Skip to main content
Erschienen in: Neuroradiology 10/2010

01.10.2010 | Diagnostic Neuroradiology

Accuracy of 3 T MR angioraphy in vertebral artery stenosis and coincidence with other cerebrovascular stenoses

verfasst von: Hyun Seok Choi, Dong Ik Kim, Dong Joon Kim, Jinna Kim, Eun Soo Kim, Seung-Koo Lee

Erschienen in: Neuroradiology | Ausgabe 10/2010

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Ostium of vertebral artery (VA) is a common site of pseudostenosis on contrast-enhanced MR angiography (CE-MRA). The purpose of this study was to determine the diagnostic accuracy of CE-MRA at 3 T in the evaluation of ostial stenosis of VA and to find associated coincidental stenoses using logistic regression analysis.

Methods

One hundred and thirty-five VA ostial regions from 72 patients who received CE-MRA of neck vessels, intracranial time of flight (TOF) MRA, and digital subtraction angiography (DSA) were retrospectively reviewed. The sensitivity and specificity of the CE-MRA in detection of ostial stenosis were calculated with reference standard of DSA. Ostial stenosis on MRA was correlated with coincidental lesions in intracranial and cervical arteries by logistic regression analysis.

Results

The sensitivity and specificity of the CE-MRA were 100% and 80.4% for detection of significant stenosis. In case of significant stenoses, CE-MRA showed a tendency of overestimation with a false-positive rate of 52.5%. Logistic regression analysis showed that the stenoses of middle cerebral artery (MCA) on TOF MRA was associated with significant stenoses of VA ostia (OR = 5.84, 95% confidence intervals 1.41–24.17).

