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Cardiovasc Intervent Radiol. 2012 Feb;35(1):49-58. doi: 10.1007/s00270-011-0108-z. Epub 2011 Feb 8.

Carotid artery stenosis at MSCT: is there a threshold in millimeters that determines clinical significance?

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  • 1Department of Radiology, Azienda Ospedaliero Universitaria, di Cagliari-Polo di Monserrato, s.s. 554, 09045 Monserrato, CA, Italy. lucasaba@tiscali.it

Abstract

PURPOSE:

The purpose of this work was to determine whether it is possible to identify a reliable carotid stenosis threshold--measured in millimeters (mm)--that is associated with cerebrovascular symptoms.

METHODS:

Written, informed consent was obtained for each patient; 149 consecutive patients (98 men; median age, 68 years) were studied for suspected pathology of the carotid arteries by using MDCTA. In each patient, carotid artery stenosis was quantified using the mm-method. Continuous data were described as the mean value ± standard deviation (SD), and they were compared by using the Student's t test. A ROC curve was calculated to test the study hypothesis and identify a specific mm-stenosis threshold. Logistic regression analysis was performed to include other MDCTA findings, such as plaque type and ulcerations. A P value < 0.05 was considered to indicate statistical significance.

RESULTS:

Twenty-six patients were excluded. Of those remaining, 75 patients suffered cerebrovascular symptoms (61%). There was a statistically significant difference (P = 0.0046) in the mm-carotid stenosis between patients with symptoms (1.31 ± 0.64 mm SD) and without symptoms (1.68 ± 0.79 mm SD). Multiple logistic regression analysis confirmed that symptoms were associated with increased luminal stenosis (P = 0.013) and with the presence of fatty plaques (P = 0.0491). Moreover, the ROC curve (Az = 0.669; ±0.051 SD; P = 0.0009) indicated that a threshold of 1.6 mm stenosis was associated with a sensitivity to symptoms of 76%.

CONCLUSIONS:

The results of our study suggest an association between luminal stenosis (measure in mm) and the presence of cerebrovascular symptoms. Luminal stenosis of 1.6 mm is associated, with a sensitivity of 76%, with cerebrovascular symptoms.

PMID:
21301843
[PubMed - indexed for MEDLINE]
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