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At least 379 records · Page 21Linked to original sources
PubMed2001

High-spatial-resolution contrast-enhanced MR angiography of the renal arteries: a prospective comparison with digital subtraction angiography.

PURPOSE: To evaluate a high-spatial-resolution three-dimensional (3D) contrast material-enhanced magnetic resonance (MR) angiographic technique for detecting proximal and distal renal arterial stenosis. MATERIALS AND METHODS: Twenty-five patients underwent high-spatial-resolution small-field-of-view (FOV) 3D contrast-enhanced MR angiography of the renal arteries, which was followed several minutes later by more standard, large-FOV 3D contrast-enhanced MR angiography that included the distal aorta and iliac arteries. For both acquisitions, MR fluoroscopic triggering and an elliptic centric view order were used. Two readers evaluated the MR angiograms for grade and hemodynamic significance of renal arterial stenosis, diagnostic quality, and presence of artifacts. MR imaging results for each patient were compared with those of digital subtraction angiograms. RESULTS: The high-spatial-resolution small-FOV technique provided high sensitivity (97%) and specificity (92%) for the detection of renal arterial stenosis, including all four distal stenoses encountered. The portrayal of the segmental renal arteries was adequate for diagnosis in 19 (76%) of 25 patients. In 12% of the patients, impaired depiction of the segmental arteries was linked to motion. CONCLUSION: The combined high-spatial-resolution small-FOV and large-FOV MR angiographic examination provides improved spatial resolution in the region of the renal arteries while maintaining coverage of the abdominal aorta and iliac arteries.

Aged↗
PubMed2002

Magnetic resonance angiography in childhood arterial brain infarcts: a comparative study with contrast angiography.

BACKGROUND AND PURPOSE: Contrast angiography (CA) is the reference examination for the diagnosis of cerebral arterial abnormality, but this procedure is invasive. In childhood, ischemic strokes are being increasingly investigated by means of MRI, including MR angiography (MRA). Very few data are available about the accuracy of MRA compared with CA in the specific context of acute pediatric stroke. We sought to compare the results of MRA with those of CA for the study of cerebral arteries in children with arterial infarction in an arterial distribution. METHODS: Twenty-four children presenting with 26 infarcts were studied. All were examined with cerebral MRI and MRA and with CA. The interval between CA and MRA was <3 days for most of the patients. RESULTS: Arterial lesions were detected in all but 2 children. They were located in the major cerebral arteries, predominantly in the anterior circulation (85% of cases). All lesions shown by CA were present on MRA (19 cases). Patients with no lesion on MRA had normal CA (2 cases). Associated distal vascular lesions and degree of arterial stenosis were more accurately detected with CA. CONCLUSIONS: MRA is sensitive enough to provide an adequate initial evaluation of arterial brain disease in childhood.

Adolescent↗
PubMed2003

Duplex ultrasound and magnetic resonance angiography compared with digital subtraction angiography in carotid artery stenosis: a systematic review.

