Diagnostic Value Of CT Angiography Research Articles

Diagnostic Value of CT Angiography in Acute Cerebrovascular Disease in Neurology Department

Diagnostic Value of CT Angiography in Acute Cerebrovascular Disease in Neurology Department

Diagnostic Value of CT Angiography Combined with High-Resolution Magnetic Resonance Angiography in Vascular Lesions in Acute Stroke

Cerebrovascular disease is increasing rapidly because of its high morbidity and high mortality, which is a serious threat to human health. For the early diagnosis and treatment of diseases, the CT vascular noise combined with high-resolution magnetic resonance angiography in acute cerebral apoplexy vascular disease is adopted. 150 patients with ischemic stroke were selected, which were admitted to the Department of Radiology, Huizhou Central People’s Hospital, from January 2020 to December 2020. All patients accepted digital subtraction angiography (DSA), magnetic resonance angiography (MRA), and CT angiography (CTA) examination. Results. There were 76 cases of aneurysm in DSA examination, accounting for 46%; 69 cases with pulsating stenosis, accounting for 50.67%; and 5 cases of moyamoya disease, accounting for 3.33%. The number and proportion of cases of the above diseases in MRA examination were (75, 69, 71; 53.33%, 45.67%, 4%), and those in CTA examination were (71, 76, 3, 47.33%, 50.67%, 2%). Relative to the DSA gold standard, the sensitivity, specificity, and false positive rate of MRA were 81.51%, 95.19%, and 2.1, respectively, and those of CTA were 95.78%, 79.17%, and 11.0, respectively. The number of cases and accuracy of detection of cerebral aneurysms by MRA were (75, 96.57%), and those by CTA were (71, 91.2%), which was not statistically considerable, P > 0.05 . For the number of cases and the detection accuracy of cerebrovascular malformations, MRA was (38, 92.68%) and CTA was (37, 90.24%), which was not statistically considerable, P > 0.05 . Conclusion. The detection sensitivity and accuracy of MRA were better than those of CTA, while specific CTA was superior to MRA. The differences between the two detections were substantial ( P < 0.05 ), while the sensitivity and false positive rate were not remarkably different ( P > 0.05 ). Therefore, the combination of the two detections was of great significance to the diagnosis and treatment of stroke and other vascular diseases.

Diagnostic Value of CT Angiography (CTA) in Carotid Cavernous Fistula (CCF) Patients Using the Digital Subtraction Angiography (DSA) as The Gold Standard: Observation in Dr. Soetomo General Hospital Surabaya from January 2016 to July 2020

Background: CT angiography (CTA) is the initial modality for diagnosing the Carotid Cavernous Fistula (CCF), identifying the type of CCF, measuring the diameter of the fistula and the diameter of the internal carotid artery (ICA) pre and post fistula, and then confirmed by Digital Subtraction Angiography (DSA) as the gold standard. CTA is expected to provide more information to improve the accuracy of CCF diagnosis to benefit therapy and prevent complications. This study aimed to determine the diagnostic value of CTA in CCF patients in Dr. Soetomo General Hospital Surabaya, using the DSA as a gold standard.
 Methods: An observational retrospective study of CCF patients met the inclusion and exclusion criteria and underwent CTA and DSA examinations at the Radiology Installation of Dr. Soetomo General Hospital, Surabaya, from January 2016 to July 2020.
 Results: In the comparison of types of CCF CTA to DSA, the direct group was 53.8% and 57.7%, respectively, while the indirect group was 46.1% and 42.3% with a very strong correlation (κ = 0.922; p = 0.000), sensitivity was 93.3%, specificity was 100 %, PPV of 100%, NPV of 91.7% and accuracy of 96.15%. Direct type evaluation on the DSA showed a large picture of the fistula diameter; the ICA pre fistula's size was enlarged; therefore, the ICA post fistula diameter was reduced or absent. There was a strong correlation of fistula diameter measurement results between CTA and DSA (r = 0.695, p = 0.006).
 Conclusion: CTA has a similarity rate of 92.2% with DSA in identifying the type of CCF. The accuracy value of CTA is close to DSA in fistula diameter measurements.

