Perspective study on the use of spiral CT in evaluation of carotid stenosis of patients submitted to endo-arteriectomy

Aim. For the preoperative detection of atherosclerotic lesions of carotid arteries echo color-Doppler (ECD) is an established operator-dependent method, whereas angiography is associated with a not-insignificant level of complications; spiral CT is a promising diagnostic tool that allows noninvasive, operator-independent evaluation of extracranial cerebral arteries. The aim of our study was to evaluate spiral CT reliability by comparing the degree of carotid artery stenosis measured with preoperative ECD and spiral CT with an intraoperative measurement of catorid stenosis percentage. Methods. We studied 50 patients due to undergo carotid endoarteriectomy with preoperative ECD and spiral CT and with intraoperative measurement of carotid stenosis; as regards spiral CT, measurements are carried out using the ECST method. Results. We considered correlations among ECD, spiral CT and intraoperative measurements using the Pearson Correlation Test: correlation ratios between Spiral CT and intraoperative measurement (R=0.3768; p=0.007) and between ECD and intraoperative measurement (R=0.2897, p=0.041) both proved statistically significant. Correlation between spiral CT and ECG also proved considerably significant with an high R value (R=0.7962, p=0.001), revealing a substantial data concordance between these 2 instrumental exams. We also studied spiral CT and ECD diagnostic specificity (93% and 95%) and sensibility (58% and 44%) and Youden's Index values (0.51 and 0.39). Conclusion. Spiral CT is extremely reliable in the preoperative evaluation of carotid stenosis percentage, reaching the same ECD accuracy level. Spiral Ct is operator-non-dependent and produces images which are extremely similar to angiography ones, quite useful, therefore, in case of surgery, with no complications.