BACKGROUND AND PURPOSE: The purpose of this work was to review and compare published data on the diagnostic value of duplex ultrasonography (DUS), MR angiography (MRA), and conventional digital subtraction angiography (DSA) for the diagnosis of carotid artery stenosis. METHODS: We performed a systematic review of published studies retrieved through PUBMED, from bibliographies of review papers, and from experts. The English-language medical literature was searched for studies that met the selection criteria: (1) The study was published between 1994 and 2001; (2) MRA and/or DUS was performed to estimate the severity of carotid artery stenosis; (3) DSA was used as the standard of reference; and (4) the absolute numbers of true positives, false negatives, true negatives, and false positives were available or derivable for at least one definition of disease (degree of stenosis). RESULTS: Sixty-three publications on duplex, MRA, or both were included in the analysis, yielding the test results of 64 different patient series on DUS and 21 on MRA. For the diagnosis of 70% to 99% versus <70% stenosis, MRA had a pooled sensitivity of 95% (95% CI, 92 to 97) and a pooled specificity of 90% (95% CI, 86 to 93). These numbers were 86% (95% CI, 84 to 89) and 87% (95% CI, 84 to 90) for DUS, respectively. For recognizing occlusion, MRA yielded a sensitivity of 98% (95% CI, 94 to 100) and a specificity of 100% (95% CI, 99 to 100), and DUS had a sensitivity of 96% (95% CI, 94 to 98) and a specificity of 100% (95% CI, 99 to 100). A multivariable summary receiver-operating characteristic curve (ROC) analysis for diagnosing 70% to 99% stenosis demonstrated that the type of MR scanner predicted the performance of MRA, whereas the presence of verification bias predicted the performance of DUS. For diagnosing occlusion, no significant heterogeneity was found for MRA; for DUS, the presence of verification bias and type of DUS scanner were explanatory variables. MRA had a significantly better discriminatory power than DUS in diagnosing 70% to 99% stenosis (regression coefficient, 1.6; 95% CI, 0.37 to 2.77). No significant difference was found in detecting occlusion (regression coefficient, 0.73; 95% CI, -2.06 to 3.51). CONCLUSIONS: These results suggest that MRA has a better discriminatory power compared with DUS in diagnosing 70% to 99% stenosis and is a sensitive and specific test compared with DSA in the evaluation of carotid artery stenosis. For detecting occlusion, both DUS and MRA are very accurate.

Angiography, Digital Subtraction↗
PubMed2004

Internal carotid artery stenosis measurement: comparison of 3D computed rotational angiography and conventional digital subtraction angiography.

BACKGROUND AND PURPOSE: Clinical trials have shown that carotid endarterectomy reduces stroke risk in symptomatic individuals with severe internal carotid artery (ICA) stenosis. As a result of these trials, digital subtraction angiography (DSA) became a standard of reference for ICA stenosis diagnosis. Newer 3D techniques provide a larger number of views than DSA, which may influence the estimated degree of stenosis. We evaluate this possibility by directly comparing stenosis grades from 3D computed rotational angiography (CRA) and DSA. METHODS: As a prospective diagnostic study, we performed CRA and DSA on 26 consecutive symptomatic patients. Only 1 angiographic procedure was performed on normal asymptomatic arteries, yielding 42 arteries for comparison. Four neuroradiologists graded the CRA maximum intensity projections (MIPs) and DSA images, according to the North American Symptomatic Carotid Endarterectomy Trial guidelines. CRA studies included a search for the narrowest view by evaluating 60 MIPs generated at 3 degrees intervals and measurement of actual artery diameters. Artery diameters and stenosis grades were analyzed graphically; statistical significance was determined using a paired t test. RESULTS: The mean difference of 1.2% (CI, -18%, 21%) between CRA and DSA stenosis grades was not statistically significant (P=0.55). Agreement of the optimal CRA viewing angle was limited, with an interobserver variability of 24+/-13 degrees . The interobserver variability of DSA and CRA stenosis grades, 9.1% (CI, 0%, 21%) and 9.4% (CI, 0%, 22%), respectively, was not significantly different (P=0.79). CONCLUSIONS: CRA provides stenosis grades equivalent to DSA, as well as absolute measurements, providing a comparison for newer 3D techniques.

Aged↗
PubMed2004

Noninvasive detection of steno-occlusive disease of the supra-aortic arteries with three-dimensional contrast-enhanced magnetic resonance angiography: a prospective, intra-individual comparative analysis with digital subtraction angiography.

BACKGROUND AND PURPOSE: Concomitant disease of the supra-aortic arteries can influence the outcome of surgical treatment of carotid artery stenosis. However, sensitivity and specificity data of noninvasive contrast-enhanced 3-dimensional (3D) magnetic resonance angiography (CE MRA) for the detection of steno-occlusive disease of the entire supra-aortic arteries including the circle of Willis remain unclear. We aimed to intra-individually compare high-spatial-resolution CE 3D MRA and digital subtraction angiography (DSA) for the assessment of steno-occlusive vascular disease of the supra-aortic arteries. METHODS: CE MRA and DSA of the supra-aortic arteries were prospectively performed in 50 consecutive patients. Intra-individual comparison of CE MRA and DSA was available in 833 arteries. High-spatial-resolution CE MRA comprised a measured voxel size of 0.81 mm x 0.81 mm x 1 mm (0.66 mm3). Steno-occlusive vascular disease of the 833 arteries was assessed independently by 2 radiologists according to the NASCET criteria. RESULTS: CE MRA had a sensitivity of 100% (73/73), a specificity of 99.3% (760/765), a positive predictive value of 93.6% (73/78), and a negative predictive value of 100% (760/760) by using a 70% to 99% threshold of arterial diameter stenosis. For detection of occlusion, sensitivity, specificity, PPV, and NPV value of CE MRA were 100%, respectively. CONCLUSIONS: Noninvasive high-spatial-resolution CE MRA is suited to replace diagnostic DSA for the detection of steno-occlusive disease of the supra-aortic arteries.

