J Korean Soc Magn Reson Med.  2011 Dec;15(3):234-241. 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

• Lee J
• Chung TS
• Lee KY
• Suh SH

• KMID: 2000052
• DOI: http://doi.org/10.13104/jksmrm.2011.15.3.234

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.

Keyword

Carotid artery stenosis; Computed tomography angiography (CTA); Magnetic resonance angiography (MRA)

MeSH Terms

Angiography
Carotid Arteries
Carotid Stenosis
Constriction, Pathologic
Humans
Prospective Studies
Sensitivity and Specificity
Ultrasonography, Doppler, Color

Figure

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  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.

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  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.

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