Accuracy of 3 T MR angioraphy in vertebral artery stenosis and coincidence with other cerebrovascular stenoses.
BACKGROUND
Ostium of vertebral artery (VA) is a common site of pseudostenosis on contrast-enhanced MR angiography (CE-MRA). The purpose of this study was to determine the diagnostic accuracy of CE-MRA at 3 T in the evaluation of ostial stenosis of VA and to find associated coincidental stenoses using logistic regression analysis.


METHODS
One hundred and thirty-five VA ostial regions from 72 patients who received CE-MRA of neck vessels, intracranial time of flight (TOF) MRA, and digital subtraction angiography (DSA) were retrospectively reviewed. The sensitivity and specificity of the CE-MRA in detection of ostial stenosis were calculated with reference standard of DSA. Ostial stenosis on MRA was correlated with coincidental lesions in intracranial and cervical arteries by logistic regression analysis.


RESULTS
The sensitivity and specificity of the CE-MRA were 100% and 80.4% for detection of significant stenosis. In case of significant stenoses, CE-MRA showed a tendency of overestimation with a false-positive rate of 52.5%. Logistic regression analysis showed that the stenoses of middle cerebral artery (MCA) on TOF MRA was associated with significant stenoses of VA ostia (OR = 5.84, 95% confidence intervals 1.41-24.17).


CONCLUSIONS
CE-MRA is sensitive in detection of VA ostial stenosis although it has high false-positive rate. True positive ostial stenosis should be considered in cases of coincidental stenoses of MCA on TOF MRA.
Choi
Hyun Seok
HS
Department of Radiology, Yonsei University College of Medicine, 250 Seongsanro, Seodaemungu, Seoul, 120-752, Korea.
Kim
Dong Ik
DI
Kim
Dong Joon
DJ
Kim
Jinna
J
Kim
Eun Soo
ES
Lee
Seung-Koo
SK
D002561:Cerebrovascular Disorders / Q000150:complications* / Q000473:pathology*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014715:Vertebrobasilar Insufficiency / Q000150:complications* / Q000473:pathology*