Adult↗
PubMed1991

Renal artery imaging: a prospective comparison of intra-arterial digital subtraction angiography with conventional angiography.

This study describes a systematic comparison of intra-arterial digital subtraction angiography (DSA) of the main renal arteries with conventional angiography (CA), the currently accepted "gold standard" for the diagnosis of renal artery stenosis. Twenty-five patients scheduled for abdominal aortography for various indications underwent first DSA then CA. The DSA and CA images were evaluated for number of renal arteries, presence and grade of renal artery stenosis, presence of post-stenotic dilation or fibromuscular changes, and diagnostic and pictorial adequacy of the images. DSA was found to be diagnostically adequate in 92% of cases, compared with 96% for CA. In evaluating significant main renal artery stenosis, which the authors assumed to be any stenosis greater than 50%, there were 10 such stenoses seen by CA. DSA also detected 10 cases, but there was 1 false positive and 1 false negative, yielding a sensitivity of 90% and a specificity of 98%. There was also close correlation of DSA and CA for the few cases of post-stenotic dilatation and fibromuscular dysplasia encountered. The authors conclude that DSA is an acceptable substitute for CA in the evaluation of patients for main renal artery stenosis.

Angiography↗
PubMed2003

Comparison of computed tomographic angiography with digital subtraction angiography in the diagnosis of cerebral aneurysms: a meta-analysis.

OBJECTIVE: To compare a novel diagnostic radiological technique, computed tomographic angiography (CTA), with the standard method, namely digital subtraction angiography (DSA), in the diagnosis of cerebral aneurysms. METHODS: A comprehensive search of the world literature on CTA was performed. Articles that reported on prospective comparisons of CTA and DSA in the evaluation of patients suspected of harboring cerebral aneurysms were selected for data extraction. Suitable statistical methods were applied to the extracted data for meta-analysis. RESULTS: Twenty-one references met the criteria for use in the meta-analysis. Unweighted calculations based on data for 1251 patients resulted in a sensitivity of 0.933 (93.3%; range, 75.4-100%) and a specificity of 0.878 (87.8%; range, 0-100%). When the studies were weighted for the number of patients in each study, the sensitivity decreased slightly, to 0.927 (92.7%), and the specificity decreased more substantially, to 0.772 (77.2%). CONCLUSION: On the basis of this meta-analysis, DSA remains the standard method. However, many who use CTA have reported it to be as good as or better than DSA in the diagnosis and treatment of cerebral aneurysms, as well as being of less risk and discomfort to their patients and easier and less expensive to perform.

Angiography, Digital Subtraction↗
PubMed2004

Results of a prospective protocol of computed tomographic angiography in place of catheter angiography as the only diagnostic and pretreatment planning study for cerebral aneurysms by a combined neurovascular team.

