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Lee, Chung, Lee, and Suh: Comparison of Non-invasive Imaging Studies in the Evaluation of Carotid Artery Stenosis and Occlusion: CT Angiography, Time-of-Flight MR Angiography and Contrast-Enhanced MR Angiography
Original Contribution
Journal of the Korean Society of Magnetic Resonance in Medicine

Journal of the Korean Society of Magnetic Resonance in Medicine 2011; 15(3): 234-241.

Published online: 31 December 2011

DOI: https://doi.org/10.13104/jksmrm.2011.15.3.234

Comparison of Non-invasive Imaging Studies in the Evaluation of Carotid Artery Stenosis and Occlusion: CT Angiography, Time-of-Flight MR Angiography and Contrast-Enhanced MR Angiography

Junhyung Lee1, Tae-Sub Chung1, Kyung-Yul Lee2, Sang Hyun Suh1

1Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Korea.

2Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Korea.

Address reprint requests to: Sang Hyun Suh, M.D., Department of Radiology, Gangnam Severance Hospital, 712 Eonju-ro, Gangnam-gu, Seoul 135-720, Korea. Tel. 82-2-2019-3510, Fax. 82-2-3462-5472, suhsh11@yuhs.ac

Received 14 June 2011       Revised 22 July 2011       Accepted 25 October 2011

Copyright © 2011 Korean Society of Magnetic Resonance in Medicine

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We compared non-invasive imaging studies of CTA, TOF-MRA and CE-MRA to evaluate detecting internal carotid artery stenosis and occlusion.

Materials and Methods

We enrolled 20 patients with clinically suspected internal carotid artery stenosis and occlusion, or asymptomatic patient with more than 50% stenosis suspected on color Doppler ultrasonography for regular check-up. Prospectively, CTA, TOF-MRA and CE-MRA were performed, and sensitivity, specificity, positive predictive value, negative predictive value and accuracy of TOF-MRA and CE-MRA using CTA as a reference standard for detecting more than 50% stenosis were evaluated, and correlations of measured percent stenosis between 3 imaging studies were also evaluated.

Results

No significant difference was found between 3 imaging studies in measuring stenosis(p>0.05). Correlation coefficient was 0.932 between CTA and TOF-MRA, and 0.971 between CTA and CE-MRA. TOF-MRA had 83.3% sensitivity, 87.5% specificity, 71.4% positive predictive value, 93.3% negative predictive value and 86.4% accuracy for detecting more than 50% stenosis and occlusion. CE-MRA had 83.3% sensitivity, 93.8% specificity, 83.3% positive predictive value, 93.8% negative predictive value and 90.9% accuracy.

Conclusion

TOF-MRA and CE-MRA provided high correlations in the evaluation of internal carotid artery stenosis and occlusion.

Keywords: Carotid artery stenosis, Computed tomography angiography (CTA), Magnetic resonance angiography (MRA)

Figures and Tables

Fig. 1
A 73-year-old male patient with headache and dizziness.
(a) TOF-MRA (b) CE-MRA (c) CTA, These images show a low grade stenosis in right ICA.
jksmrm-15-234-g001
Fig. 2
A 64-year-old male non-symptomatic patient.
(a) TOF-MRA shows no stenotic lesion or plaque.
(b) CE-MRA shows no stenotic lesion or plaque.
(c, d) CTA(C: coronal, D: sagittal) shows a small calcified plaque in the left proximal ICA with mild degree stenosis.
jksmrm-15-234-g002
Table 1
Comparison of the Degree of ICA Stenosis with CT angiography, TOF-MRA and CE-MRA
jksmrm-15-234-i001

Note.-TOF-MRA = Time of flight Magnetic Resonance Angiography

CE-MRA = Contrast enhance MRA

Table 2
Comparison of 3-level Degree of ICA Stenosis with CT Angiography, TOF-MRA and CE-MRA
jksmrm-15-234-i002

Note.-TOF-MRA = Time of flight Magnetic Resonance Angiography

CE-MRA = Contrast enhance MRA

Table 3
Diagnostic index of TOF-MRA and CE-MRA
jksmrm-15-234-i003

Note.-TOF-MRA = Time of flight Magnetic Resonance Angiography

CE-MRA = Contrast enhance MRA, PPV = Positive predictive value, NPV = Negative predictive value

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