MR angiography of internal carotid artery stenosis: contrast enhanced MRA versus gated 2D TOF MRA / 中华放射学杂志

ABSTRACT

Objective To compare the accuracy of CE MRA and Gated 2D TOF MRA in evaluation of internal carotid artery stenosis. Methods 34 patients (male 27, female 7, age range 45-78 years) were evaluated with contrast enhanced three dimensional magnetic resonance angiography (CE MRA) and unenhanced ECG gated two dimensional time of flight MRA (Gated 2D TOF MRA). Digital subtraction angiography (DSA) was used as the “gold standard”. The MRA images were reprojected with maximum intensity projection (MIP) algorithm. Sensitivity, specificity, diagnositic accuracy,overestimation and underestimation were assessed. Results (1) DSA provided 68 diagnostic judgments: 23 were negatives and 45 were positives (mild stenosis 10, moderate stenosis 14, severe stenosis 17, occlusion 4). CE MRA was in agreement with angiography in 66 (97%), but overestimation resulted in 2 cases. Gated 2D TOF MRA was in agreement with angiography in 56 (82%), with 9 overestimation and 3 underestimation. (2) Taking negative and positive cases as judgement, CE MRA showed higher sensitivity, specificity, and diagnostic accuracy than Gated 2D TOF MRA (100% versus 95 6%, 100% versus 78.3%, 100% versus 89.4%, respectively). (3) Taking 70% stenosis as judgement, CE MRA also showed higher sensitivity, specificity, and diagnostic accuracy than Gated 2D TOF MRA (100% versus 95 2%, 97.8% versus 93.6%, 98.5% versus 94.1%, respectively). Gated 2D TOF MRA vs DSA, CE MRA vs DSA and Gated 2D TOF MRA vs CE MRA all had no significant difference (? 2=3.000 with P =0.083, ? 2=2.000 with P =0.157, and ? 2=1.600 with P =0.206 respectively) Conclusion Compared with Gated 2D TOF MRA,CE MRA is more accurate in evaluation of carotid artery stenosis.