Artifacts and problems limiting artery evaluation

Type of ArtifactsDescriptionNo. of Cases (incidence) on 64-Section CTANo. of Cases (incidence) on 16-Section CTAP Value (Fisher exact test)
Patient motion artifactsGross motion during scan acquisition0 (0%)3 (2.7%).247
Streak artifacts of venous originDense undiluted contrast in SCV, BCV; SVC obscures great vessel origins32 (32%)29 (25.7%).363
Shoulder streak artifactsPhoton starvation between shoulders obscures CCA, VA, IJV in lower neck28 (28%)33 (29.2%).880
Metallic streak artifactsDental hardware, cardiac defibrillator leads, spinal fusion hardware obscure adjacent arteries26 (26%)32 (28.3%).759
Contrast material refluxContrast reflux into veins of neck obscures adjacent VA16 (16%)17 (15%).852
Flow artifacts:Altered flow dynamics (eg, slow flow) and rapid scanning time create appearance of dissection flap or nonopacification of patent vessel14a (14%)0 (0%)<.001
    Arterial
        Pseudo-dissection5
        Pseudo-occlusion6
        Differential attenuation1
    Venous
        Pseudo-thrombosis3

  • Note:—CCA indicates common carotid artery; BCV, brachiocephalic vein; IJV, internal jugular vein; SCV, subclavian vein; SVC, superior vena cava; VA, vertebral artery; CTA, CT angiography.

  • a One patient had both pseudodissection and pseudo-occlusion.