MR Imaging: Influence of Imaging Technique and Postprocessing on Measurement of Internal Carotid Artery Stenosis

Runck, Frank; Steiner, R.; Bautz, W.; Lell, Michael

doi:10.3174/ajnr.a1179

Cited by 14 publications

(9 citation statements)

References 34 publications

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“…Firstly, the high reproducibility of basilar artery measurements has also been reported by others [18]. Moreover, analyses are not time-consuming (duration of 1 measurement including data processing about 5–10 min), and the MR angiography is broadly available, noninterventional and without contrast agent.…”

Section: Discussionmentioning

confidence: 95%

“…Studies validating TOF MR angiography measurements of the cerebral vessel diameters by phantom studies, animal models or by digital subtraction angiography showed sufficient concordance of the different measures [18,19,20]. One has to mention that the TOF angiography without the use of contrast agents is especially sensitive to fast-flowing blood, because only unsaturated blood produces a high signal [21,22].…”

Section: Discussionmentioning

confidence: 99%

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Basilar Artery Diameter Is a Potential Screening Tool for Fabry Disease in Young Stroke Patients

Fellgiebel¹,

Keller²,

Martus³

et al. 2010

Cerebrovasc Dis

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Background: Fabry disease (FD) is a rare hereditary lysosomal storage disease that has been highlighted as a possible etiology of stroke at a young age. Enlarged basilar artery diameters (BADs) have been demonstrated in FD, and we hypothesize that they might be useful for the screening of FD in young stroke patients. The aim of this study was to compare BADs of young stroke patients without FD to those of FD patients and of healthy age-matched controls. Methods: BADs were measured using MR angiography in 3 age- and gender-matched groups: 25 FD patients (aged 36.5 ± 11.0 years), 26 non-FD stroke patients and 20 healthy controls. Results: Compared to the non-FD stroke patients, FD patients had significantly enlarged BADs. FD patients could be significantly separated from stroke patients by BADs (area under the curve = 0.89, 95% confidence interval 0.81–0.98). Eighty-six percent of all subjects could be correctly classified by BADs (sensitivity 84%, specificity 88.5%). Conclusions: Enlarged BADs were able to detect FD within a cohort of FD, stroke patients and healthy controls. BAD measurement could be an easily obtainable and sensitive screening tool for FD in young stroke patients.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Basilar Artery Diameter Is a Potential Screening Tool for Fabry Disease in Young Stroke Patients

Fellgiebel¹,

Keller²,

Martus³

et al. 2010

Cerebrovasc Dis

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show abstract

“…Previous observational studies using MR angiography reported overestimations that have included a wide range of carotid artery stenosis, including a significant number of lesions with moderate to severe stenosis (23,24). Multiple factors may contribute to the stenosis measurement bias, including spatial resolution, sequence type (25), and postprocessing algorithms (26). However, as we found in this study, the improved motion-sensitization driven equilibrium-based 3D BB MR approach has potential advantages, such that flow artifacts should be of lesser concern and steno-occlusive lesions are directly visualized.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Carotid Artery Atherosclerotic Disease by Using Three-dimensional Fast Black-Blood MR Imaging: Comparison with DSA

Zhao¹,

Wang

Liu

et al. 2015

Radiology

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).q RSNA, 2014 Purpose:To assess fast three-dimensional (3D) black-blood (BB) magnetic resonance (MR) imaging as a noninvasive alternative to intraarterial digital subtraction angiography (DSA) at quantifying moderate to severe carotid artery atherosclerotic disease. Materials and Methods:Local ethics committee approval and written informed patient consent were obtained for this study. Sixty-five carotid arteries from 52 patients with at least 50% stenosis underwent 3D BB MR imaging and DSA. Quantitative measurements, including stenosis, lesion length, and the presence or absence of plaque ulceration, obtained with the two modalities were independently determined. Sensitivity and specificity, the intraclass correlation coefficient (ICC), Cohen k, and Bland-Altman analysis were used to assess the agreement. Results:Excellent agreement in measuring luminal stenosis was found between 3D BB MR imaging and DSA (ICC, 0.96; 95% confidence interval [CI]: 0.93, 0.97). Three-dimensional BB MR imaging was also found to have high sensitivity (91.7%), specificity (96.2%), and agreement (Cohen k, 0.85; 95% CI: 0.66, 0.99) with DSA for detection of ulcers. Good agreement was found between lesion length measured by using 3D BB MR imaging and DSA (ICC, 0.75; 95% CI: 0.51, 0.84). However, lesion length measurements by using 3D BB MR imaging were, on average, 4.0 mm longer than those measured by using DSA (P , .001). Conclusion:Three-dimensional BB MR imaging is a noninvasive and accurate way to quantify moderate to severe carotid artery atherosclerotic disease. With fast acquisition and large coverage, 3D BB MR imaging has the potential to become an alternative imaging approach in evaluating the severity of atherosclerosis.q RSNA, 2014

