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Detection of Occlusive Lesions in Intracranial Arteries by Three-Dimensional Time-of-Flight Magnetic Resonance Angiography
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1994
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Cerebrovascular DiseaseNeurovascular DiseaseVascular SurgeryVascular ImagingExtracranial ComplicationsBrain InjuryNeurologyMiddle Cerebral ArteryCerebrovascular InterventionPublic HealthRadiologyCardiovascular ImagingVascular ImageMedical ImagingMedicineNeurological MonitoringNeuroimagingCerebral Blood FlowMild StenosisDigital Subtraction AngiographyConventional AngiographyIntracranial ArteriesInterventional NeuroradiologyCardiovascular DiseaseIschemic StrokeOcclusive LesionsStroke
To evaluate the accuracy of 3-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA) for detecting intracranial arterial occlusive disease, this technique was compared with conventional angiography. The subjects were 54 patients with cerebrovascular ischemic disease. Using a semi-quantified grading scheme, stenotic lesions were assessed for each segment of the intracranial arteries to the level of the second segment. A high correlation in the degree of stenosis (Spearman rank correlation = 0.68, p = 0.0001, ĸstatistic = 0.846) and an extremely high sensitivity (100%) for detecting occlusive lesions were found. Specificity for each segment of the intracranial arteries varied from 94.8% (Ml portion of the middle cerebral artery) to 83.3% (Al portion of the anterior cerebral artery). However, mild stenosis tended to be slightly overestimated, and false-positive readings in specific parts of the vessels (the carotid siphon, the anterior cerebral artery orifice, and the middle cerebral artery bifurcation) were not insubstantial. We conclude that despite a relatively high false-positive rate in some regions, 3D TOF MRA is useful for evaluating intracranial major vessels in stroke patients.