| Noninvasive detection of vertebral artery stenosis: a comparison of contrast-enhanced MR angiography, CT angiography, and ultrasound. | |
| | |
MedLine Citation:
|
PMID: 19762707 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND AND PURPOSE: Vertebral stenosis is associated with a high risk of recurrent stroke, but noninvasive imaging techniques to identify it have lacked sensitivity. Contrast-enhanced MR angiography and CT angiography have been recently developed and appear to have better sensitivity. However, no prospective studies have compared both of these techniques with ultrasound against the gold standard of intra-arterial angiography in the same group of patients. METHODS: Forty-six patients were prospectively recruited in whom intra-arterial angiography was being performed. Contrast-enhanced MR angiography, CT angiography, and duplex ultrasound were also performed. Angiographic images were analyzed blinded to patient identity by 2 experienced neuroradiologists. RESULTS: Contrast-enhanced MR angiography had the highest sensitivity and specificity (Radiologist 1, 0.83 and 0.91, respectively; Radiologist 2, 0.89 and 0.87) for detecting >or=50% stenosis. CT angiography had good sensitivity (Radiologist 1, 0.68; Radiologist 2, 0.58) and excellent specificity (Radiologist 1, 0.92; Radiologist 2, 0.93), whereas duplex had low sensitivity (0.44) but excellent specificity (0.95). For vertebral origin stenosis >or=50%, sensitivities were similar for contrast-enhanced MR angiography (Radiologist 1, 0.91; Radiologist 2, 0.82) but relatively higher for CT angiography (Radiologist 1, 0.82; Radiologist 2, 0.82) and duplex (0.67). CONCLUSIONS: Contrast-enhanced MR angiography is the most sensitive noninvasive technique to detect vertebral artery stenosis and also has high specificity. CT angiography has good sensitivity and high specificity. In contrast, ultrasound has low sensitivity and will miss many vertebral stenoses. |
| | |
Authors:
|
Sofia Khan; Philip Rich; Andrew Clifton; Hugh S Markus |
Related Documents
:
|
16772847 - Isotropic high spatial resolution magnetic resonance angiography of the supra-aortic ar... 22394477 - Magnetic nanoparticle density mapping from the magnetically induced displacement data: ... 15706217 - Penetrating injuries of the neck: use of helical computed tomographic angiography. 20331497 - Incidental findings of persistent primitive trigeminal artery on 3-dimensional time-of-... 11950657 - Radiculomyelitic rabies: can mr imaging help? 21403187 - Analytical evaluation of the signal and noise propagation in x-ray differential phase-c... |
Publication Detail:
|
Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2009-09-17 |
Journal Detail:
|
Title: Stroke; a journal of cerebral circulation Volume: 40 ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2009 Nov |
Date Detail:
|
Created Date: 2009-10-27 Completed Date: 2009-11-23 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0235266 Medline TA: Stroke Country: United States |
Other Details:
|
Languages: eng Pagination: 3499-503 Citation Subset: IM |
Affiliation:
|
Clinical Neuroscience, St George's University of London, London, UK. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Angiography / standards Female Humans Magnetic Resonance Angiography / standards* Male Middle Aged Prospective Studies Tomography, X-Ray Computed / standards* Ultrasonography, Doppler, Duplex / standards* Vertebrobasilar Insufficiency / diagnosis, radiography*, ultrasonography* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Prophylactic, Endovascularly Based, Long-Term Normothermia in ICU Patients With Severe Cerebrovascul...
Next Document: HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination...