Yüksel BALCI, Altan YILDIZ, Anıl ÖZGÜR, Arda YILMAZ, Engin KARA

Ekstrakraniyal Karotis ve Vertebral Arter Darlıklarında 64 Kesitli BT Anjiyografi ile DSA Bulgularının Karşılaştırılması

Amaç: Bu çalışmada ekstrakraniyal karotis ve vertebral arter VA darlıklarının tanısında 64 kesitli bilgisayarlı tomografik anjiyografinin BTA ’nin etkinliği araştırılmıştır. Hastalar ve Yöntem: Bu prospektif çalışmada merkezimize geçici iskemik atak, inme, hemipleji, baş dönmesi, hareket bozukluğu gibi sebeplerle refere edilen 45 hastaya ana karotid arter AKA , internal karotid arter İKA ve vertebral arterlere yönelik BTA incelemeleri yapıldı. İş istasyonunda gerek aksiyel kesitlerden gerekse de maksimum intensite projeksiyonu MİP ile elde edilen görüntüler üzerinden darlık ölçümleri yapıldı. Daha sonra tüm hastalara dijital substraksiyon anjiyografisi DSA yapıldı. Olguların karotid ve VA darlıklarının dereceleri NASCET North American Symptomatic Endarterectomy Trial kriterlerine göre belirlendi. BTA ile elde edilen sonuçlar DSA bulguları ile istatistiksel olarak karşılaştırıldı. Bulgular: BTA ile 42’si karotid 5 sol AKA, 18 sağ İKA, 19 sol İKA ve 41’i VA 18 sağ VA, 23 sol VA olmak üzere toplam 83 darlık saptandı. DSA ile bu olguların ikisi normal olarak değerlendirildi; 11’i evre 2, 24’ü evre 3, 14’ü evre 4, 15’i evre 5, ve 17’si evre 6 olmak üzere toplam 81 darlık tanısı kondu. DSA ile aksiyel-BTA sonuçları arasında %84, MİP-BTA sonuçları arasında ise %82 oranında uyum saptandı. Sonuç: 64 kesitli BTA, ekstrakraniyal karotis ve vertebral arter darlıklarının değerlendirilmesinde etkili bir alternatif görüntüleme yöntemidir.

Comparison of 64-Detector-Row Computed Tomography Angiography and Digital Substraction Angiography In The Diagnosis of Carotid and Vertebral Artery Stenosis

Purpose: In this study, our aim is to investigate the efficiency of 64-detectorrow computed tomography CT angiography in the diagnosis of carotid and vertebral artery stenosis. Patients and Methods: In this prospective study, we evaluated 45 patients who were referred to our department with suspected diagnoses such as transient ischemic attack, stroke, hemiplegia, vertigo using 64-detectorrow CT angiography. Measurements of the stenoses were carried out on axial and maximum intensity projection MIP images, respectively, on the workstation. Subsequently, all patients were evaluated with digital substraction angiography DSA . Grades of the stenoses of carotid and vertebral arteries were determined by using North American Symptomatic Endarterectomy Trial NASCET criteria. Results of the 64-detector-row CT angiography were statistically compared with the findings of DSA. Results: A total of 83 stenosis in 42 carotid arteries 5 left common carotid artery, 18 right internal carotid artery, 19 left internal carotid artery and 41 vertebral arteries 18 right vertebral artery, 23 left vertebral artery were found using CT angiography. At DSA; two of these stenosis were evaluated as normal and a total of 81 stenosis 11 grade 2, 24 grade 3, 14 grade 4, 15 grade 5 and 17 grade 6 were detected. Consistency ratio between DSA and axial CT images and between DSA and MIP CT images were 84 % and 82 %, respectively. Conclusion: 64-detector-row CT angiography is an effective alternative imaging technique in the evaluation of carotid and vertebral artery stenosis.

Keywords:

computed tomography angiography, digital substraction angiography, carotid stenosis, vertebral artery stenosis,

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