{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,11]],"date-time":"2024-08-11T00:27:36Z","timestamp":1723336056613},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,8,10]],"date-time":"2024-08-10T00:00:00Z","timestamp":1723248000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,10]],"date-time":"2024-08-10T00:00:00Z","timestamp":1723248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004063","name":"Knut and Alice Wallenberg Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004063","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Region V\u00e4sterbotten"},{"name":"V\u00e4strag\u00f6talandsregionen"},{"name":"The Swedish Heart-Lung Foundation"},{"name":"The Swedish Stroke foundation"},{"name":"Jeansson Foundation"},{"DOI":"10.13039\/501100007308","name":"Swedish Medical Association","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007308","id-type":"DOI","asserted-by":"crossref"}]},{"name":"The research foundation for neurological research at the University Hospital of Northern Sweden"},{"name":"The research foundation for medical research at Ume\u00e5 University"},{"DOI":"10.13039\/501100005760","name":"University of Gothenburg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005760","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The hypothesis of this study was that evaluation of radiodensity assessment beyond a carotid stenosis in arterial and\/or venous phase can be used to separate near-occlusion and conventional\u2009\u2265\u200950% stenosis. We prospectively included participants with\u2009\u2265\u200950% carotid stenosis with inclusion preference for cases with extracranial internal carotid artery (ICA) asymmetry. All participants were examined with a research biphasic computed tomography angiography (CTA) protocol (arterial and venous phase). Reference diagnosis was set by interpretation on CTA and radiodensity difference between ipsilateral and contralateral ICA (c-corrected) or vertebral (v-corrected) was compared. We included 93 participants, 62 with near-occlusion and 31 with conventional\u2009\u2265\u200950% stenosis. Just beyond the stenosis, median c-corrected radiodensity was \u2212\u200920 Hounsfield units (HU) among near-occlusions and \u2212\u20091 HU among conventional\u2009\u2265\u200950% stenoses (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) in the arterial phase. For the venous phase, these findings were\u2009+\u200917 HU and\u2009+\u20093 HU (<jats:italic>p<\/jats:italic>\u2009=\u20090.007). Similar group differences were seen for v-correction. No parameter had good diagnostic performance, area under the curve\u2009\u2264\u20090.82. With specificity set at\u2009\u2265\u200995%, detected near-occlusions were foremost those with large side-to-side differences in distal ICA-diameter. Carotid near-occlusions can have reduced radiodensity beyond the stenosis in arterial phases and increased radiodensity in venous phases compared to a reference artery\u2014which was not clearly seen for conventional stenoses. However, these radiodensity findings are best seen in near-occlusion cases that are not diagnostically challenging, while they work poorly as additional diagnostic aids.<\/jats:p>","DOI":"10.1038\/s41598-024-68732-w","type":"journal-article","created":{"date-parts":[[2024,8,10]],"date-time":"2024-08-10T19:02:04Z","timestamp":1723316524000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessments of arterial and venous phase radiodensity does not improve carotid near-occlusion diagnostics"],"prefix":"10.1038","volume":"14","author":[{"given":"Karolina","family":"Brunnander","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Henze","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allan J.","family":"Fox","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elias","family":"Johansson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,8,10]]},"reference":[{"key":"68732_CR1","first-page":"2086","volume":"26","author":"AJ Fox","year":"2005","unstructured":"Fox, A. 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EJVES 65, 7\u2013111 (2023).","journal-title":"EJVES"},{"key":"68732_CR4","doi-asserted-by":"publisher","first-page":"1709","DOI":"10.1007\/s00234-022-03007-7","volume":"64","author":"E Johansson","year":"2022","unstructured":"Johansson, E. et al. Diagnosing carotid near-occlusion is a difficult task\u2014but it might get easier. Neuroradiology. 64, 1709\u20131714 (2022).","journal-title":"Neuroradiology."},{"key":"68732_CR5","first-page":"1","volume":"6","author":"LH Bonati","year":"2022","unstructured":"Bonati, L. H. et al. European Stroke Organisation guideline on endarterectomy and stenting for carotid artery stenosis. Eur. Stroke J. 6, 1\u201347 (2022).","journal-title":"Eur. Stroke J."},{"key":"68732_CR6","doi-asserted-by":"publisher","first-page":"2543","DOI":"10.1007\/s00330-019-06636-4","volume":"30","author":"E Johansson","year":"2020","unstructured":"Johansson, E. et al. Carotid near-occlusion is often overlooked when CT angiography is assessed in routine practice. Eur. Radiol. 30, 2543\u20132551 (2020).","journal-title":"Eur. Radiol."},{"key":"68732_CR7","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1007\/s00234-021-02687-x","volume":"63","author":"E Johansson","year":"2021","unstructured":"Johansson, E. et al. Near-occlusion is difficult to diagnose with common carotid ultrasound methods. Neuroradiology 63, 721\u2013730 (2021).","journal-title":"Neuroradiology"},{"key":"68732_CR8","doi-asserted-by":"publisher","first-page":"1729","DOI":"10.1007\/s00234-022-02995-w","volume":"64","author":"MM Manrique-Zegarra","year":"2022","unstructured":"Manrique-Zegarra, M. M. et al. CT-Angiography for diagnosis of carotid near-occlusion. A digital subtraction angiography validation study. Neuroradiology 64, 1729\u20131735 (2022).","journal-title":"Neuroradiology"},{"key":"68732_CR9","doi-asserted-by":"publisher","first-page":"927","DOI":"10.3174\/ajnr.A7076","volume":"42","author":"E Johansson","year":"2021","unstructured":"Johansson, E. et al. 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