Diagnostic Value of CT Angiography (CTA) in Carotid Cavernous Fistula (CCF) Patients Using the Digital Subtraction Angiography (DSA) as The Gold Standard: Observation in Dr. Soetomo General Hospital Surabaya from January 2016 to July 2020

Introduction: CT angiography (CTA) is the initial modality for diagnosing theCarotid Cavernous Fistula (CCF), identifying the type of CCF, measuring thediameter of the fistula and the diameter of the internal carotid artery (ICA) pre andpost fistula, and then confirmed by Digital Subtraction Angiography (DSA) as thegold standard. CTA is expected to provide more information to improve theaccuracy of CCF diagnosis to benefit therapy and prevent complications. Thisstudy aimed to determine the diagnostic value of CTA in CCF patients in Dr.Soetomo General Hospital Surabaya, using the DSA as a gold standard. Methods:An observational retrospective study of CCF patients met the inclusion andexclusion criteria and underwent CTA and DSA examinations at the RadiologyInstallation of Dr. Soetomo General Hospital, Surabaya, from January 2016 toJuly 2020. Results: In the comparison of types of CCF CTA to DSA, the directgroup was 53.8% and 57.7%, respectively, while the indirect group was 46.1% and42.3% with a very strong correlation (κ = 0.922; p = 0.000), sensitivity was 93.3%,specificity was 100 %, PPV of 100%, NPV of 91.7% and accuracy of 96.15%. Directtype evaluation on the DSA showed a large picture of the fistula diameter; the ICApre fistula's size was enlarged; therefore, the ICA post fistula diameter wasreduced or absent. There was a strong correlation of fistula diametermeasurement results between CTA and DSA (r = 0.695, p = 0.006).Conclusion: CTA has a similarity rate of 92.2% with DSA in identifying the typeof CCF. The accuracy value of CTA is close to DSA in fistula diametermeasurements.

The Diagnostic Value of CT Angiography in the Diagnosis of Residual Aneurysm After Brain Aneurysm Surgery

Background: The existence of residual aneurysm after intracranial aneurysm clipping bears the risk of re-bleeding, which worsens with the passage of time. Digital subtraction angiography (DSA) is accepted as the gold standard for evaluation of residual aneurysm, but it is invasive, costly, and serious complications are possible. Objectives: The aim of this study was to compare DSA to 64-slice CT angiography for assessing residual aneurysm. Patients and Methods: Forty patients with 43 clipped aneurysms from which 36 were torn, were evaluated by DSA after improvement in clinical status, and after a month they were evaluated by 64-slice CT angiography. The pictures were assessed by two neuroradiologists separately, in terms of quality, artifact due to the clips, and the completion of aneurysm closing. Results: In multislice computed tomographic angiography (MSCT) analysis, 36 pictures (90) had good quality and four pictures (10) had poor quality. In case of good quality pictures in MSCT and angiography, the 2- and 3-millimeter residual aneurysms were approved for two patients based on which, sensitivity, feature and positive/negative predictive value for diagnosis of residual aneurysm was 100 for good-quality pictures by MSCT. The level of agreement between the two neuroradiologists was 1 for diagnosing residual aneurysm and 0.86 for vasospasm. The average time for doing MSCT was 12 minutes compared to 45 minutes for DSA angiography, which was cost effective. Conclusion: CT angiography is a less invasive method with high sensitivity and capabilities for diagnosing residual aneurysm. It is cheaper, quicker and can be accomplished for critical patients. Therefore, it can be taken as the first choice and a replacement for DSA in post-surgery evaluation of patients with clipped brain aneurysm. © 2018, Iranian Journal of Radiology.

The comparative study of CT angiography with DSA in vertebral artery dissection

Objective To explore the diagnostic value of CT angiography (CTA) of vertebral artery dissection (VAD) value. Methods We retrospectively analysed vertebral artery dissection in 30 patients (32 branches) according to the results of DSA. Tow radiologists independently analyzed the CTA images, and the sensitivity, specificity and accuracy of CTA in VAD patients were determined. The consistency of DSA and CTA results were evaluated by Kappa test. Results Thirty two branches of 60 vertebral arteries were diagnosed as VAD by DSA, 31 branches were diagnosed as VAD by CTA, 1 branch was misdiagnosis. Eight branches with dissection aneurysm were all displayed by CTA and DSA. Eleven branches of 12 branches withstring of beads signwere diagnosed by CTA. Five branches of 6 branches withstring and pearl signwere diagnosed by CTA;CTA and DSA of 1 branch withdouble-lumen signwere all displayed. Six branches of 5 branch withlinear signwere diagnosed by CTA. One branch showedlinear sign, but was diagnosed thrombosis by CTA. Two branches were showedlinear sign, but were diagnosedstring of beads signandstring and pearl sign. The sensitivity, specificity, accuracy of CT angiography in diagnosing VA dissection were 96.8% (31/32) , 100% (28/28) , 98.3% (59/60) , respectively. The results made good agreement with DSA(Kappa=0.967, P<0.01). Conclusion Dual source CTA was a sensitive and accurate technique for the diagnosis of VAD. Key words: Vertebral artery dissection; Tomography, X-ray computed; Angiography

Diagnosis of lower gastrointestinal bleeding by multi-slice CT angiography: A meta-analysis

