Document Detail


Gadofosveset-enhanced MR angiography of carotid arteries: does steady-state imaging improve accuracy of first-pass imaging? Comparison with selective digital subtraction angiography.
MedLine Citation:
PMID:  19401574     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the diagnostic accuracy of gadofosveset-enhanced magnetic resonance (MR) angiography in the assessment of carotid artery stenosis, with digital subtraction angiography (DSA) as the reference standard, and to determine the value of reading first-pass, steady-state, and "combined" (first-pass plus steady-state) MR angiograms. MATERIALS AND METHODS: This study was approved by the local ethics committee, and all subjects gave written informed consent. MR angiography and DSA were performed in 84 patients (56 men, 28 women; age range, 61-76 years) with carotid artery stenosis at Doppler ultrasonography. Three readers reviewed the first-pass, steady-state, and combined MR data sets, and one independent observer evaluated the DSA images to assess stenosis degree, plaque morphology and ulceration, stenosis length, and tandem lesions. Interobserver agreement regarding MR angiographic findings was analyzed by using intraclass correlation and Cohen kappa coefficients. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated by using the McNemar test to determine possible significant differences (P < .05). RESULTS: Interobserver agreement regarding all MR angiogram readings was substantial. For grading stenosis, sensitivity, specificity, PPV, and NPV were, respectively, 90%, 92%, 91%, and 91% for first-pass imaging; 95% each for steady-state imaging; and 96%, 99%, 99%, and 97% for combined imaging. For evaluation of plaque morphology, respective values were 84%, 86%, 88%, and 82% for first-pass imaging; 98%, 97%, 98%, and 97% for steady-state imaging; and 98%, 100%, 100%, and 97% for combined imaging. Differences between the first-pass, steady-state, and combined image readings for assessment of stenosis degree and plaque morphology were significant (P < .001). CONCLUSION: Gadofosveset-enhanced MR angiography is a promising technique for imaging carotid artery stenosis. Steady-state image reading is superior to first-pass image reading, but the combined reading protocol is more accurate.
Authors:
Michele Anzidei; Alessandro Napoli; Beatrice Cavallo Marincola; Italo Nofroni; Daniel Geiger; Fulvio Zaccagna; Carlo Catalano; Roberto Passariello
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Publication Detail:
Type:  Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Radiology     Volume:  251     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-29     Completed Date:  2009-05-28     Revised Date:  2009-12-02    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  457-66     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiological Sciences, University of Rome La Sapienza, Viale Regina Elena 324, 00161 Rome, Italy. michele.anzidei@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiography, Digital Subtraction*
Carotid Stenosis / diagnosis*
Contrast Media
Female
Gadolinium / diagnostic use*
Humans
Image Enhancement / methods*
Magnetic Resonance Angiography / methods*
Male
Middle Aged
Organometallic Compounds / diagnostic use*
Reproducibility of Results
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Organometallic Compounds; 0/gadofosveset trisodium; 7440-54-2/Gadolinium
Comments/Corrections
Comment In:
Radiology. 2009 Nov;253(2):574-5; author reply 575   [PMID:  19864535 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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