Skip to main content
Top
Published in: Neuroradiology 9/2014

01-09-2014 | Diagnostic Neuroradiology

The normal internal carotid artery: a computed tomography angiographic study

Authors: Suvi Maaria Koskinen, Lauri Soinne, Leena Valanne, Heli Silvennoinen

Published in: Neuroradiology | Issue 9/2014

Login to get access

Abstract

Introduction

Systematic computed tomography angiographic (CTA) studies investigating variation in internal carotid artery (ICA) luminal diameters (LDs) are scarce. Knowledge of the normal intra-individual LD variability would provide a cut-off value for detection of more subtle collapses. In addition, low intra-individual variability would allow using contralateral LD as a reference for estimation of stenosis degree in cases where ipsilateral measurement is hampered. Therefore, our aim was to investigate intra-individual LD variation of normal ICA.

Methods

We retrospectively collected multidetector high-speed CTAs of 104 patients younger than 40 years who were considered not to have carotid pathology. We carried out independent measurements of the common carotid artery (CCA) and ICA LDs bilaterally from axial source images by two observers, analysing side-to-side LD differences from averaged double measurements with a paired t test.

Results

We discovered no significant side-to-side LD differences. In the female group, the mean differences (mm) with 95 % confidence intervals were 0.08 (0.00, 0.17) for CCA and 0.03 (−0.04, 0.11) for ICA, with ICA LD standard deviation of 0.4 mm. In the male group, these were: 0.06 (−0.04, 0.17), 0.02 (-0.07, 0.11) and 0.4 mm, respectively. We detected no ICA agenesis.

