Interventional Neuroradiology, Radiology Department, Torrecardenas University Hospital, Almería, Spain.
Radiology Department, Torrecardenas University Hospital, Almería, Spain.
Clin Imaging. 2023 Oct;102:60-64. doi: 10.1016/j.clinimag.2023.07.005. Epub 2023 Aug 11.
Accurate differentiation between the intracranial and extracranial location of the acute internal carotid artery (ICA) occlusion is essential for guiding treatment decisions and mechanical thrombectomy planning. Multiphase Computed Tomography angiography (mCTA) appears to be superior to Single-phase Computed Tomography angiography (sCTA) in the evaluation of acute ICA occlusions. The main objective of our research is to study the accuracy of mCTA compared to sCTA in distinguishing isolated acute intracranial ICA occlusion from extracranial or tandem occlusion.
Two observers independently analyzed sCTA and mCTA of patients with acute ICA occlusion at two different time points. The location of the occlusion was categorized as intracranial or extracranial for both imaging techniques and then compared with digital subtraction angiography (gold standard). Sensitivity and specificity rates for isolated intracranial ICA occlusion on sCTA and mCTA were calculated. Kappa statistics were used to assess interobserver agreement.
The sensitivity of sCTA and mCTA was 48.28% (28.36%-68.19%) and 79.31% (62.84%-95.78%) respectively for the diagnosis of isolated intracranial ICA occlusion, with an almost perfect interobserver agreement between both observers (p < 0.001).
Our research suggests that mCTA is more accurate than sCTA in distinguishing isolated intracranial occlusions from extracranial or tandem occlusions.
准确区分急性颈内动脉（ICA）颅内和颅外位置对于指导治疗决策和机械取栓规划至关重要。多相 CT 血管造影（mCTA）似乎优于单相 CT 血管造影（sCTA），可用于评估急性 ICA 闭塞。我们研究的主要目的是研究 mCTA 与 sCTA 相比在区分孤立性急性颅内 ICA 闭塞与颅外或串联闭塞方面的准确性。
两名观察者分别在两个不同的时间点独立分析急性 ICA 闭塞患者的 sCTA 和 mCTA。对两种成像技术的闭塞位置进行颅内或颅外分类，然后与数字减影血管造影（金标准）进行比较。计算 sCTA 和 mCTA 对孤立性颅内 ICA 闭塞的敏感性和特异性。使用 Kappa 统计评估观察者间的一致性。
sCTA 和 mCTA 诊断孤立性颅内 ICA 闭塞的敏感性分别为 48.28%（28.36%-68.19%）和 79.31%（62.84%-95.78%），两名观察者之间的观察者间一致性几乎为完美（p<0.001）。
我们的研究表明，mCTA 比 sCTA 更准确地区分孤立性颅内闭塞与颅外或串联闭塞。
