Carotid Artery Disease Diagnosed with MR Angiography
High-grade internal carotid artery (ICA) occlusions and stenoses can be effectively diagnosed with time-of-flight (TOF) and contrast-enhanced (CE) MR angiography. Data to this effect was described in last month’s issue of Stroke.
Researchers from SUNY Downstate completed a systematic review, complemented by a diagnostic meta-analysis of existing data. Studies were required to compare either CE or TOF MRA with intra-arterial angiography. Data was compiled from the PubMed, SCOPUS, and EMBASE databases through November 2006.
This information was utilized to determine both the sensitivity and specificity of CE and TOF MRA alike in the detection of high-grade ICA stenoses and occlusions. They further determined such for patients with moderately severe stenosis. An additional endpoint of interest was the overall accuracy of the two different imaging methods.
The sensitivity of TOF MRA for high-grade disease was documented at 91.2 percent and sensitivity was 88.3 percent. Sensitivity and specificity for CE MRA in assessing the worst disease, respectively, was 94.6 and 91.9 percent. Both approaches had increased rates of sensitivity and specificity for detection of ICA occlusions. Alternatively, both are limited in the ability to detect moderate stenosis.
Data presented suggested that this approach may be even more effective than the current standard of care to evaluate patients for disease, intra-arterial angiography. Correctly determining the extent of disease in these patients is critical for choosing an appropriate regimen to minimize the probability of stroke.
September 4, 2008 Related topics: Imaging, Diagnostic, Cardiology