Document Detail


Investigation of childhood central nervous system vasculitis: magnetic resonance angiography versus catheter cerebral angiography.
MedLine Citation:
PMID:  20132140     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: We compared the clinical utility of magnetic resonance angiography (MRA) to catheter cerebral angiography (CA) in the investigation of children with suspected central nervous system (CNS) vasculitis. METHOD: Single-centre retrospective review of children with a suspected diagnosis of CNS vasculitis studied with both MRA and CA. MRA and CA-detected abnormalities (location, multiplicity, and morphology) were compared; sensitivity and specificity were calculated on a per lesion and per patient basis for MRA, with CA as the reference standard. RESULTS: Findings in fourteen patients (median age at presentation of 5 y 10 mo [range 1 y 5 mo-14 y 5 mo]; eight males, six females) relating to sixteen paired studies of MRA and CA were reviewed. CA-detected lesions were commonly bilateral (13/16 studies, p<0.05), and likely to be proximally distributed (15/16 studies, p<0.05).The sensitivity and specificity of MRA for CA lesion detection was 63% (95% confidence interval [CI] 48-78) and 89% (95% CI 81-93), respectively with moderate agreement between the two modalities (kappa=0.51, 95% CI 0.37-0.66). The majority of the false negative observations involved the posterior circulation (9/14). The overall sensitivity for MRA diagnosis of vasculitis per patient was 94% (95% CI 67-99). INTERPRETATION: MRA failed to identify all lesions detected on CA, particularly those in the posterior circulation. MRA is a reasonable initial modality in the investigation of suspected CNS vasculitis but in cases of abnormal parenchymal MRI and normal MRA, CA should be considered.
Authors:
Despina Eleftheriou; Tim Cox; Dawn Saunders; Nigel J Klein; Paul A Brogan; Vijeya Ganesan
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-01-28
Journal Detail:
Title:  Developmental medicine and child neurology     Volume:  52     ISSN:  1469-8749     ISO Abbreviation:  Dev Med Child Neurol     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-24     Completed Date:  2010-09-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0006761     Medline TA:  Dev Med Child Neurol     Country:  England    
Other Details:
Languages:  eng     Pagination:  863-7     Citation Subset:  IM    
Affiliation:
Department of Paediatric Rheumatology, Institute of Child Health, London, UK. d.eleftheriou@ich.ucl.ac.uk
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Brain / blood supply,  pathology
Catheterization
Cerebral Angiography / instrumentation,  methods*
Cerebrovascular Circulation
Child
Child, Preschool
False Negative Reactions
False Positive Reactions
Female
Humans
Infant
Magnetic Resonance Angiography*
Male
Retrospective Studies
Sensitivity and Specificity
Vasculitis, Central Nervous System / diagnosis*,  pathology
Comments/Corrections
Comment In:
Dev Med Child Neurol. 2010 Sep;52(9):792   [PMID:  20187886 ]

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


Previous Document:  Mechanical properties of the plantarflexor musculotendinous unit during passive dorsiflexion in chil...
Next Document:  Diffusion-weighted imaging of cerebral white matter and the cerebellum following preterm birth.