Conclusion

CE-MRA is sensitive in detection of VA ostial stenosis although it has high false-positive rate. True positive ostial stenosis should be considered in cases of coincidental stenoses of MCA on TOF MRA.
Literatur
1.
Zurück zum Zitat Randoux B, Marro B, Koskas F et al (2001) Carotid artery stenosis: prospective comparison of ct, three-dimensional gadolinium-enhanced mr, and conventional angiography. Radiology 220:179–185PubMed Randoux B, Marro B, Koskas F et al (2001) Carotid artery stenosis: prospective comparison of ct, three-dimensional gadolinium-enhanced mr, and conventional angiography. Radiology 220:179–185PubMed
2.
Zurück zum Zitat Sundgren PC, Sunden P, Lindgren A, Lanke J, Holtas S, Larsson EM (2002) Carotid artery stenosis: contrast-enhanced mr angiography with two different scan times compared with digital subtraction angiography. Neuroradiology 44:592–599CrossRefPubMed Sundgren PC, Sunden P, Lindgren A, Lanke J, Holtas S, Larsson EM (2002) Carotid artery stenosis: contrast-enhanced mr angiography with two different scan times compared with digital subtraction angiography. Neuroradiology 44:592–599CrossRefPubMed
3.
Zurück zum Zitat Alvarez-Linera J, Benito-Leon J, Escribano J, Campollo J, Gesto R (2003) Prospective evaluation of carotid artery stenosis: elliptic centric contrast-enhanced mr angiography and spiral ct angiography compared with digital subtraction angiography. AJNR Am J Neuroradiol 24:1012–1019PubMed Alvarez-Linera J, Benito-Leon J, Escribano J, Campollo J, Gesto R (2003) Prospective evaluation of carotid artery stenosis: elliptic centric contrast-enhanced mr angiography and spiral ct angiography compared with digital subtraction angiography. AJNR Am J Neuroradiol 24:1012–1019PubMed
4.
Zurück zum Zitat Huang BY, Castillo M (2009) Neurovascular imaging at 1.5 tesla versus 3.0 tesla. Magn Reson Imaging Clin N Am 17:29–+CrossRefPubMed Huang BY, Castillo M (2009) Neurovascular imaging at 1.5 tesla versus 3.0 tesla. Magn Reson Imaging Clin N Am 17:29–+CrossRefPubMed
5.
Zurück zum Zitat Habibi R, Lell MM, Steiner R et al (2009) High-resolution 3t mr angiography of the carotid arteries: comparison of manual and semiautomated quantification of stenosis. Am J Neuroradiol 30:46–52CrossRefPubMed Habibi R, Lell MM, Steiner R et al (2009) High-resolution 3t mr angiography of the carotid arteries: comparison of manual and semiautomated quantification of stenosis. Am J Neuroradiol 30:46–52CrossRefPubMed
6.
Zurück zum Zitat Anzidei M, Napoli A, Marincola BC et al (2009) Gadofosveset-enhanced mr angiography of carotid arteries: does steady-state imaging improve accuracy of first-pass imaging? Comparison with selective digital subtraction angiography. Radiology 251:457–466CrossRefPubMed Anzidei M, Napoli A, Marincola BC et al (2009) Gadofosveset-enhanced mr angiography of carotid arteries: does steady-state imaging improve accuracy of first-pass imaging? Comparison with selective digital subtraction angiography. Radiology 251:457–466CrossRefPubMed
7.
Zurück zum Zitat Khan S, Cloud GC, Kerry S, Markus HS (2007) Imaging of vertebral artery stenosis: a systematic review. J Neurol Neurosurg Psychiatry 78:1218–1225CrossRefPubMed Khan S, Cloud GC, Kerry S, Markus HS (2007) Imaging of vertebral artery stenosis: a systematic review. J Neurol Neurosurg Psychiatry 78:1218–1225CrossRefPubMed
8.
Zurück zum Zitat Wentz KU, Rother J, Schwartz A, Mattle HP, Suchalla R, Edelman RR (1994) Intracranial vertebrobasilar system: mr angiography. Radiology 190:105–110PubMed Wentz KU, Rother J, Schwartz A, Mattle HP, Suchalla R, Edelman RR (1994) Intracranial vertebrobasilar system: mr angiography. Radiology 190:105–110PubMed
9.
Zurück zum Zitat Remonda L, Heid O, Schroth G (1998) Carotid artery stenosis, occlusion, and pseudo-occlusion: first-pass, gadolinium-enhanced, three-dimensional mr angiography—preliminary study. Radiology 209:95–102PubMed Remonda L, Heid O, Schroth G (1998) Carotid artery stenosis, occlusion, and pseudo-occlusion: first-pass, gadolinium-enhanced, three-dimensional mr angiography—preliminary study. Radiology 209:95–102PubMed
10.
Zurück zum Zitat Randoux B, Marro B, Koskas F, Chiras J, Dormont D, Marsault C (2003) Proximal great vessels of aortic arch: comparison of three-dimensional gadolinium-enhanced mr angiography and digital subtraction angiography. Radiology 229:697–702CrossRefPubMed Randoux B, Marro B, Koskas F, Chiras J, Dormont D, Marsault C (2003) Proximal great vessels of aortic arch: comparison of three-dimensional gadolinium-enhanced mr angiography and digital subtraction angiography. Radiology 229:697–702CrossRefPubMed
11.
Zurück zum Zitat Cosottini M, Calabrese R, Puglioli M et al (2003) Contrast-enhanced three-dimensional mr angiography of neck vessels: does dephasing effect alter diagnostic accuracy? Eur Radiol 13:571–581PubMed Cosottini M, Calabrese R, Puglioli M et al (2003) Contrast-enhanced three-dimensional mr angiography of neck vessels: does dephasing effect alter diagnostic accuracy? Eur Radiol 13:571–581PubMed
12.
Zurück zum Zitat Leclerc X, Martinat P, Godefroy O et al (1998) Contrast-enhanced three-dimensional fast imaging with steady-state precession (fisp) mr angiography of supraaortic vessels: preliminary results. AJNR Am J Neuroradiol 19:1405–1413PubMed Leclerc X, Martinat P, Godefroy O et al (1998) Contrast-enhanced three-dimensional fast imaging with steady-state precession (fisp) mr angiography of supraaortic vessels: preliminary results. AJNR Am J Neuroradiol 19:1405–1413PubMed
13.
Zurück zum Zitat Krinsky G, Maya M, Rofsky N et al (1998) Gadolinium-enhanced 3d mra of the aortic arch vessels in the detection of atherosclerotic cerebrovascular occlusive disease. J Comput Assist Tomogr 22:167–178CrossRefPubMed Krinsky G, Maya M, Rofsky N et al (1998) Gadolinium-enhanced 3d mra of the aortic arch vessels in the detection of atherosclerotic cerebrovascular occlusive disease. J Comput Assist Tomogr 22:167–178CrossRefPubMed
14.
Zurück zum Zitat Puchner S, Haumer M, Rand T et al (2007) Cta in the detection and quantification of vertebral artery pathologies: a correlation with color doppler sonography. Neuroradiology 49:645–650CrossRefPubMed Puchner S, Haumer M, Rand T et al (2007) Cta in the detection and quantification of vertebral artery pathologies: a correlation with color doppler sonography. Neuroradiology 49:645–650CrossRefPubMed
15.
Zurück zum Zitat Khan S, Rich P, Clifton A, Markus HS (2009) Noninvasive detection of vertebral artery stenosis: a comparison of contrast-enhanced mr angiography, ct angiography, and ultrasound. Stroke 40:3499–3503CrossRefPubMed Khan S, Rich P, Clifton A, Markus HS (2009) Noninvasive detection of vertebral artery stenosis: a comparison of contrast-enhanced mr angiography, ct angiography, and ultrasound. Stroke 40:3499–3503CrossRefPubMed
16.
Zurück zum Zitat Yang CW, Carr JC, Futterer SF et al (2005) Contrast-enhanced mr angiography of the carotid and vertebrobasilar circulations. AJNR Am J Neuroradiol 26:2095–2101PubMed Yang CW, Carr JC, Futterer SF et al (2005) Contrast-enhanced mr angiography of the carotid and vertebrobasilar circulations. AJNR Am J Neuroradiol 26:2095–2101PubMed
17.
Zurück zum Zitat Taylor RA, Siddiq F, Memon MZ et al (2009) Vertebral artery ostial stent placement for atherosclerotic stenosis in 72 consecutive patients: clinical outcomes and follow-up results. Neuroradiology 51:531–539CrossRefPubMed Taylor RA, Siddiq F, Memon MZ et al (2009) Vertebral artery ostial stent placement for atherosclerotic stenosis in 72 consecutive patients: clinical outcomes and follow-up results. Neuroradiology 51:531–539CrossRefPubMed
18.
Zurück zum Zitat Tsutsumi M, Kazekawa K, Onizuka M et al (2007) Stent fracture in revascularization for symptomatic ostial vertebral artery stenosis. Neuroradiology 49:253–257CrossRefPubMed Tsutsumi M, Kazekawa K, Onizuka M et al (2007) Stent fracture in revascularization for symptomatic ostial vertebral artery stenosis. Neuroradiology 49:253–257CrossRefPubMed
19.
Zurück zum Zitat Feldmann E, Daneault N, Kwan E et al (1990) Chinese-white differences in the distribution of occlusive cerebrovascular disease. Neurology 40:1541–1545PubMed Feldmann E, Daneault N, Kwan E et al (1990) Chinese-white differences in the distribution of occlusive cerebrovascular disease. Neurology 40:1541–1545PubMed
20.
Zurück zum Zitat Suh DC, Lee SH, Kim KR et al (2003) Pattern of atherosclerotic carotid stenosis in korean patients with stroke: different involvement of intracranial versus extracranial vessels. AJNR Am J Neuroradiol 24:239–244PubMed Suh DC, Lee SH, Kim KR et al (2003) Pattern of atherosclerotic carotid stenosis in korean patients with stroke: different involvement of intracranial versus extracranial vessels. AJNR Am J Neuroradiol 24:239–244PubMed
21.
Zurück zum Zitat Kim SH, Lee JS, Kwon OK, Han MK, Kim JH (2005) Prevalence study of proximal vertebral artery stenosis using high-resolution contrast-enhanced magnetic resonance angiography. Acta Radiol 46:314–321CrossRefPubMed Kim SH, Lee JS, Kwon OK, Han MK, Kim JH (2005) Prevalence study of proximal vertebral artery stenosis using high-resolution contrast-enhanced magnetic resonance angiography. Acta Radiol 46:314–321CrossRefPubMed
22.
Zurück zum Zitat Thomas CS, Habib F, Varghese K, Abraham MT, Hayat NJ, Cherian G (2003) Disease of proximal part of vertebral artery in patients with coronary artery disease. Angiology 54:205–209CrossRefPubMed Thomas CS, Habib F, Varghese K, Abraham MT, Hayat NJ, Cherian G (2003) Disease of proximal part of vertebral artery in patients with coronary artery disease. Angiology 54:205–209CrossRefPubMed
23.
Zurück zum Zitat Nederkoorn PJ, van der Graaf Y, Eikelboom BC, van der Lugt A, Bartels LW, Mali WP (2002) Time-of-flight mr angiography of carotid artery stenosis: does a flow void represent severe stenosis? AJNR Am J Neuroradiol 23:1779–1784PubMed Nederkoorn PJ, van der Graaf Y, Eikelboom BC, van der Lugt A, Bartels LW, Mali WP (2002) Time-of-flight mr angiography of carotid artery stenosis: does a flow void represent severe stenosis? AJNR Am J Neuroradiol 23:1779–1784PubMed
Metadaten
Titel
Accuracy of 3 T MR angioraphy in vertebral artery stenosis and coincidence with other cerebrovascular stenoses
verfasst von
Hyun Seok Choi
Dong Ik Kim
Dong Joon Kim
Jinna Kim
Eun Soo Kim
Seung-Koo Lee
Publikationsdatum
01.10.2010
Verlag
Springer-Verlag
Erschienen in
Neuroradiology / Ausgabe 10/2010
Print ISSN: 0028-3940
Elektronische ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-010-0655-z

