ArticleAJNR. American journal of neuroradiology2009
Contrast-enhanced MR angiography is not more accurate than unenhanced 2D time-of-flight MR angiography for determining > or = 70% internal carotid artery stenosis.
Article in AJNR. American journal of neuroradiology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed, 45 citations in OpenAlex.
- The pitfalls and challenges in the diagnosis and treatment of patients with carotid near-occlusion: a narrative review.Quantitative imaging in medicine and surgery · 2024Review
- Differential Assessment of Internal Jugular Vein Stenosis in Patients Undergoing CT and MRI with Contrast.Tomography (Ann Arbor, Mich.) · 2024Article
- Can intracranial time-of-flight-MR angiography predict extracranial carotid artery stenosis?Journal of neurology · 2022Article
- Article
- MR angiography at 3 Tesla to assess proximal internal carotid artery stenoses: contrast-enhanced or 3D time-of-flight MR angiography?Clinical neuroradiology · 2015Article
- Intraplaque high-intensity signal on 3D time-of-flight MR angiography is strongly associated with symptomatic carotid artery stenosis.AJNR. American journal of neuroradiology · 2014Article
- Carotid CTA: radiation exposure and image quality with the use of attenuation-based, automated kilovolt selection.AJNR. American journal of neuroradiology · 2014Article
- Non-ECG-gated unenhanced MRA of the carotids: optimization and clinical feasibility.European radiology · 2013Article
- Time-of-flight angiography: a viable alternative to contrast-enhanced MR angiography and fat-suppressed T1w images for the diagnosis of cervical artery dissection?European radiology · 2013Article
- Evaluation of the supraaortic arteries using non-contrast-enhanced Velocity MR angiography "Inhance".Neuroradiology · 2012Article
- Automated quantification of carotid artery stenosis on contrast-enhanced MRA data using a deformable vascular tube model.The international journal of cardiovascular imaging · 2012Article
- Imaging of acute stroke.Nature reviews. Neurology · 2010Review
- Use of magnetic resonance imaging to predict outcome after stroke: a review of experimental and clinical evidence.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2010Review
- Computer-assisted extraction of intracranial aneurysms on 3D rotational angiograms for computational fluid dynamics modeling.Medical physics · 2009Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeInternal carotid artery (ICA) atheromatous disease is an important cause of ischemic stroke, and endarterectomy or stent placement is typically indicated for symptomatic patients with > or = 70% stenosis. Our purpose was to compare contrast-enhanced MR angiography (CE-MRA) with unenhanced 2D time-of-flight MR angiography (2D TOF MRA) in detecting hemodynamically significant ICA stenosis, by using CT angiography (CTA) as the reference standard. MATERIALS AND
methodsThis was an institutional review board-approved retrospective study. We identified 177 consecutive patients (354 ICAs) who received correlative CE-MRA, 2D TOF MRA, and CTA. Two neuroradiologists blinded to the CTA data graded the degree of ICA stenosis according to a 5-point scale. Additionally, luminal signal-intensity characteristics including 1) signal intensity drop-out, 2) distal-vessel narrowing, and 3) distal-vessel signal-intensity reduction were recorded. MRA results were correlated with those of CTA, and receiver-operating-characteristic (ROC) curves were constructed.
resultsOn CTA, there were 55 ICAs with and 299 without > or = 70% stenosis. CE-MRA was 84% sensitive and 96% specific for detecting > or = 70% stenosis; 2D TOF MRA was 80% sensitive and 95% specific. The area under the ROC curve was 0.97 for CE-MRA and 0.95 for 2D TOF MRA (P = .51, not significant). For both MRA studies, each of the luminal signal-intensity characteristics had high specificity (> 98%) but poor-to-mild sensitivity (35%-66%) in detecting > or = 70% stenosis.
conclusionsAlthough it is established that CE-MRA more accurately delineates neurovascular anatomy than does unenhanced 2D TOF MRA, the administration of gadolinium did not offer a significant advantage in distinguishing surgically treatable ICA stenosis. This conclusion may be important in patients with contraindications to gadolinium.
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