title: Diagnostic ability of 3-dimensional contrast-enhanced MR angiography in identifying vertebral basilar artery stenosis.
abstract: BACKGROUND
  Vertebral-basilar artery stenosis is associated with posterior circulation infarction. So correct detection of vertebral basilar artery stenosis is very important. Studies concerning the sensitivity and specificity of 3-dimensional contrast enhanced MR angiography (3D-CE-MRA) in detecting vertebral basilar artery stenosis is generally lacking.
  
  
  METHODS
  Retrospectively reviewed the imagines of consecutive one hundred and forty-nine Chinese patients with ischemic stroke or vertigo/dizziness who underwent 3D-CE-MRA and DSA. DSA and CE-MRA images were studied separately and to determine the presence of mild, moderate, or severe stenosis of the vertebral-basilar arteries. Analysis combined with vascular origin image was applied when evaluating the vertebral artery origin stenosis. Sensitivity, specificity, positive and negative predictive values, and the accuracy of 3D-CE-MRA in detecting and grading of vertebral-basilar artery stenosis were calculated.
  
  
  RESULTS
  Compared with DSA, sensitivity, specificity and accuracy of 3D-CE-MRA in detecting of vertebral artery origin ≥70% stenosis or occlusion was 97.1%, 77.4% and 81.9%, but diagnostic consistency was poor (K=0.59); Analysis combined with vascular origin images, the specificity (97.8%), accuracy (92.9%) and consistency (K=0.826) was significantly improved.
  
  
  CONCLUSIONS
  3D-CE-MRA is a sensitive and noninvasive technique for the detection of vertebral artery origin stenosis. Furthermore, analysis combined with vascular origin image would improve the diagnostic accuracy.
authors.affiliation: Department of Neurology, Zhangzhou affiliated Hospital of Fujian Medical University, Fujian, China. Electronic address: siyuyufen@163.com.
authors.forename: Ting-yu
authors.initials: TY
authors.lastname: Yi
authors.affiliation: Department of Neurology, Zhangzhou affiliated Hospital of Fujian Medical University, Fujian, China.
authors.forename: Wen-huo
authors.initials: WH
authors.lastname: Chen
authors.affiliation: Department of Neurology, Zhangzhou affiliated Hospital of Fujian Medical University, Fujian, China.
authors.forename: Mei-fang
authors.initials: MF
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Zhangzhou affiliated Hospital of Fujian Medical University, Fujian, China.
authors.forename: Yue-hong
authors.initials: YH
authors.lastname: Chen
authors.affiliation: Department of Neurology, 2nd Affiliated of Fujian Medical University, China.
authors.forename: Ruo-wei
authors.initials: RW
authors.lastname: Cai
authors.affiliation: Department of Neurology, Zhangzhou affiliated Hospital of Fujian Medical University, Fujian, China.
authors.forename: Zong-zhong
authors.initials: ZZ
authors.lastname: Wu
authors.affiliation: Department of Neurology, Zhangzhou affiliated Hospital of Fujian Medical University, Fujian, China.
authors.forename: Yan-min
authors.initials: YM
authors.lastname: Wu
authors.affiliation: Department of Neurology, Zhangzhou affiliated Hospital of Fujian Medical University, Fujian, China.
authors.forename: Yan-chuan
authors.initials: YC
authors.lastname: Shi
authors.affiliation: Department of Neurology, Zhangzhou affiliated Hospital of Fujian Medical University, Fujian, China.
authors.forename: Bai-ling
authors.initials: BL
authors.lastname: Chen
authors.affiliation: Department of Neurology, Zhangzhou affiliated Hospital of Fujian Medical University, Fujian, China.
authors.forename: Ting-hui
authors.initials: TH
authors.lastname: Guo
authors.affiliation: Department of Neurology, Zhangzhou affiliated Hospital of Fujian Medical University, Fujian, China.
authors.forename: Chao-xin
authors.initials: CX
authors.lastname: Wu
authors.affiliation: Department of Neurology, Zhangzhou affiliated Hospital of Fujian Medical University, Fujian, China.
authors.forename: Miao-xiong
authors.initials: MX
authors.lastname: Yang
authors.affiliation: Department of Neurology, Zhangzhou affiliated Hospital of Fujian Medical University, Fujian, China.
authors.forename: Xue-jiao
authors.initials: XJ
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction / Q000379:methods / Q000592:standards*; D002681:China / Q000453:epidemiology; D003287:Contrast Media; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods / Q000592:standards*; D018810:Magnetic Resonance Angiography / Q000379:methods / Q000592:standards*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging* / Q000453:epidemiology
chemical_list: D003287:Contrast Media
keywords: Contrast-enhanced MR angiography; Digital subtraction angiography; Stenosis; Vertebral basilar artery