Weitere Artikel der Ausgabe 10/2010

Neuroradiology 10/2010 Zur Ausgabe

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Frühe Alzheimertherapie lohnt sich

25.04.2024 AAN-Jahrestagung 2024 Nachrichten

Ist die Tau-Last noch gering, scheint der Vorteil von Lecanemab besonders groß zu sein. Und beginnen Erkrankte verzögert mit der Behandlung, erreichen sie nicht mehr die kognitive Leistung wie bei einem früheren Start. Darauf deuten neue Analysen der Phase-3-Studie Clarity AD.

Viel Bewegung in der Parkinsonforschung

25.04.2024 Parkinson-Krankheit Nachrichten

Neue arznei- und zellbasierte Ansätze, Frühdiagnose mit Bewegungssensoren, Rückenmarkstimulation gegen Gehblockaden – in der Parkinsonforschung tut sich einiges. Auf dem Deutschen Parkinsonkongress ging es auch viel um technische Innovationen.

Demenzkranke durch Antipsychotika vielfach gefährdet

23.04.2024 Demenz Nachrichten

Wenn Demenzkranke aufgrund von Symptomen wie Agitation oder Aggressivität mit Antipsychotika behandelt werden, sind damit offenbar noch mehr Risiken verbunden als bislang angenommen.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.