OBJECTIVE: At many centers, patients undergo both computed tomographic angiography (CTA) and digital subtraction angiography (DSA). This practice negates most of the advantages of CTA, and it renders the risks and disadvantages of the two techniques additive. Previous reports in the literature have assessed the sensitivity and specificity of CTA compared with DSA; however, these investigations have not analyzed the clinical implications of a protocol that replaces DSA with CTA as the only diagnostic and pretreatment planning study for patients with cerebral aneurysms. METHODS: Since late 2001/early 2002, the combined neurovascular unit of the Massachusetts General Hospital has adopted a prospective protocol of CTA in place of DSA as the only diagnostic and pretreatment planning study for patients with cerebral aneurysms (ruptured and unruptured). We report the results obtained during the 12-month period from January 2002 to January 2003. RESULTS: During the study period, 223 patients with cerebral aneurysms underwent initial diagnostic evaluation for cerebral aneurysm by the combined neurovascular team of Massachusetts General Hospital. Of the 223 patients, 109 patients had confirmed subarachnoid hemorrhage (Group A) and 114 patients did not have SAH (Group B). All of these patients were included in the prospective CTA protocol. Cerebral aneurysm treatment was initiated on the basis of CTA alone in 93 Group A patients (86%), in 89 Group B patients (78%), and in 182 patients (82%) overall. Treatment consisted of surgical clipping in 152 patients (68%), endovascular coiling in 56 patients (25%), endovascular parent artery balloon occlusion in 4 patients (2%), and external carotid artery to internal carotid artery bypass and carotid artery surgical occlusion in 2 patients (1%). Nine patients (4%) did not undergo treatment. The cerebral aneurysm detection rate by CTA was 100% for the presenting aneurysm (ruptured aneurysm in Group A or symptomatic/presenting aneurysm in Group B) in both groups. The detection rate by CTA for total cerebral aneurysms, including incidental multiple aneurysms, was 95.3% in Group A, 98.3% in Group B, and 97% overall. The overall morbidity associated with DSA (pretreatment or as intraoperative or postoperative clip evaluation) was one patient (1.3%) with a minor nonneurological complication, one patient (1.3%) with a minor neurological complication, and no patients (0%) with a major neurological complication. CONCLUSION: We have demonstrated promising results with a prospective protocol of CTA in place of DSA as the only diagnostic and pretreatment planning study for patients with ruptured and unruptured cerebral aneurysms. It seems safe and effective to make decisions regarding treatment on the basis of CTA, without performing DSA, in the majority of patients with ruptured and unruptured cerebral aneurysms.

Adolescent↗
PubMed1995

Management of congenital angiodysplasia of the lower limb: magnetic resonance imaging and angiography versus conventional angiography.

The purpose of the study was to compare magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) with conventional angiography in distinguishing congenital angiodysplasia amenable to radical cure from that in which only palliation is feasible and to design a rational pre-operative work-up in those patients undergoing an interventional procedure. Axial T1, T2 weighted spin-echo and contrast-enhanced 3D SPGR sequences were performed in 13 patients with angiodysplasia, followed by time-of-flight MRA. The results were compared with conventional arteriography and venography. Dysplasia was arteriovenous with microshunts in nine cases and purely venous in the remaining four. MRI was the best method for assessing the extent of malformation and involvement of anatomical structures. MR arteriography and MR venography were inferior to conventional techniques. It is concluded that MRI is valuable in distinguishing patients amenable to radical cure from those in whom only palliation is feasible. Pre-operatively, conventional arteriography and venography remain mandatory.

Adolescent↗
PubMed2004

Comparison of MR angiography versus digital subtraction angiography as a basis for planning treatment of lower limb occlusive disease.

PURPOSE: To compare contrast-enhanced moving-bed magnetic resonance angiography (MRA) with digital subtraction angiography (DSA) for the ability to provide adequate information on which to construct a therapeutic strategy in patients suffering from peripheral arterial occlusive disease (PAOD). METHODS: A prospective study was conducted involving 48 consecutive patients (25 men; mean age 65.7+/-10.2 years) with PAOD who underwent MRA and DSA of the peripheral arteries on 2 consecutive days. Every leg was divided into 3 anatomical regions (suprainguinal, femoropopliteal, calf), and the sensitivity and specificity for the detection of significant (>70%) lesions, as well as the interobserver variability, were calculated. The potential differences in the therapeutic strategy based on the results of both modalities were evaluated. RESULTS: The MRA and DSA studies in the 48 study patients produced 864 arterial segments for interpretation. The sensitivity of MRA for the detection of significant lesions was 94.7% for the suprainguinal, 89.5% for the femoropopliteal, and 91.3% for the calf arteries. Corresponding specificity was 98.1%, 96.2% and 93.4%, respectively. The interobserver correlation for the detection of significant lesions by MRA and DSA was excellent (kappa>0.8) for all 3 segments, with slightly superior values for MRA. MRA and DSA agreed in the grading of 821 (95.0%) segments. In 8 (16.7%) patients, MRA suggested an additional intervention, and in 3 (6.3%) patients, additional DSA was necessary for the final diagnosis. CONCLUSIONS: The accuracy of MRA for the detection of significant lesions is comparable to DSA. Basing the therapeutic strategy solely on the results of MRA can reduce the number of DSAs by three quarters, but at the risk of incurring lesion overestimation in approximately 17%.

