The value of MR angiography techniques in the detection of head and neck paragangliomas.
OBJECTIVE
The objective of this study was to compare three-dimensional phase-contrast angiography (3D PCA), 2D time-of-flight (2D TOF), and 3D TOF magnetic resonance (MR) angiography and a proton density weighted technique in terms of their ability to detect head and neck paragangliomas.


METHODS
14 patients with 29 paragangliomas were examined at 1.5 T. Three MR angiography sequences (3D PCA, 2D TOF, and multi-slab 3D TOF) and a proton density (PD) weighted sequence were reviewed by four neuroradiologists. The gold standard was digital subtraction angiography. Presence of tumor was assessed in five grades of confidence. Sensitivity and specificity were calculated after dichotomizing the results. Data was analyzed using the logistic regression method.


RESULTS
Mean sensitivity and specificity for the four observers were for PD: 72%/97%, for 3D PCA: 75%/90%, for 2D TOF: 66%/93%, and for 3D TOF: 90%/92%. Sensitivity was significantly better for 3D TOF MRA (P < 0.001). No substantial between-observer variation for tumor detection was present.


CONCLUSIONS
Our results demonstrate that, using 3D TOF MRA, paragangliomas in the head and neck region can be detected with high sensitivity and specificity. Further investigation is necessary to judge the value of 3D TOF MR angiography against fat suppressed contrast enhanced T1 weighted and fat suppressed T2 weighted MR sequences to find the optimal imaging sequence for paragangliomas.
van den Berg
René
R
Department of Radiology, C2-S Leiden University Medical Center, Albinusdreef 2, Leiden 2300, RC, The Netherlands. rvdberg@lumc.nl
Schepers
Abbey
A
de Bruïne
Francisca T
FT
Liauw
Lishya
L
Mertens
Bart J A
BJ
van der Mey
Andel G L
AG
van Buchem
Mark A
MA
D000328:Adult; D000792:Angiography / Q000379:methods / Q000706:statistics & numerical data; D015901:Angiography, Digital Subtraction / Q000706:statistics & numerical data; D002345:Carotid Body Tumor / Q000175:diagnosis; D003287:Contrast Media; D005260:Female; D005925:Glomus Jugulare Tumor / Q000175:diagnosis; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D016015:Logistic Models; D018810:Magnetic Resonance Angiography / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010235:Paraganglioma / Q000175:diagnosis*; D011856:Radiographic Image Enhancement / Q000379:methods; D012680:Sensitivity and Specificity
D003287:Contrast Media