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“…Studies employing magnetic resonance venography (MRV) to examine venous stenosis in MS will have to examine both caliber and hemodynamic flow abnormalities, as well as determine the significance of these potential findings. In contrast to studies examining carotid artery stenosis and its clinical significance,49, 50 there are no such data for IJV or AV. Meticulously conducted MRV studies from multiple centers may be needed to provide insight into CCSVI and its potential relationship with MS.…”

mentioning

confidence: 97%

Chronic cerebrospinal venous insufficiency and multiple sclerosis

Khan

Filippi

Freedman

et al. 2010

Annals of Neurology

127

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A chronic state of impaired venous drainage from the central nervous system, termed chronic cerebrospinal venous insufficiency (CCSVI), is claimed to be a pathologic phenomenon exclusively seen in multiple sclerosis (MS). This has invigorated the causal debate of MS and generated immense interest in the patient and scientific communities. A potential shift in the treatment paradigm of MS involving endovascular balloon angioplasty or venous stent placement has been proposed as well as conducted in small patient series. In some cases, it may have resulted in serious injury. In this Point of View, we discuss the recent investigations that led to the description of CCSVI as well as the conceptual and technical shortcomings that challenge the potential relationship of this phenomenon to MS. The need for conducting carefully designed and rigorously controlled studies to investigate CCVSI has been recognized by the scientific bodies engaged in MS research. Several scientific endeavors examining the presence of CCSVI in MS are being undertaken. At present, invasive and potentially dangerous endovascular procedures as therapy for patients with MS should be discouraged until such studies have been completed, analyzed, and debated in the scientific arena. ANN NEUROL 2010;67:286 -290 R ecently, the topic of chronic cerebrospinal venous insufficiency (CCSVI) and its potential relationship to multiple sclerosis (MS) has generated tremendous interest in the news media, spilling over to the patient and scientific communities. Described as a state of chronic impaired venous drainage from the central nervous system (CNS), the emergence of CCSVI with respect to MS is based on the work done by Zamboni and colleagues. This was followed by a small open-label study conducted to study the effect of endovascular angioplasty in MS patients with CCSVI.2 Prompted by this series of events, this Point of View will review available information on CCSVI, its potential relationship to MS pathology, and what further research needs to be undertaken while keeping patient safety foremost.Transcranial color-coded Doppler sonography (TCCS) is a technique that superimposes a color-coded image of blood flow of intracranial vessels on a gray scale image to evaluate intracranial veins. By combining TCCS and extracranial color-Doppler sonography (ECD), Zamboni and colleagues studied 109 MS patients and 177 matched controls.3 Based on venous flow parameters established in their laboratory, they found 288 normal and 257 anomalous TCCS-ECD parameters in MS patients. In contrast, 861 normal and 24 anomalous parameters were seen in control subjects. The authors focused in particular on 5 anomalous parameters of cerebral venous drainage: (1) reflux in the internal jugular (IJV) and vertebral veins (VV), (2) reflux in the deep cerebral veins, (3) high-resolution B-mode evidence of IJV stenosis, (4) flow Published online in Wiley InterScience (www.interscience.wiley.com).

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MR Imaging: Influence of Imaging Technique and Postprocessing on Measurement of Internal Carotid Artery Stenosis

Cited by 14 publications

References 34 publications

Basilar Artery Diameter Is a Potential Screening Tool for Fabry Disease in Young Stroke Patients

Basilar Artery Diameter Is a Potential Screening Tool for Fabry Disease in Young Stroke Patients

Assessment of Carotid Artery Atherosclerotic Disease by Using Three-dimensional Fast Black-Blood MR Imaging: Comparison with DSA

Chronic cerebrospinal venous insufficiency and multiple sclerosis

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