ABSTRACT
PURPOSE: To determine whether computed tomographic (CT) angiography with the volume-rendering technique (VRT) can be used to accurately quantify carotid arterial stenosis and to identify occlusions. MATERIALS AND METHODS: Spiral CT was performed in 23 patients who were referred for carotid stenosis evaluation. VRT images and shaded-surface display (SSD) images of 46 carotid arterial bifurcations were compared with findings from digital subtraction angiography (DSA). RESULTS: Agreement on stenosis category between VRT CT angiography and DSA was found in 39 (85%) of the 46 carotid arteries studied. VRT CT angiography was 92% (49 of 53) sensitive and 96% (82 of 85) specific for the detection of grade 2-3 stenoses (> or = 70% stenosis). Agreement on stenosis category between SSD CT angiography and DSA was found in 38 (83%) of the 46 carotid arteries studied. SSD CT angiography was 91% (48 of 53) sensitive and 93% (79 of 85) specific for the detection of grade 2-3 stenoses. Calcified stenoses were correctly graded at VRT CT angiography in 10 of the 10 cases with heavy mural calcified plaques, while eight of the 10 stenoses were accurately quantified at SSD CT angiography. CONCLUSION: These results indicate that VRT CT angiography is as accurate as SSD CT angiography in the evaluation of carotid arterial bifurcations.
Subject(s)
Carotid Arteries/diagnostic imaging , Carotid Stenosis/diagnostic imaging , Tomography, X-Ray Computed/methods , Aged , Aged, 80 and over , Angiography, Digital Subtraction , Female , Humans , Image Processing, Computer-Assisted , Male , Middle Aged , Observer Variation , Sensitivity and SpecificitySubject(s)
Abdominal Injuries/complications , Aneurysm, False/etiology , Aortic Aneurysm, Abdominal/etiology , Wounds, Gunshot/complications , Adult , Aneurysm, False/diagnostic imaging , Aortic Aneurysm, Abdominal/diagnostic imaging , Humans , Male , Tomography, X-Ray Computed , Ultrasonography, Doppler, ColorABSTRACT
Distinguishing between osteomyelitis and neuropathic osteoarthropathy of the foot frequently presents a clinical and radiologic challenge in patients with diabetes. Magnetic resonance (MR) imaging was performed in 26 diabetic patients to observe changes in signal intensity in the complicated diabetic foot. In every patient with osteomyelitis (n = 13), signal intensity abnormalities were seen within the bone marrow (low signal intensity on T1-weighted images and high signal intensity on T2-weighted images in 12 cases). Most of these patients had cortical lesions (n = 9) or associated soft-tissue infection (n = 12). Normal bone marrow signal intensity was observed in three of the four patients without osteomyelitis. Characteristic MR imaging findings (decreased signal intensity in bone marrow regardless of pulse sequence) were seen in patients with chronic neuropathic osteoarthropathy (n = 7), who were easily distinguished from patients with osteomyelitis. Conversely, in patients with acutely evolving neuropathic osteoarthropathy (n = 2), signal intensity changes within the bone marrow were similar to those observed in osteomyelitis, leading to potential diagnostic pitfalls. Familiarity with MR imaging findings observed in osteomyelitis and neuropathic osteoarthropathy can help identify these two entities, allowing early diagnosis and appropriate therapy.
