Abstract：
OBJECTIVE: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: Our research suggests that mCTA is more accurate than sCTA in distinguishing isolated intracranial occlusions from extracranial or tandem occlusions.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: Our research suggests that mCTA is more accurate than sCTA in distinguishing isolated intracranial occlusions from extracranial or tandem occlusions.
摘要：
目的：准确区分急性颈内动脉（ICA）闭塞的颅内和颅外位置对于指导治疗决策和机械取栓计划至关重要。在评估急性ICA闭塞方面，多相计算机断层扫描血管造影（mCTA）似乎优于单相计算机断层扫描血管造影（sCTA）。我们研究的主要目的是研究mCTA与sCTA相比在区分孤立的急性颅内ICA闭塞与颅外或串联闭塞方面的准确性。
方法：两名观察者在两个不同时间点独立分析了急性ICA闭塞患者的sCTA和mCTA。两种成像技术都将闭塞的位置分为颅内或颅外，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。Kappa统计数据用于评估观察员之间的协议。
结果: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%),两个观察者之间几乎完美的观察者间协议(p<0.001)。
结论：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。
方法：两名观察者在两个不同时间点独立分析了急性ICA闭塞患者的sCTA和mCTA。两种成像技术都将闭塞的位置分为颅内或颅外，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。Kappa统计数据用于评估观察员之间的协议。
结果: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%),两个观察者之间几乎完美的观察者间协议(p<0.001)。
结论：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。
