Document Detail


Territorial arterial spin labeling in the assessment of collateral circulation: comparison with digital subtraction angiography.
MedLine Citation:
PMID:  18845805     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Collateral circulation plays a vital role in patients with steno-occlusive disease, in particular for predicting stroke outcome. Digital subtraction angiography (DSA) is the gold standard for the assessment of collateral circulation, despite its invasive nature. Recently, the development of a new class of arterial spin labeling (ASL) methods allowed independent measurement of territorial flow information without the need for contrast media injection. Here, we compared combined territorial ASL (TASL) and MR angiography (MRA) against DSA in the assessment of collateral circulation. METHODS: Eighteen patients presenting with extra- or intracranial arterial steno-occlusive disease were recruited. All DSA studies were performed using a biplane angiography unit. MR imaging consisted of time-of-flight MRA and TASL, performed at 3T. Collateral circulation on both modalities was evaluated in consensus in a double-blinded manner by 3 neuroradiologists. RESULTS: Good agreement was found between DSA and TASL in the assessment of collateral flow: Cramer coefficient, V=0.53 (P<0.0001) and Contingency coefficient, C=0.67, with kappa=0.70 and kappa=0.72 in the assessment of flow and collaterals, respectively. TASL and DSA successfully evaluated 89% and 98% of the vessels, respectfully. Failure was linked to motion-related artifacts in TASL, and highly tortuous vessels in DSA. Generally, combined MRA-TASL was comparable to DSA in diagnostic quality. CONCLUSIONS: TASL provided radiological information comparable to DSA on collateral flow, with the advantage that it could be performed during routine MRI studies. TASL may provide insight on collateral perfusion in patients who may not otherwise be candidates for DSA, and may potentially replace it.
Authors:
Soke Miang Chng; Esben Thade Petersen; Ivan Zimine; Yih-Yian Sitoh; C C Tchoyoson Lim; Xavier Golay
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-10-09
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  39     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-25     Completed Date:  2009-01-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3248-54     Citation Subset:  IM    
Affiliation:
Department of Neuroradiology, National Neuroscience Institute, Singapore.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angiography, Digital Subtraction*
Artifacts
Carotid Artery, Internal / physiopathology,  radiography
Carotid Stenosis / complications,  diagnosis,  physiopathology,  radiography
Cerebral Infarction / etiology
Cerebrovascular Circulation*
Cerebrovascular Disorders / diagnosis*,  physiopathology,  radiography
Collateral Circulation*
Double-Blind Method
Female
Humans
Ischemic Attack, Transient / etiology
Magnetic Resonance Angiography
Male
Middle Aged
Motion
Predictive Value of Tests
Spin Labels*
Chemical
Reg. No./Substance:
0/Spin Labels

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


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