Time-of-flight angiography: a viable alternative to contrast-enhanced MR angiography and fat-suppressed T1w images for the diagnosis of cervical artery dissection?
Eur Radiol
; 23(10): 2784-92, 2013 Oct.
Article
en En
| MEDLINE
| ID: mdl-23732685
ABSTRACT
OBJECTIVES:
To compare the use of an unenhanced high-resolution time-of-flight MR angiography sequence (Hr-TOF MRA) with fat-suppressed axial/coronal T1-weighted images and contrast-enhanced angiography (standard MRI) for the diagnosis of cervical artery dissection (cDISS).METHODS:
Twenty consecutive patients (9 women, 11 men, aged 24-66 years) with proven cDISS on standard MRI underwent Hr-TOF MRA at 3.0 T using dedicated surface coils. Sensitivity (SE), specificity (SP), positive and negative predictive values (PPV, NPV), Cohen's kappa (к) and accuracy of Hr-TOF MRA were calculated using the standard protocol as the gold standard. Image quality and diagnostic confidence were assessed on a four-point scale.RESULTS:
Image quality was rated better for standard MRI (P = 0.02), whereas diagnostic confidence did not differ significantly (P = 0.27). There was good agreement between Hr-TOF images and the standard protocol for the presence/absence of cDISS, with к = 0.95 for reader 1 and к = 0.89 for reader 2 (P < 0.001). This resulted in SE, SP, PPV, NPV and accuracy of 97 %, 98 %, 97 %, 98 % and 97 % for reader 1 and 93 %, 96 %, 93 %, 96 % and 95 % for reader 2.CONCLUSIONS:
Hr-TOF MRA can be used to diagnose cDISS with excellent agreement compared with the standard protocol. This might be useful in patients with renal insufficiency or if contrast-enhanced MR angiography is of insufficient image quality. KEY POINTS ⢠New magnetic resonance angiography sequences are increasingly used for vertebral artery assessment. ⢠A high-resolution time-of-flight sequence allows the diagnosis of cervical artery dissection. ⢠This technique allows the diagnosis without intravenous contrast medium. ⢠It could help in renal insufficiency or when contrast-enhanced MRA fails.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Imagen por Resonancia Magnética
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Interpretación de Imagen Asistida por Computador
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Aumento de la Imagen
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Tejido Adiposo
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Almacenamiento y Recuperación de la Información
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Técnica de Sustracción
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Disección de la Arteria Carótida Interna
Tipo de estudio:
Diagnostic_studies
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Guideline
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Prognostic_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur Radiol
Asunto de la revista:
RADIOLOGIA
Año:
2013
Tipo del documento:
Article
País de afiliación:
Alemania