Assessment of CE-MRA for the rapid detection of supra-aortic vascular disease.
BACKGROUND
Contrast-enhanced MR angiography (CE-MRA) using a combined head and neck coil permits non-invasive imaging of the vasculature from the aortic arch through to the Circle of Willis in less than 2 minutes.


OBJECTIVE
To determine the accuracy of CE-MRA for the detection of vascular pathology, in particular vascular stenoses, using digital subtraction angiography (DSA) as the gold standard.


METHODS
In a prospective study of 81 patients referred for DSA, CE-MRA and DSA studies were performed within 72 hours of each other. CE-MRA was performed on a 1.5 Tesla clinical MRI scanner using a five-channel neurovascular array (head and neck coil), with dynamic tracking of the IV gadolinium bolus. CE-MRAs and DSA films were read by two interventional neuroradiologists blinded to the clinical presentation of the patient.


RESULTS
On DSA, there were 77 vascular stenoses > or =50% identified, 51 extracranial and 26 intracranial. The overall sensitivity of CE-MRA using the neurovascular array for the detection of vascular stenoses > or =50% was 57% (95% CI: 46 to 68%) with a specificity of 98% (97 to 99%). The sensitivity for the detection of extracranial vascular stenoses > or =50% was 82% (72 to 93%) with a specificity of 97% (96 to 98%). However, the sensitivity for the detection of intracranial vascular stenoses > or =50% was only 8% (0 to 18%), with a specificity of 99% (98 to 100%).


CONCLUSIONS
At this stage Contrast-enhanced MR angiography using a neurovascular coil shows promise as a rapid, specific, and noninvasive screening method for extracranial vascular disease, but not for intracranial vascular disease.
Wright
V L
VL
Stroke Neuroscience Unit, NINDS/NIH, 10 Center Drive, MSC 1294, Room 3N258, Bethesda, MD 20892-1294, USA.
Olan
W
W
Dick
B
B
Yu
H
H
Alberts-Grill
N
N
Latour
L L
LL
Baird
A E
AE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction / Q000009:adverse effects / Q000592:standards*; D002340:Carotid Artery Diseases / Q000175:diagnosis; D002342:Carotid Artery, External / Q000000981:diagnostic imaging / Q000473:pathology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology; D016893:Carotid Stenosis / Q000175:diagnosis; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D003287:Contrast Media / Q000592:standards*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000295:instrumentation / Q000379:methods* / Q000592:standards*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020521:Stroke / Q000175:diagnosis / Q000517:prevention & control; D013997:Time Factors
D003287:Contrast Media