Comparison of non-contrast vessel wall imaging and 3-D time-of-flight MRA for atherosclerotic stenosis and plaque characterization within intracranial arteries - 22/06/19
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Graphical abstract |
Highlights |
• | VWI has reasonable sensitivity (92.5%) and specificity (82.1%) for luminal narrowing and diameter assessment of the intracranial arteries compared to 3D-TOF. |
• | 3D-TOF has relatively limited sensitivity (59.4%) for identification of areas of plaques compared to VWI. |
• | Mean intra-rater differences in diameter measurements between VWI and 3D-TOF, and mean inter-rater differences in luminal measurements for VWI ranged from 0.02 mm to 0.35 mm (SD 0.49–0.66 mm), corresponding to good to excellent agreement. |
• | VWI without gadolinium can be used for simultaneous luminal stenosis and atherosclerotic plaque assessment of the major intracranial arteries. |
Abstract |
Purpose |
We compared the ability of intracranial high-resolution vessel wall imaging (VWI) without gadolinium and 3-D time-of-flight (3D-TOF) MRA techniques to characterize intracranial arterial stenosis and arterial wall plaque consistent with atherosclerotic plaque.
Methods |
Consecutive intracranial VWI examinations performed within 2 months of a 3D-TOF exam with at least 1 noted plaque was included. Examinations assessed 17 vessel segments for plaque and diameters of stenotic and normal segments using double oblique reformatted images. Results were compared with the VWI and 3D-TOF exams considered the reference standard for plaque and luminal stenosis, respectively.
Results |
Assessed segments totaled 286 from 17 patients. Proximal segment sensitivity and specificity for luminal stenosis detection with VWI was 92.5% and 82.1%, respectively, whereas for assessing plaque with 3D-TOF it was 59.4% and 98.3%, respectively. The mean intra-rater difference in luminal diameter measurements between VWI and 3D-TOF at normal segments and at the area of maximal stenosis was 0.02mm (SD 0.51mm) and 0.08mm (SD 0.66mm), respectively.
Conclusions |
Intracranial VWI demonstrated reasonably high sensitivity and specificity for luminal stenosis assessment using 3D-TOF as a reference standard, while 3D-TOF demonstrated low sensitivity for plaque detection. Our results suggest that VWI can be used for simultaneous assessment of luminal stenosis and plaque in the intracranial arteries.
Le texte complet de cet article est disponible en PDF.Keywords : Vessel wall imaging, Magnetic resonance angiogram, Magnetic resonance imaging, Atherosclerosis
Abbreviations : 3D-TOF
Plan
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