Document Detail

Measuring carotid stenosis on contrast-enhanced magnetic resonance angiography: diagnostic performance and reproducibility of 3 different methods.
MedLine Citation:
PMID:  15243149     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2004-07-08
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  35     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-08-27     Completed Date:  2005-04-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2083-8     Citation Subset:  IM    
University Department of Radiology, Addenbrooke's Hospital, Cambridge, United Kingdom.
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MeSH Terms
Aged, 80 and over
Angiography, Digital Subtraction
Carotid Stenosis / diagnosis*,  epidemiology,  pathology
Contrast Media*
Imaging, Three-Dimensional
Magnetic Resonance Angiography / methods*
Middle Aged
Observer Variation
Prospective Studies
Reproducibility of Results
Sensitivity and Specificity
Severity of Illness Index
Single-Blind Method
Reg. No./Substance:
0/Contrast Media

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

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