| Measuring carotid stenosis on contrast-enhanced magnetic resonance angiography: diagnostic performance and reproducibility of 3 different methods. | |
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MedLine Citation:
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PMID: 15243149 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: The aim of this study was to compare diagnostic performance and reproducibility of 3 different methods of quantifying stenosis on contrast-enhanced magnetic resonance angiography (CEMRA), with intra-arterial digital subtraction angiography (DSA) as the reference standard. METHODS: 167 symptomatic patients scheduled for DSA, after screening Doppler ultrasound, were prospectively recruited to undergo CEMRA. Severity of stenosis was measured according to the North American Symptomatic Trial Collaborators (NASCET), European Carotid Surgery Trial (ECST), and the common carotid (CC) methods. Measurements for each method were made for 284 vessels (142 included patients) on both CEMRA and DSA in a blinded and randomized manner by 3 independent attending neuroradiologists. RESULTS: Significant differences in prevalence of severe stenosis were seen with the 3 methods on both DSA and CEMRA, with ECST yielding the least and NASCET the most cases of severe stenosis. Overall, all 3 methods performed similarly well in terms of intermodality correlation and agreement. No significant differences in interobserver agreement were found on either modality. With CEMRA, however, we found a significantly lower sensitivity for detection of severe stenosis with ECST (79.8%) compared with NASCET (93.0%), with DSA as reference standard. CONCLUSIONS: Uniformity of carotid stenosis measurement methods is desirable because patient management may otherwise differ substantially. All 3 methods are adequate for use with DSA. With CEMRA, however, this study supports use of the NASCET method because of improved sensitivity for detecting severe stenosis. |
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Authors:
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Jean Marie K S U-King-Im; Rikin A Trivedi; Justin J Cross; Nicholas J P Higgins; William Hollingworth; Martin Graves; Ilse Joubert; Peter J Kirkpatrick; Nagui M Antoun; Jonathan H Gillard |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial Date: 2004-07-08 |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 35 ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2004 Sep |
Date Detail:
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Created Date: 2004-08-27 Completed Date: 2005-04-05 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: United States |
Other Details:
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Languages: eng Pagination: 2083-8 Citation Subset: IM |
Affiliation:
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University Department of Radiology, Addenbrooke's Hospital, Cambridge, United Kingdom. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Angiography, Digital Subtraction Carotid Stenosis / diagnosis*, epidemiology, pathology Contrast Media* Female Humans Imaging, Three-Dimensional Magnetic Resonance Angiography / methods* Male Middle Aged Observer Variation Prevalence Prospective Studies Reproducibility of Results Sensitivity and Specificity Severity of Illness Index Single-Blind Method |
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Reg. No./Substance:
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0/Contrast Media |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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