Document Detail


Time-resolved MR angiography in the evaluation of central thoracic venous occlusive disease.
MedLine Citation:
PMID:  19457842     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of our study was to assess the feasibility and diagnostic performance of time-resolved MR angiography (MRA) in the evaluation of central thoracic venous occlusive disease and to compare time-resolved MRA with conventional MRA and catheter angiography. MATERIALS AND METHODS: Twenty patients (eight women and 12 men; age range, 19-74 years) with suspected central thoracic venous occlusive disease underwent time-resolved MRA using time-resolved angiography with interleaved stochastic trajectories (TWIST) and parallel acquisition, followed by conventional MRA. Catheter angiography was performed within 1-14 days after MRA and was available for a total of 60 segments for correlation. Time-resolved and conventional MRA images were evaluated in separate reading sessions by two independent radiologists for image quality and level of confidence and degree of venoocclusive disease. The interobserver and intermodality agreement, sensitivity, and specificity were calculated using catheter angiography as the standard of reference. RESULTS: Time-resolved MRA resulted in diagnostic-quality images that did not differ significantly in quality compared with conventional MRA. Thirty-one segmental venous stenoses were identified. The kappa coefficient revealed moderate intermodality agreement (kappa = 0.54; 95% CI, 0.32-0.76) between time-resolved MRA and conventional MRA. When compared with catheter angiography, the sensitivity and specificity for the diagnosis of significant stenosis (> or = 70%) were 87.5% and 68% for time-resolved MRA and 90% and 90% for conventional MRA, respectively. CONCLUSION: Time-resolved MRA, as described in this study, has the potential to be used as an initial and screening diagnostic tool obviating conventional MRA and its associated higher contrast dose in normal and near-normal examinations. However, because of its relatively lower specificity, adjunct use of conventional MRA is still required for accurate grading of venous occlusive disease.
Authors:
Kambiz Nael; Mayil Krishnam; Stefan G Ruehm; Henrik J Michaely; Gerhard Laub; J Paul Finn
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  192     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-21     Completed Date:  2009-06-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1731-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, 90095-7206, USA. nkambiz@mednet.ucla.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Feasibility Studies
Female
Humans
Image Enhancement / methods*
Magnetic Resonance Angiography / methods*
Male
Middle Aged
Reproducibility of Results
Sensitivity and Specificity
Thorax / blood supply*,  pathology
Venous Thrombosis / diagnosis*

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


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