Aged↗
PubMed2001

Internal carotid artery stenosis: comparison of duplex scan and magnetic resonance angiography with digital subtraction angiography.

OBJECTIVE: We compare duplex scan (DS) and magnetic resonance angiography (MRA) with digital angiography (DGA) in respect to accuracy in measuring internal carotid artery (IC) stenosis in symptomatic patients. METHOD: Ten symptomatic patients with IC stenosis greater than 70% previously diagnosed by DS were submitted to another DS and to both MRA and DGA. Both ICs from each patient (total 20 ICs) were evaluated by physicians blinded for the results of other tests. DS and MRA were compared with DGA, using the intraclass correlation coefficient (r) and its 95% confidence interval (95% ci). For each diagnostic test, the study group (20 Ics) was also divided in surgical patients (IC stenosis between 70 and 99%) and non surgical patients, using kappa concordance coefficient (k) to compare the results. RESULTS: Main comparisons are: DS and DGA, r = 0.71 (0.4 - 0.87); MRA and DGA, r = 0.61 (0.25 - 0.82). After division into surgical vs. non-surgical groups, k = 0.857 (p < 0.0001) between DS and DGA; and k = 0.545 (p = 0.003) between MRA and DGA. Most DS and MRA errors occurred in IC sub-occlusions. CONCLUSION: The results suggest that when they are used together, DS and non-contrast MRA may substitute DGA in the evaluation of patients for IC stenosis surgery, except when there is discordance between their results or when the methods show sub-occlusive stenosis.

Adult↗
PubMed1998

Prospective analysis of complications of catheter cerebral angiography in the digital subtraction angiography and magnetic resonance era.

Permanent and temporary neurological complications of catheter cerebral angiography were prospectively evaluated in 500 consecutive diagnostic cerebral angiographic procedures, 268 performed on 213 males and 232 on 175 females. Complications were divided into permanent (> 1 week), reversible (< or = 1 week, > 24 hours), and temporary (< or = 24 hours). There were four permanent (0.8%), one reversible (0.2%), and nine temporary neurological complications (1.8%). There was no death. With the correct selection of patients, catheter cerebral angiography is considered to be safe with acceptable rates of complications.

Aged↗
PubMed1980

Intravenous angiography using digital video subtraction: intravenous cervicocerebrovascular angiography.

The clinical application of intravenous angiography to study the cervicocerebrovascular system using the digital video subtraction system described in a companion article is reported. About 0.75 ml/kg of a standard 76% iodine contrast solution is injected into an antecubital vein using a power injector. Then 15-20 exposures of the head and neck region at a 1/sec rate are made on the image intensifier. The images are recorded by a high performance video system and the output signal is digitized for subsequent computer manipulation. The subtraction images of these vessels produced by the computer show the vessels clearly, even though they contain very low concentrations of contrast media. Standard exposure factors of 75-80 kVp, 9-10 msec at 800-1,000 mA are used. Clinically pertinent features of the data alteration and flow through the system and the step-by-step computer procedures used to achieve and analyze the various forms of subtracted images are described. Five experimental and clinical cases demonstrate appropriate applications to cervicocerebrovascular disease: (1) evaluating the effects of surgical and medical therapy on atherosclerosis; (2) providing a screening angiographic test for patients with asymptomatic bruits and/or positive noninvasive studies; (3) evaluating patients who have significant generalized vascular disease either precluding or presenting hazardous contraindications to transarterial catheterization; (4) evaluating significantly aged patients in whom standard angiography has higher risk; and (5) evaluating currently asymptomatic patients who are medically at higher risk for developing atherosclerotic lesions. Numerous examples of the various types of image manipulations are presented: (1) linear subtraction; (2) logarithmic subtraction; (3) alterations of electronic contrast enhancement (map slope); (4) the usefulness of a series of angiographic images; and (5) the importance of multiple projections with this technique.