Conclusion

The intrinsic intra-individual variation of the LD of normal ICA is minimal. This uniformity may serve as the basis for detection of subtle grades of side-to-side variation caused by pathology.
Literature
1.
go back to reference North American Symptomatic Carotid Endarterectomy Trial Collaborators (1991) Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med 325:445–453CrossRef North American Symptomatic Carotid Endarterectomy Trial Collaborators (1991) Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med 325:445–453CrossRef
2.
go back to reference North American Symptomatic Carotid Endarterectomy Trial (1991) Methods, patient characteristics, and progress. Stroke 22:711–720CrossRef North American Symptomatic Carotid Endarterectomy Trial (1991) Methods, patient characteristics, and progress. Stroke 22:711–720CrossRef
3.
go back to reference Osborne A (ed) (2012) Diagnostic imaging: brain. Amirsys, Altona Osborne A (ed) (2012) Diagnostic imaging: brain. Amirsys, Altona
4.
go back to reference Wakhloo AK, Lieber BB, Seong J, Sadasivan C, Gounis MJ, Miskolczi L, Sandhu JS (2004) Hemodynamics of carotid artery atherosclerotic occlusive disease. J Vasc Interv Radiol 15:S111–S121PubMedCrossRef Wakhloo AK, Lieber BB, Seong J, Sadasivan C, Gounis MJ, Miskolczi L, Sandhu JS (2004) Hemodynamics of carotid artery atherosclerotic occlusive disease. J Vasc Interv Radiol 15:S111–S121PubMedCrossRef
5.
go back to reference Fox AJ, Eliasziw M, Rothwell PM, Schmidt MH, Warlow CP, Barnett HJ (2005) Identification, prognosis, and management of patients with carotid artery near occlusion. AJNR Am J Neuroradiol 26:2086–2094PubMed Fox AJ, Eliasziw M, Rothwell PM, Schmidt MH, Warlow CP, Barnett HJ (2005) Identification, prognosis, and management of patients with carotid artery near occlusion. AJNR Am J Neuroradiol 26:2086–2094PubMed
6.
go back to reference Bartlett ES, Walters TD, Symons SP, Fox AJ (2006) Diagnosing carotid stenosis near-occlusion by using CT angiography. AJNR Am J Neuroradiol 27:632–637PubMed Bartlett ES, Walters TD, Symons SP, Fox AJ (2006) Diagnosing carotid stenosis near-occlusion by using CT angiography. AJNR Am J Neuroradiol 27:632–637PubMed
7.
go back to reference Bartlett ES, Walters TD, Symons SP, Fox AJ (2007) Carotid stenosis index revisited with direct CT angiography measurement of carotid arteries to quantify carotid stenosis. Stroke 38:286–291PubMedCrossRef Bartlett ES, Walters TD, Symons SP, Fox AJ (2007) Carotid stenosis index revisited with direct CT angiography measurement of carotid arteries to quantify carotid stenosis. Stroke 38:286–291PubMedCrossRef
8.
go back to reference Stary HC, Chandler AB, Dinsmore RE, Fuster V, Glagov S, Insull W Jr, Rosenfeld ME, Schwartz CJ, Wagner WD, Wissler RW (1995) A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Arterioscler Thromb Vasc Biol 15:1512–1531PubMedCrossRef Stary HC, Chandler AB, Dinsmore RE, Fuster V, Glagov S, Insull W Jr, Rosenfeld ME, Schwartz CJ, Wagner WD, Wissler RW (1995) A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Arterioscler Thromb Vasc Biol 15:1512–1531PubMedCrossRef
9.
go back to reference Juonala M, Kahonen M, Laitinen T, Hutri-Kahonen N, Jokinen E, Taittonen L, Pietikainen M, Helenius H, Viikari JS, Raitakari OT (2008) Effect of age and sex on carotid intima-media thickness, elasticity and brachial endothelial function in healthy adults: the cardiovascular risk in Young Finns Study. Eur Heart J 29:1198–1206PubMedCrossRef Juonala M, Kahonen M, Laitinen T, Hutri-Kahonen N, Jokinen E, Taittonen L, Pietikainen M, Helenius H, Viikari JS, Raitakari OT (2008) Effect of age and sex on carotid intima-media thickness, elasticity and brachial endothelial function in healthy adults: the cardiovascular risk in Young Finns Study. Eur Heart J 29:1198–1206PubMedCrossRef
10.
go back to reference Silvennoinen HM, Ikonen S, Soinne L, Railo M, Valanne L (2007) CT angiographic analysis of carotid artery stenosis: comparison of manual assessment, semiautomatic vessel analysis, and digital subtraction angiography. AJNR Am J Neuroradiol 28:97–103PubMedCrossRef Silvennoinen HM, Ikonen S, Soinne L, Railo M, Valanne L (2007) CT angiographic analysis of carotid artery stenosis: comparison of manual assessment, semiautomatic vessel analysis, and digital subtraction angiography. AJNR Am J Neuroradiol 28:97–103PubMedCrossRef
12.
go back to reference Ozdemir H, Artas H, Serhatlioglu S, Ogur E (2006) Effects of overweight on luminal diameter, flow velocity and intima-media thickness of carotid arteries. Diagn Interv Radiol 12:142–146PubMed Ozdemir H, Artas H, Serhatlioglu S, Ogur E (2006) Effects of overweight on luminal diameter, flow velocity and intima-media thickness of carotid arteries. Diagn Interv Radiol 12:142–146PubMed
