The current role of 1.5T non-contrast 3D time-of-flight magnetic resonance angiography to detect intracranial steno-occlusive disease.
OBJECTIVE
This study was performed to evaluate the role of non-contrast 3D time-of-flight (TOF) magnetic resonance angiography (MRA) to detect and quantify intracranial steno-occlusive disease.


METHODS
Between April 2004 and January 2006, 45 patients with both 1.5T TOF MRA and digital subtraction angiography (DSA) performed within a 30-day interval were included. We evaluated the following intracranial arterial segments: petrous internal carotid artery (ICA), cavernous ICA, supraclinoid ICA, M1 of middle cerebral artery, A1 of anterior cerebral artery, P1 of posterior cerebral artery, basilar artery, and distal vertebral artery. In total, 675 arterial segments were evaluated and categorized as negative, moderate-1 (3049% stenosis), moderate-2 (5069%), severe (7099% stenosis, including gap sign on MRA), and occlusion.


RESULTS
The sensitivity and specificity of TOF MRA for > 29% stenosis and > 49% stenosis were 94%, 96% and 95%, 96%, respectively; while sensitivity and specificity for occlusion lesions were both 100%. However, 44 segments (37% of diseased segments) were overestimated by MRA, including 20 false-positive stenoses (which occurred in 10 [22%] patients) and 24 overestimated stenosis degree. The gap sign as severe stenosis only showed about 21% sensitivity and 41% specificity. Seven lesions were underestimated by MRA: three arterial segments were out of the field of MRA examination, and four were moderate-1stenosis on DSA.


CONCLUSIONS
TOF MRA has high sensitivity and specificity in detecting all categories of stenosis degree and occlusion. However, it tends to overestimate lesions. Therefore, MRA can be considered as a screening study. Confirmation with other studies is recommended in doubtful cases.
Sadikin
Cindy
C
Department of Radiology, Dokter Soetomo Hospital, Surabaya, Indonesia.
Teng
Michael Mu-Huo
MM
Chen
Ting-Yi
TY
Luo
Chao-Bao
CB
Chang
Feng-Chi
FC
Lirng
Jiing-Feng
JF
Sun
Ying-Chou
YC
D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002561:Cerebrovascular Disorders / Q000175:diagnosis*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity