The current role of 1.5T non-contrast 3D time-fo-flight magnetic resonance angiography to detect intracranial steno-occlusive disease

Cindy Sadikin, Michael Mu Huo Teng*, Ting Yi Chen, Chao Bao Luo, Feng Chi Chang, Jiing Feng Lirng, Ying Chou Sun

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

Abstract

Background/Purpose: This study was performed to evaluate the role of non-contrast 3D time-of-flight (TOF) magnetic resonance angiography (MRA) to detect and quantify intracranial steno-occlusive disease. Methods: Between April 2004 and January 2006, 45 patients with both 1.5T TOF MRA and digital subtraction angiography (DSA) performed within a 30-day interval were included. We evaluated the following intracranial arterial segments: petrous internal carotid artery (ICA), cavernous ICA, supraclinoid ICA, M1 of middle cerebral artery, A1 of anterior cerebral artery, P1 of posterior cerebral artery, basilar artery, and distal vertebral artery. In total, 675 arterial segments were evaluated and categorized as negative, moderate-1 (30-49% stenosis), moderate-2 (50-69%), severe (70-99% stenosis, including gap sign on MRA), and occlusion. Results: The sensitivity and specificity of TOF MRA for >29% stenosis and >49% stenosis were 94%, 96% and 95%, 96%, respectively; while sensitivity and specificity for occlusion lesions were both 100%. However, 44 segments (37% of diseased segments) were overestimated by MRA, induding 20 false-positive stenoses (which occurred in 10 [22%] patients) and 24 overestimated stenosis degree. The gap sign as severe stenosis only showed about 21% sensitivity and 41% specificity. Seven lesions were underestimated by MRA: three arterial segments were out of the field of MRA examination, and four were moderate-1 stenosis on DSA. Conclusion: TOF MRA has high sensitivity and specificity in detecting all categories of stenosis degree and occlusion. However, it tends to overestimate lesions. Therefore, MRA can be considered as a screening study. Confirmation with other studies is recommended in doubtful cases.

Original languageEnglish
Pages (from-to)691-699
Number of pages9
JournalJournal of the Formosan Medical Association
Volume106
Issue number9
DOIs
StatePublished - Sep 2007

Keywords

  • Digital subraction angiography
  • Intracranial vessels
  • Occlusion
  • Stenosis
  • Time-of-flight magnetic resonance angiography

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