[Assessment of extracranial internal carotid artery stenosis by duplex scanning magnetic resonance angiography and digital subtraction angiography: a comparative study].
OBJECTIVE
To investigate the correlation between duplex scanning, magnetic resonance angiography (MRA), and digital subtraction angiography (DSA) in the evaluation of extracranial internal carotid artery (EICA) stenosis.


METHODS
All the examinations mentioned-above were performed on 32 patients. According to NASCET, EICA stenosis were classified into four grades: mild (the diameter reduction < 30%), moderate (31% approximately 69%), severe (70% approximately 99%), and total occlusion.


RESULTS
One (3.1%) patient suffered from acute brain infarction after DSA. To compare duplex with DSA, Kappa = 0.78, and by the use of a severe or a greater than 30% stenosis as a positive study, the sensitivity, specificity and accuracy were 78%, 95%, 92% and 97%, 91%, 94%, respectively. To compare MRA with DSA, Kappa = 0.73, and with the same criteria, the sensitivity, specificity and accuracy were 78%, 90%, 89% and 97%, 91%, 94%, respectively. In the evaluation where the results of duplex and MRA were in agreement, to compare duplex + MRA with DSA, Kappa = 0.93, and the sensitivity, specificity and accuracy in the diagnosis of severe stenosis were 100%, 95% and 96%, and the accuracy in the diagnosis of > 30% stenosis was 100%.


CONCLUSIONS
There is good correlativity between duplex scanning, MRA and DSA in the examination of EICA stenosis. A combination of duplex and MRA with their results in agreement may ultimately eliminate the need of DSA in the evaluation of EICA stenosis.
Guo
D
D
Research Unit of Vascular Surgery, Zhongshan Hospital, Shanghai Medical University, Shanghai 200032, China.
Wang
Y
Y
Fu
W
W
D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color / Q000379:methods