Aged↗
PubMed1997

CT angiography versus intraarterial digital subtraction angiography for assessment of aortoiliac occlusive disease.

OBJECTIVE: The purpose of this study was to evaluate the accuracy of CT angiography (CTA) with a single helical acquisition for assessment of stenoses and occlusions of the iliac arteries. SUBJECTS AND METHODS: In our prospective study, intraarterial digital subtraction angiography and IV CTA were performed from the suprarenal aorta to below the femoral bifurcation in 30 patients with vascular occlusive disease. Maximum-intensity-projection images in multiple views were also obtained. The accuracy of CTA with and without analysis of axial images was determined. RESULTS: Sensitivity and specificity of CTA were 100% for iliac artery occlusions with a confidence interval 85-100% and 97-100%, respectively. When axial scans were interpreted, 14 of 15 high-grade (> 75%) stenoses were recognized. Sensitivity and specificity of CTA were 93% (range, 68-100%) and 99% (range, 97-100%), respectively. When maximum intensity projections alone were analyzed, sensitivity for the diagnosis of 15 high-grade stenoses was only 53% (range, 27-79%) because calcified plaques obscured six stenoses. CONCLUSIONS: CTA accurately reveals iliac artery occlusions. Observers of CT angiograms may overlook short stenoses in rare instances. Calcified plaques limit the use of maximum-intensity-projection images.

Angiography↗
PubMed1999

Three-dimensional MR coronary angiography using the navigator technique compared with conventional coronary angiography.

OBJECTIVE: We evaluated the diagnostic accuracy of three-dimensional (3D) MR coronary angiography with the navigator technique for the detection of coronary artery stenoses in comparison with that of conventional radiographic angiography. SUBJECTS AND METHODS: Thirty patients with coronary artery disease were examined with an ECG-triggered 3D fast low-angle shot sequence using retrospective respiratory gating and the navigator technique on a 1.5-T MR scanner. The data set was evaluated as a 3D view with a surface rendering technique. RESULTS: Imaging of the proximal coronary arteries was possible in all patients. The average visualized lengths of the left main, left anterior descending, left circumflex, and right coronary arteries were 1.9+/-0.5 cm (mean +/- SD), 5.2+/-2.3 cm, 4.2+/-1.9 cm, and 5.2+/-2.5 cm, respectively. Irregular breathing reduced image quality in seven of the 30 patients, making diagnosis of stenoses impossible. In the 77% of patients whose examinations resulted in high-quality images, the sensitivity and specificity for detection of significant stenoses and occlusions in all four main coronary arteries were 81% and 89%, respectively. CONCLUSION: The navigator technique allows reproducible imaging of the proximal course of coronary arteries. This technique obviates breath-hold studies, thus allowing more patients to be examined. In patients whose examinations resulted in high-quality images, significant coronary artery lesions could be seen. However, for widespread clinical use, further technical improvement is necessary to increase sensitivity and specificity.

Adult↗
PubMed1999

Contrast-enhanced MR angiography (CE MRA) in the study of the carotid stenosis: comparison with digital subtraction angiography (DSA).

PURPOSE: To determine sensitivity, specificity and diagnostic accuracy of contrast-enhanced magnetic resonance angiography (CE MRA) compared to digital subtraction angiography (DSA) in the study of carotid stenosis. METHODS AND MATERIAL: We studied 23 patients with suspected cerebro-vascular insufficiency by carotid stenosis. Diagnostic examinations by means of CE MRA and DSA were carried out within 24 hours of each other. A 1.5 T superconductive magnet (Signa-General Electric) was used for CE MRA. This technique was performed using a fast spoiled gradient echo recalled (SPGR) sequence acquired in coronal plane 13 sec after injection of contrast medium. Imaging parameters were: TR/TE/FA 8 msec/1 msec/60 degrees, matrix 256 x 128, 1 excitation, FOV 18 x 13 cm, 28 slices per slab, slice thickness of 1 mm, acquisition time of 32 sec. The post-processing was performed using maximum intensity projection (MIP) and targeted MIP. For DSA examinations a Politron 1000 VR unit (Siemens) was used. RESULTS: In the identification and quantification of lesions, CE MRA showed values of 100%. In particular, in comparison to DSA, CE MRA was accurate in diagnosing all true negative and positive cases. The location of stenosis evaluated with CE MRA agreed in all cases with DSA. CONCLUSION: In our experience CE MRA proved to be a very valuable technique in diagnosing carotid stenosis, showing the same diagnostic accuracy as DSA. In this way CE MRA appears to be a substantial alternative technique to conventional MRA and other non-invasive diagnostic methods.

