| Investigation of childhood central nervous system vasculitis: magnetic resonance angiography versus catheter cerebral angiography. | |
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MedLine Citation:
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PMID: 20132140 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Despina Eleftheriou; Tim Cox; Dawn Saunders; Nigel J Klein; Paul A Brogan; Vijeya Ganesan |
Publication Detail:
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Type: Comparative Study; Journal Article Date: 2010-01-28 |
Journal Detail:
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Title: Developmental medicine and child neurology Volume: 52 ISSN: 1469-8749 ISO Abbreviation: Dev Med Child Neurol Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-24 Completed Date: 2010-09-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0006761 Medline TA: Dev Med Child Neurol Country: England |
Other Details:
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Languages: eng Pagination: 863-7 Citation Subset: IM |
Affiliation:
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Department of Paediatric Rheumatology, Institute of Child Health, London, UK. d.eleftheriou@ich.ucl.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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Dev Med Child Neurol. 2010 Sep;52(9):792
[PMID:
20187886
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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