratio of 25.3. Percent stenosis of 80.4 %.
Fig 10: CTA and DUS images of 55-year-old male showing >=90 % carotid stenosis on right side. A) Volume rendered CTA image, B) MPR CTA image with millimeter stenosis, C) DUS image of right ICA showing PSV 367 cm/sec and D) DUS image of right CCA showing EDV of 12 cm/sec. Thus, amounting to St. Mary’s Ratio of 30.1. Percent stenosis of 90 %. - Doppler ultrasound is another non-invasive modality that is good for physicians who are taking management steps. According to our study, a strong correlation existed between percent stenosis on CTA and St. Mary’s ratio on DUS. St. Mary’s Ratio is a good velocity parameter ratio and could be used as a good screening tool.