title: Noninvasive detection of steno-occlusive disease of the supra-aortic arteries with three-dimensional contrast-enhanced magnetic resonance angiography: a prospective, intra-individual comparative analysis with digital subtraction angiography.
abstract: OBJECTIVE
  Concomitant disease of the supra-aortic arteries can influence the outcome of surgical treatment of carotid artery stenosis. However, sensitivity and specificity data of noninvasive contrast-enhanced 3-dimensional (3D) magnetic resonance angiography (CE MRA) for the detection of steno-occlusive disease of the entire supra-aortic arteries including the circle of Willis remain unclear. We aimed to intra-individually compare high-spatial-resolution CE 3D MRA and digital subtraction angiography (DSA) for the assessment of steno-occlusive vascular disease of the supra-aortic arteries.
  
  
  METHODS
  CE MRA and DSA of the supra-aortic arteries were prospectively performed in 50 consecutive patients. Intra-individual comparison of CE MRA and DSA was available in 833 arteries. High-spatial-resolution CE MRA comprised a measured voxel size of 0.81 mm x 0.81 mm x 1 mm (0.66 mm3). Steno-occlusive vascular disease of the 833 arteries was assessed independently by 2 radiologists according to the NASCET criteria.
  
  
  RESULTS
  CE MRA had a sensitivity of 100% (73/73), a specificity of 99.3% (760/765), a positive predictive value of 93.6% (73/78), and a negative predictive value of 100% (760/760) by using a 70% to 99% threshold of arterial diameter stenosis. For detection of occlusion, sensitivity, specificity, PPV, and NPV value of CE MRA were 100%, respectively.
  
  
  CONCLUSIONS
  Noninvasive high-spatial-resolution CE MRA is suited to replace diagnostic DSA for the detection of steno-occlusive disease of the supra-aortic arteries.
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, D-53105 Bonn, Germany. winfried.willinek@ukb.uni-bonn.de
authors.forename: Winfried A
authors.initials: WA
authors.lastname: Willinek
authors.forename: Marcus
authors.initials: M
authors.lastname: von Falkenhausen
authors.forename: Markus
authors.initials: M
authors.lastname: Born
authors.forename: Jürgen
authors.initials: J
authors.lastname: Gieseke
authors.forename: Tobias
authors.initials: T
authors.lastname: Höller
authors.forename: Thomas
authors.initials: T
authors.lastname: Klockgether
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Textor
authors.forename: Hans H
authors.initials: HH
authors.lastname: Schild
authors.forename: Horst
authors.initials: H
authors.lastname: Urbach
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D001011:Aorta; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003287:Contrast Media; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media