PurposeTo estimate the diagnostic value of multi-slice spiral CT angiography (CTA) in lower gastrointestinal bleeding by a meta-analysis. MethodsThe relevant clinical studies on the diagnostic value of CTA were searched on PubMed, Embase and other electronic documents databases with the deadline of 2016 September. Language was limited to English. A diagnostic meta-analysis was performed by using Meta-DiSc software. The effect sizes included sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) and 95% confidence interval (CI). The Cochran-Q test and I2 statistic based on χ2 test were used for estimation of the heterogeneity. Meta-regression was performed to explore the source of heterogeneity. SROC curve was established. ResultsA total of 14 articles including 549 patients with lower gastrointestinal bleeding were enrolled in the meta-analysis. The combined PLR, NLR and DOR were respectively 8.149, 0.158 and 56.213. There were significant heterogeneities in all estimations but we could not find the sources by meta-regression based on study design, study location, CT slices and sample size. The AUC and Q index under the fixed effect model was respectively 0.9463 and 0.8856. ConclusionsThe multi-slice CTA has high diagnostic value for lower gastrointestinal bleeding.

The diagnostic value of CT angiography on diabetic lower extremity vascular disease

Objective To investigate the value of vascular disease of lower extremity of 64 slice spiral CT angiography in patients with diabetic foot. Methods 48 patients with diabetic lower limb underwent arterial CT angiography, Using CT a variety of post- processing techniques and compared with the original image. Results 48 patients were successfully obtained CTA image,41 patients had peripheral artery disease,40 cases were bilateral,39 cases of unilateral or bilateral had severe stenosis or occlusion;25 cases had obvious collateral circulation. Lower extremity arterial segments CTA and DSA showed good agreement(Kappa Value= 0.887). Positive predictive rate was 92.5%,the negative predictive value was 98.6%.After delayed scanning, CTA on the foot artery count developing increased, checked with the DSA consistency. Conclusion 64 slice spiral CTA can accurately and comprehensive assessment of lower extremity arterial disease of diabetic foot. Diabetic lower limb vascular lesions can be used as the preferred method of examination. Key words: Diabetic foot; Tomography, spiral computed; Angiography, digital subtraction; Lower extremity

Diagnostic value of CTA in acute occlusion of coronary arterys

Objective To review the diagnostic value of CT angiography (CTA) (64-layer spiral CT) in coronary artery diseases in the recovery period of acute myocardial infarction (AMI) patients.Methods Coronary angiography (CAG) was taken as the gold standard,CTA and CAG were compared in 126 cases of recover-term AMI patients who underwent emergency PCI,to evaluate the value of CTA in the diagnosis of AMI lesions and distal vascular lesions.Results The sensitivity of CTA to recanalization in AMI lesions was 86.89％,specificity was 93.85％,positive predictive value was 92.98％ and negative predictive value was 88.41％.It was the most valuable diagnostic capabilities of the left anterior descending branch.In spite of the infarct-related artery reperfusion or nonreperfusion,the diagnostic value of CTA in distal vascular lesions were consistent with CAG(r=0.8123,P ＜ 0.01).Conclusion CTA can accurately diagnose coronary artery recanalization in AMI,and provide a primary diagnosis for the infarct-related lesion beyond related vessels. Key words: CTA; Coronary arterys; Diagnosis

The diagnostic value of CT angiography in iliac vein compression syndrome and secondary thrombosis

Objective To assess the value of multi-slice spiral CTA in the diagnosis of iliac vein compression syndrome(IVCS)and secondary thrombosis.Methods The CTA data of 80 controls and 31 patients with IVCS conformed by DSA were retrospectively studied.The inner diameters of the compressed iliac vein in two groups were measured and compression ratios were calculated.The data were compared using t test and Wilcoxon test.The findings of CTA were compared with that of DSA and the accuracy of CTA was analyzed.Results For the control group,the inner diameters of left iliac vein in female group(7.0±2.5)mm were significantly less than that in male group(8.1±2.5)mm(t=2.42,P＜0.05).For the control group,the inner diameters of left iliac vein was(7.6±2.0)mm,and the compression ratios were 0 to 65.41%(median 27.65%).The compression ratios were no statistical differences between male group(0 to 61.36%,median 26.82%)and female group(0 to 65.41%,median 28.75%)(Z=-0.59,P＞0.05).For the patients group,the inner diameters of compression iliac vein was(2.7±1.1)mm.The compression ratios were 55.18% to 100%(median 76.12%).Both inner diameters and compression ratios were statistically different between the control and patients group(t=12.78,P＜0.05;Z=-8.18,P＜0.05).Fifteen of 31 cases with IVCS were accompanied with deep vein thrombosis.The left iliac veins were compress in 28 cases,while right iliac veins were compressed in 2 cases.The left and right iliac common veins were compressed by the left and right jliac common arteries in one case.The results of CTA were consistent with that of DSA in all cases.Conclusions CTA can not only measure the inner diameters of iliae vein compression and calculate compression ratios,but also demonstrate secondary thrombosis clearly.CTA is an effective examination in diagnosis of IVCS and secondary thrombosis. Key words: Tomography,X-ray computed; Angiography; Iliac vein; Vein thrombosis

