Comparison of magnetic resonance angiography, conventional angiography, and duplex scanning.

Riles, Thomas S.; Eidelman, E M; Litt, Andrew W.; Pinto, Richard S.; Oldford, F.; Schwartzenberg, G W

doi:10.1161/01.str.23.3.341

Cited by 107 publications

(56 citation statements)

References 17 publications

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“…DS was associated with better results, as previously described 14,18,22 . The most important task of the diagnostic tests evaluated here is to determine which should be referred to endarterectomy.…”

Section: Discussionsupporting

confidence: 79%

“…Also, there is some error related to DGA, as shown when inter-observer concordance is assessed [14][15][16] . The present study compares two non-invasive procedures to DGA, attempting to reduce the risks and costs attributed to DGA, as other authors have done before 14,[16][17][18][19][20][21][22][23] .…”

mentioning

confidence: 99%

“…New technologies, like power-Doppler and ultrasound contrast make this exam even more accurate 15,25 . DS is a safe, non-invasive exam and can be done on bedside, although it is a professional-dependent method 13,18 .…”

mentioning

confidence: 99%

“…Some studies on this issue divide IC stenosis in categories, from simple dicotomization 22 to five categories 18 . There is also a report distinguishing only occlusion and sub-occlusion 16 .…”

mentioning

confidence: 99%

“…There is no agreement about the accuracy of non-invasive methods in the various studies. Some showed bad results 16,18,20,23 , while others obtained good correlation with only limited restrictions, mainly in cases of IC sub-occlusion or when DS and MRA disagree 14,17,19,21,22 .…”

mentioning

confidence: 99%

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Internal carotid artery stenosis: comparison of duplex scan and magnetic resonance angiography with digital subtraction angiography

André

Azevedo

et al. 2001

Arq. Neuro-Psiquiatr.

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-Objective: We compare duplex scan (DS) and magnetic resonance angiography (MRA) with digital angiography (DGA) in respect to accuracy in measuring internal carotid artery (IC) stenosis in symptomatic patients. Method: Ten symptomatic patients with IC stenosis greater than 70% previously diagnosed by DS were submitted to another DS and to both MRA and DGA. Both ICs from each patient (total 20 ICs) were evaluated by physicians blinded for the results of other tests. DS and MRA were compared with DGA, using the intraclass correlation coeficient (r) and its 95% confidence interval (95% ci). .or each diagnostic test, the study group (20 Ics) was also divided in surgical patients (IC stenosis between 70 and 99%) and non surgical patients, using kappa concordance coeficient (k) to compare the results. KEY WORDS: carotid stenosis, diagnosis, cerebrovascular disease, comparative study.Estenose da artéria carótida interna extracraniana: comparação de duplex-scan e angio-ressonância com angiografia digital RESUMO -Objetivo: .oram comparados duplex scan (DS) e angio-ressonância magnética (AGRM) com angiografia digital (AGD) na avaliação da estenose da artéria carótida interna (CI). Método: .oram estudados 10 pacientes sintomáticos com estenose da CI superior a 70% em estudos de triagem com DS. Os pacientes foram submetidos a novo DS, AGRM e AGD para estudo de ambas as CIs (total 20 CIs). O DS e a AGRM foram comparados com a AGD utilizando-se o coeficiente de correlação intra-classe (r) e o seu intervalo de confiança a 95% (ic 95%). Para cada método diagnóstico, o grupo de pacientes (considerando as 20 CIs) foi também dicotomizado em casos cirúrgicos (estenose entre 70% e 99%) e não cirúrgicos, utilizando-se o coeficiente kappa de concordância (k). Resultados: Na comparação entre DS e AGD, obteve-se r = 0,71 (0,4 -0,87). Entre AGRM e AGD, r = 0,61 (0,25 -0,82). Após a dicotomização da amostra, obteve-se, entre DS e AGD, k = 0,857, p < 0,0001; e entre AGRM e AGD, k = 0,545, p = 0,003. A maioria dos erros de DS e AGRM ocorreu nos casos de suboclusão arterial. Conclusão: Os resultados sugerem que o DS e a AGRM, usados em conjunto, podem substituir a AGD na indicação da endarterectomia carotídea, exceto quando há discordância entre os dois ou quando algum dos métodos detecta suboclusão arterial.

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Section: Discussionsupporting

confidence: 79%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Internal carotid artery stenosis: comparison of duplex scan and magnetic resonance angiography with digital subtraction angiography

André

Azevedo

et al. 2001

Arq. Neuro-Psiquiatr.

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The Identification by Imaging Methods of Patients Who Might Benefit From Carotid Endarterectomy

Barnett¹,

Eliasziw²,

Meldrum³

1995

Archives of Neurology

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The Uncertainties Surrounding Carotid Endarterectomy

Barnett¹

1992

JAMA

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development of intraglomerular hypertension and glomerular sclerosis, and a primary abnormality in the renal vasculature, especially in blacks, which leads to hypertension.9 The study of Walker et al5 strongly supports the need for the National Institutes of Health-led multicenter trial now being planned. This aims to determine optimum target blood pres¬ sure levels and the specific antihypertensive drug therapy required to maintain or improve true glomerular filtration rate in hypertensive African Americans.Pending the results of this trial, attempts to prevent hy¬ pertensive nephrosclerosis in African Americans might rea¬ sonably include the following measures. Periodic screening for hypertension is justified in all adult groups in the United States,10 but this is especially cost-effective for blacks and diabetics. In families with a strong history of hypertension, stroke, hypertensive cardiac failure, or hypertensive neph¬ rosclerosis, introduction in childhood of diets low in sodium chloride and high in potassium would be prudent. Even mild hypertension should be treated in blacks and in diabetics by nonpharmacological and, if necessary, drug therapy. The threshold for treatment should be low11 and if the patient is at risk for, or has already developed, hypertensive nephro¬ sclerosis, a combination of a CEI and a calcium channel block¬ er may be best if monotherapy with either is not sufficient. Black hypertensive subjects with moderate hypertension re-spond 75% of the time to a calcium channel blocker as monotherapy, but also over 50% of the time to a CEI as monotherapy.12 However, the most important thing is to control the blood pressure well with a drug the patient can tolerate and afford.

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Comparison of magnetic resonance angiography, conventional angiography, and duplex scanning.

Cited by 107 publications

References 17 publications

Internal carotid artery stenosis: comparison of duplex scan and magnetic resonance angiography with digital subtraction angiography

Internal carotid artery stenosis: comparison of duplex scan and magnetic resonance angiography with digital subtraction angiography

The Identification by Imaging Methods of Patients Who Might Benefit From Carotid Endarterectomy

The Uncertainties Surrounding Carotid Endarterectomy

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