Aged↗
PubMedDate not supplied

[MR-angiography with contrast bolus vs digital angiography in peripheral arterial occlusive disease of the legs].

PURPOSE: Aim of our study was to compare MR Angiography and Digital Angiography in the diagnosis of peripheral vascular occlusive disease. MATERIAL AND METHODS: Forty-five patients underwent both MRA and DSA examination of the peripheral arterial district. We employed a 1.5 Tesla MRI unit using 3D FSPGR T1-w sequence on coronal scan plane (TR=5.2 ms; TE=1.5 ms; slice=1.5/3 mm; FOV=48 cm; matrix 384x512; TA=16/24 s), before and after automatic iv injection of Gd-DTPA BMA (0.15/0.3 mmol/kg) with a flow rate of 2 ml/s. We evaluated the vascular district from renal to medio-distal tibial arteries. The acquisition of this arterial district required a semi-automatic movement of the examination table. Qualitative and quantitative analyses were carried out according to MIP reconstructions. DSA evaluation, considered as the gold standard, was performed by trans-femoral access using a 4-5F catheter. RESULTS: The MRA examination detected 246 steno-occlusive lesions while 285 were identified with DSA. No statistically significant differences were found among the various degrees of stenotic lesions detected by the two METHODS. The MRA examination had specificity and sensitivity values of: 100% and 84,8% for the iliac axes; 98,9% and 94,3% for the femoral district; 100% and 84,9% for the popliteal district; 97% and 89% for tibial vessels. CONCLUSIONS: MRA showed a high diagnostic accuracy close to that of DSA. On the basis of our short experience we believe that MRA will be a useful method in the detection of various degrees of peripheral artery occlusive diseases reserving DSA for the therapeutical step.

Aged↗
PubMed2000

[Assessment of extracranial internal carotid artery stenosis by duplex scanning magnetic resonance angiography and digital subtraction angiography: a comparative study].

OBJECTIVE: To investigate the correlation between duplex scanning, magnetic resonance angiography (MRA), and digital subtraction angiography (DSA) in the evaluation of extracranial internal carotid artery (EICA) stenosis. METHODS: All the examinations mentioned-above were performed on 32 patients. According to NASCET, EICA stenosis were classified into four grades: mild (the diameter reduction < 30%), moderate (31% approximately 69%), severe (70% approximately 99%), and total occlusion. RESULTS: One (3.1%) patient suffered from acute brain infarction after DSA. To compare duplex with DSA, Kappa = 0.78, and by the use of a severe or a greater than 30% stenosis as a positive study, the sensitivity, specificity and accuracy were 78%, 95%, 92% and 97%, 91%, 94%, respectively. To compare MRA with DSA, Kappa = 0.73, and with the same criteria, the sensitivity, specificity and accuracy were 78%, 90%, 89% and 97%, 91%, 94%, respectively. In the evaluation where the results of duplex and MRA were in agreement, to compare duplex + MRA with DSA, Kappa = 0.93, and the sensitivity, specificity and accuracy in the diagnosis of severe stenosis were 100%, 95% and 96%, and the accuracy in the diagnosis of > 30% stenosis was 100%. CONCLUSIONS: There is good correlativity between duplex scanning, MRA and DSA in the examination of EICA stenosis. A combination of duplex and MRA with their results in agreement may ultimately eliminate the need of DSA in the evaluation of EICA stenosis.

Aged↗