13.
go back to reference Makowicz G, Poniatowska R, Lusawa M (2013) Variants of cerebral arteries–anterior circulation. Pol J Radiol 78:42–47PubMedCentralPubMed Makowicz G, Poniatowska R, Lusawa M (2013) Variants of cerebral arteries–anterior circulation. Pol J Radiol 78:42–47PubMedCentralPubMed
14.
go back to reference Nicoletti G, Sanguigni S, Bruno F, Tardi S, Malferrari G (2009) Hypoplasia of the internal carotid artery: collateral circulation and ultrasonographic findings. A case report. J Ultrasound 12:41–44PubMedCentralPubMedCrossRef Nicoletti G, Sanguigni S, Bruno F, Tardi S, Malferrari G (2009) Hypoplasia of the internal carotid artery: collateral circulation and ultrasonographic findings. A case report. J Ultrasound 12:41–44PubMedCentralPubMedCrossRef
15.
go back to reference Tasar M, Yetiser S, Tasar A, Ugurel S, Gonul E, Saglam M (2004) Congenital absence or hypoplasia of the carotid artery: radioclinical issues. Am J Otolaryngol 25:339–349PubMedCrossRef Tasar M, Yetiser S, Tasar A, Ugurel S, Gonul E, Saglam M (2004) Congenital absence or hypoplasia of the carotid artery: radioclinical issues. Am J Otolaryngol 25:339–349PubMedCrossRef
16.
go back to reference Chen CJ, Chen ST, Hsieh FY, Wang LJ, Wong YC (1998) Hypoplasia of the internal carotid artery with intercavernous anastomosis. Neuroradiology 40:252–254PubMedCrossRef Chen CJ, Chen ST, Hsieh FY, Wang LJ, Wong YC (1998) Hypoplasia of the internal carotid artery with intercavernous anastomosis. Neuroradiology 40:252–254PubMedCrossRef
17.
go back to reference Dimmick SJ, Faulder KC (2009) Normal variants of the cerebral circulation at multidetector CT angiography. Radiographics 29:1027–1043PubMedCrossRef Dimmick SJ, Faulder KC (2009) Normal variants of the cerebral circulation at multidetector CT angiography. Radiographics 29:1027–1043PubMedCrossRef
18.
go back to reference Pilleul F, Guibaud L, Badinand N, Rouviere O, Pracros JP (2001) Bilateral internal carotid agenesis: value of CT angiography and correlation to embryogenesis. Eur Radiol 11:858–860PubMedCrossRef Pilleul F, Guibaud L, Badinand N, Rouviere O, Pracros JP (2001) Bilateral internal carotid agenesis: value of CT angiography and correlation to embryogenesis. Eur Radiol 11:858–860PubMedCrossRef
19.
go back to reference Bartlett ES, Walters TD, Symons SP, Fox AJ (2006) Quantification of carotid stenosis on CT angiography. AJNR Am J Neuroradiol 27:13–19PubMed Bartlett ES, Walters TD, Symons SP, Fox AJ (2006) Quantification of carotid stenosis on CT angiography. AJNR Am J Neuroradiol 27:13–19PubMed
20.
go back to reference Markert MS, Della-Morte D, Cabral D, Roberts EL Jr, Gardener H, Dong C, Wright CB, Elkind MS, Sacco RL, Rundek T (2011) Ethnic differences in carotid artery diameter and stiffness: the Northern Manhattan Study. Atherosclerosis 219:827–832PubMedCentralPubMedCrossRef Markert MS, Della-Morte D, Cabral D, Roberts EL Jr, Gardener H, Dong C, Wright CB, Elkind MS, Sacco RL, Rundek T (2011) Ethnic differences in carotid artery diameter and stiffness: the Northern Manhattan Study. Atherosclerosis 219:827–832PubMedCentralPubMedCrossRef
21.
go back to reference Ruan L, Chen W, Srinivasan SR, Sun M, Wang H, Toprak A, Berenson GS (2009) Correlates of common carotid artery lumen diameter in black and white younger adults: the Bogalusa Heart Study. Stroke 40:702–707PubMedCrossRef Ruan L, Chen W, Srinivasan SR, Sun M, Wang H, Toprak A, Berenson GS (2009) Correlates of common carotid artery lumen diameter in black and white younger adults: the Bogalusa Heart Study. Stroke 40:702–707PubMedCrossRef
22.
go back to reference Krejza J, Arkuszewski M, Kasner SE, Weigele J, Ustymowicz A, Hurst RW, Cucchiara BL, Messe SR (2006) Carotid artery diameter in men and women and the relation to body and neck size. Stroke 37:1103–1105PubMedCrossRef Krejza J, Arkuszewski M, Kasner SE, Weigele J, Ustymowicz A, Hurst RW, Cucchiara BL, Messe SR (2006) Carotid artery diameter in men and women and the relation to body and neck size. Stroke 37:1103–1105PubMedCrossRef
Metadata
Title
The normal internal carotid artery: a computed tomography angiographic study
Authors
Suvi Maaria Koskinen
Lauri Soinne
Leena Valanne
Heli Silvennoinen
Publication date
01-09-2014
Publisher
Springer Berlin Heidelberg
Published in
Neuroradiology / Issue 9/2014
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-014-1394-3

Other articles of this Issue 9/2014

Neuroradiology 9/2014 Go to the issue