Diagnostic value of contrast-enhanced magnetic resonance angiography for vertebral artery ostial stenosis / 中国脑血管病杂志

ABSTRACT

Objective: To evaluate the value of contrast-enhanced magnetic resonance angiography (CE-MRA) in the diagnosis of vertebral stenosis. Methods: A total of 108 patients (216 vertebral arteries) with clinical ischemic symptoms were examined by CE-MRA, then they were examined with digital subtraction angiography (DSA) within one week after CE-MRA examination. Using DSA as a standard, the accuracy of CE-MRA in the diagnosis of vertebral arteries was evaluated. Results: Circled digit oneOf the 216 vertebral arteries, 188 (87.0%) were consistent with the results of CE-MRA and DSA. The stenosis degree of 24 arteries (11.1%) determined by CE-MRA was higher than those determined by DSA. The stenosis degree of 4 arteries (1.9%) determined by CE-MRA was lower than those determined by DSA. Spearman rank correlation coefficient of the 2 kinds of examination was rs = 0.785 (P <0.001). Circled digit twoIn 168 normal vertebral arteries examined by CE-MRA, 2 were mild stenosis (stenosis rate ≤49%) and 2 were moderate to severe stenosis (stenosis rate 50-99%) examined by DSA. Of the 8 arteries with mild stenosis diagnosed by CE-MRA, DSA confirmed that 6 arteries were normal; of the 30 arteries with moderate to severe Stenosis diagnosed by CE-MRA, DSA confirmed that 10 were mild stenosis and 8 were normal. CE-MRA examination showed that the 10 occluded arteries were all confirmed by DSA. Circled digit threeUsing DSA as the gold standard, the sensitivity, specificity, false positive rate, false negative rate, positive predictive value, negative predictive value, and diagnostic consistent of CE-MRA rate were 89.5% (34/38), 92.1% (164/178), 7.9% (14/178), 10.5% (4/38), 70.8% (34/48), 97.6% (164/168), and 91.7% (198/216) , respectively. The Youden index was Y = 0.816. Conclusion: CE-MRA has high sensitivity in the diagnosis of vertebral artery ostial stenosis, it can be used as a screening means for detection. However, if we want to accurately evaluate the stenotic degree of vertebral artery, a variety of examination methods are needed.