Document Detail


Intracranial aneurysms treated with coil placement: test characteristics of follow-up MR angiography--multicenter study.
MedLine Citation:
PMID:  20505063     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine the test characteristics of magnetic resonance (MR) angiography in the assessment of occlusion of aneurysms treated with coil placement. MATERIALS AND METHODS: This was an ethics committee-approved multicenter study. written informed consent was obtained in 311 patients with 343 aneurysms, who had been treated with coil placement and were scheduled for routine follow-up with intraarterial digital subtraction angiography (DSA). Thirty-five patients participated two or three times. Either 3.0- or 1.5-T time-of-flight (TOF) and contrast material-enhanced MR angiography were performed in addition to intraarterial DSA. Aneurysm occlusion was evaluated by independent readers at DSA and MR angiography. The test characteristics of MR angiography were assessed by using DSA as the standard. The area under the receiver operating characteristic curve (AUC) was calculated for 3.0- versus 1.5-T MR angiography and for TOF versus contrast-enhanced MR angiography, and factors associated with discrepancies between MR angiography and DSA were assessed with logistic regression. RESULTS: Aneurysm assessments (n = 381) at DSA and MR angiography were compared. Incomplete occlusion was seen at DSA in 88 aneurysms (23%). Negative predictive value of MR angiography was 94% (95% confidence interval [CI]: 91%, 97%), positive predictive value was 69% (95% CI: 60%, 78%), sensitivity was 82% (95% CI: 72%, 89%), and specificity was 89% (95% CI: 85%, 93%). AUCs were similar for 3.0- (0.90 [95% CI: 0.86, 0.94]) and 1.5-T MR (0.87 [95% CI: 0.78, 0.95]) and for TOF MR (0.86 [95% CI: 0.81, 0.91]) versus contrast-enhanced MR (0.85 [95% CI: 0.80, 0.91]). A small residual lumen (odds ratio, 2.1 [95% CI: 1.1, 4.3]) and suboptimal projection at DSA (odds ratio, 5.5 [95% CI: 1.5, 21.0]) were independently associated with discordance between intraarterial DSA and MR angiography. CONCLUSION: Documentation of good diagnostic performance of TOF MR angiography at both 1.5 and 3.0 T in the current study represents an important step toward replacing intraarterial DSA with MR angiography in the follow-up of patients with aneurysms treated with coils.
Authors:
Joanna D Schaafsma; Birgitta K Velthuis; Charles B L M Majoie; René van den Berg; Patrick A Brouwer; Frederik Barkhof; Omid Eshghi; Gerard A P de Kort; Rob T H Lo; Theo D Witkamp; Marieke E S Sprengers; Marianne A van Walderveen; Joseph C Bot; Esther Sanchez; W Peter Vandertop; Jan van Gijn; Erik Buskens; Yolanda van der Graaf; Gabriël J E Rinkel
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-05-26
Journal Detail:
Title:  Radiology     Volume:  256     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-24     Completed Date:  2010-07-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  209-18     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands. j.d.schaafsma@umcutrecht.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiography, Digital Subtraction
Area Under Curve
Cerebral Angiography / methods*
Contrast Media / diagnostic use
Embolization, Therapeutic*
Female
Follow-Up Studies
Humans
Intracranial Aneurysm / diagnosis*,  therapy*
Logistic Models
Magnetic Resonance Angiography / methods*
Male
Middle Aged
Netherlands
Predictive Value of Tests
ROC Curve
Treatment Outcome
Triiodobenzoic Acids / diagnostic use
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Triiodobenzoic Acids; 92339-11-2/iodixanol

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


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