Comparing the diagnostic value of CT angiography and MR angiography in intracranial aneurysms

目的 采用Meta分析法比较CT血管成像(computer tomography angiography ,CTA)和MR血管成像(magnetic resonance angiography, MRA)对颅内动脉瘤的诊断价值.方法 检索Cochrane 图书馆、Medline、Ovid数据库和中国期刊网中有关的中英文文献,按照Cochran协作网推荐的诊断试验纳入标准选取A级文献,并提取纳入研究的诊断信息.统计分析采用Meta-Test version 0.9软件,检验异质性,再根据异质性结果选择相应的效应模型.对所纳入的研究予以加权定量合并,计算汇总敏感度和特异度及其95%可信区间,绘制汇总受试者工作特征曲线(SROC).结果 按照纳入标准共获取文献11篇,其中有关CTA诊断颅内动脉瘤4篇(单层螺旋CT),MRA为5篇[三维时间飞跃法(3D TOF)],二者共同研究者2篇;前瞻性研究 7篇,回顾性4篇;各组研究均存在异质性,按照随机效应模型对纳入文献行汇总分析.结果显示,对于每个颅内动脉瘤CTA诊断的敏感度、特异度及95%可信区间分别为0.84(0.78～0.88) 和0.77(0.68～0.84),MRA分别为0.68(0.63～0.72)和 0.76(0.70～0.82);SROC曲线下面积分别为95.40%和79.71% .结论 对于每个颅内动脉瘤,CTA诊断的准确性明显高于3D TOF法 MRA。

DIAGNOSIS OF INVASIVE PULMONARY ASPERGILLOSIS WITH MULTISLICE CT-ANGIOGRAPHY

PURPOSE: Invasive pulmonary aspergillosis (IPA) is a frequent infectious complication in neutropenic patients which is associated with a high mortality. IPA is suspected if antibiotic resistant-fever and infiltrates develop in neutropenic patients. The diagnostic yield of bronchoscopy with BAL for IPA is only 30% due to the fact that aspergillus is usually found intravascular. Typical signs on CT scan include the halo sign and consolidations with central necrosis. This study was undertaken to analyze the diagnostic value of CT angiography and to define whether signs of angio-invasiveness are more specific than other CT-signs for IPA.

Budd-Chiari syndrome with occlusion of hepatic vein: multi-slice spiral CT diagnosis and its clinical significance in the treatment

To evaluate the multi-slice spiral CT dynamic enhancement features and the diagnostic value of CT angiography in Budd-Chiari syndrome with occlusion of hepatic vein (HVBCS), and to assess the CT clinical significance in the treatment of HVBCS. Twenty-one patients with HVBCS confirmed by digital subtraction angiography (DSA) were retrospectively analyzed. All patients received multi-slice spiral dynamic enhancement scans within 2 weeks before DSA. The relevant vein vessels were reconstructed respectively with Maximum Intensity Projection (MIP), Volume Rendering (VR) and Oblique Reformat techniques. The course of disease was less than three months in four patients, more than three months in seventeen patients. In the four patients with the course of disease of less than three months, CT showed global liver enlargement with diffuse hypodensity on plain scans and patchy enhancement in caudate lobe and perihilar areas on post-contrast CT scans, and the enhancement field spread to larger area as the time of scans delayed. In the seventeen patients with the course of disease of more than three months, plain CT scans showed abnormalities of liver morphology and hypodensity either in atrophic areas or in the periphery of the liver. On post-contrast CT scans, the hypodensity areas showed poor and heterogeneous enhancement, and hepatic drainage veins in these areas obstructed, whereas in hepatic veins drainage normal areas hepatic parenchymal showed homogeneous enhancement, their drainage veins had at least one patent hepatic vein or a dilated accessory hepatic vein that can provide adequate collaterals. Hepatic CT enhancement features were closely related to the occlusion location of hepatic vein and collateral drainage veins. In twenty-one patients, a total of 42 hepatic veins were occluded. Among them, 9 left hepatic veins, 12 middle hepatic veins, 16 right hepatic veins, and 6 accessory hepatic veins were occluded. The accuracy rate of hepatic veins occlusion showed on transverse scans and CT angiography were 61.9% and 100% respectively. Multi-slice spiral dynamic enhancement scans can accurately reflect the changes of intrahepatic hymodynamics. Transverse scans combined with CT angiography can explicitly show the location of hepatic veins occlusion and collateral circulation in HVBCS, which is of important clinical significance in the treatment of HVBCS.