Diagnostic Performance of CTA and vessel wall MR imaging in Carotid webs—A Retrospective Study

Abstract Background: There currently is no consensus on the performance of Vessel wall MRI (VW MRI) with carotid webs (CaWs). No clear data exist on compare the performance of each diagnostic features in CaWs. Purpose: To set a standards about the diagnostic features and compare the performance of each diagnostic features in CaWs. Materials and methods : All patients (n = 165, median age, 56.9 ± 13.3) who has done both neck CTA and VW MRI in our radiology department, Zhongnan hospital, performed from February 2017 to April 2019 were included. All CTA and VW MRI images were read by two experienced radiologists. Interobserver agreement for the two reader’s decision of CTA was checked by using kappa statistics. Sensitivity, specificity, and area under the curve (AUC) of each diagnostic features at CTA and VW MRI were compared. Results: 10 patients with carotid web was found. The feature “double lumen sign” of CTA and “valve sign” and “contrast stasis” of VW MRI showed good specificity (specificity, 98.6% vs 92.9% vs 93.6%, respectively; P<0.001). The feature “double lumen sign” of VW MRI compared to it of CTA showed higher sensitivity (sensitivity, 80.0% [8 of 10] vs 50.0% [5 of 10], respectively; P<0.001) and better diagnostic performances (area under the curve [AUC], 0.93 [95% CI: 0.68, 0.97] and 0.74 [95% CI: 0.54, 0.94], respectively; P<0.001). Conclusion: The feature “double lumen sign” and “a line or septum” of CTA and “valve sign” and “contrast stasis” of VW MRI may be a crucial performance of carotid web.