[X-ray diagnosis of intimal ruptures of the internal carotid artery. A pathologico-anatomic controlled study].

In a prospective study to determine the accuracy of intravenous DSA in the diagnosis of ulcerative lesions of the internal carotid artery, preoperative findings obtained from DSA in patients with suspected cerebrovascular disease were reviewed and compared with thrombendarterectomy specimen (n = 74). The radiological parameters employed for the assessment of ulcerations were excavations of the vascular contour, ill defined vessel walls and steep plaque surfaces. Overall sensitivity of DSA was 66%, specificity 52%. The depth of excavations proved to be the most accurate sign in detecting ulcerative lesions (sensitivity 83%). However, in rare cases mural recesses with the angiographic appearance of ulceration corresponded to re-endothelialized cavities. Small intimal disruptions with a depth of 0.1 to 1 mm. could not be detected by intravenous DSA.