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(Stroke. 2005;36:38.)
© 2005 American Heart Association, Inc.

Original Contributions

Noninvasive Detection of Steno-Occlusive Disease of the Supra-Aortic Arteries With Three-Dimensional Contrast-Enhanced Magnetic Resonance Angiography

A Prospective, Intra-Individual Comparative Analysis With Digital Subtraction Angiography

Winfried A. Willinek, MD; Marcus von Falkenhausen, MD; Markus Born, MD; Jürgen Gieseke, PhD, MD; Tobias Höller, MSc; Thomas Klockgether, MD; Hans J. Textor, MD; Hans H. Schild, MD Horst Urbach, MD

From the Department of Radiology (W.A.W., M.v.F., M.B., J.G., H.J.T., H.H.S., H.U.), Institute of Medical Biometrics, Informatics, and Epidemiology (T.H.), and the Department of Neurology (T.K.), University of Bonn, Germany.

Correspondence to Dr W. A. Willinek, Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, D-53105 Bonn, Germany. E-mail winfried.willinek{at}ukb.uni-bonn.de

Background and Purpose— Concomitant disease of the supra-aortic arteries can influence the outcome of surgical treatment of carotid artery stenosis. However, sensitivity and specificity data of noninvasive contrast-enhanced 3-dimensional (3D) magnetic resonance angiography (CE MRA) for the detection of steno-occlusive disease of the entire supra-aortic arteries including the circle of Willis remain unclear. We aimed to intra-individually compare high-spatial-resolution CE 3D MRA and digital subtraction angiography (DSA) for the assessment of steno-occlusive vascular disease of the supra-aortic arteries.

Methods— CE MRA and DSA of the supra-aortic arteries were prospectively performed in 50 consecutive patients. Intra-individual comparison of CE MRA and DSA was available in 833 arteries. High-spatial-resolution CE MRA comprised a measured voxel size of 0.81 mm x 0.81 mm x 1 mm (0.66 mm³). Steno-occlusive vascular disease of the 833 arteries was assessed independently by 2 radiologists according to the NASCET criteria.

Results— CE MRA had a sensitivity of 100% (73/73), a specificity of 99.3% (760/765), a positive predictive value of 93.6% (73/78), and a negative predictive value of 100% (760/760) by using a 70% to 99% threshold of arterial diameter stenosis. For detection of occlusion, sensitivity, specificity, PPV, and NPV value of CE MRA were 100%, respectively.

Conclusions— Noninvasive high-spatial-resolution CE MRA is suited to replace diagnostic DSA for the detection of steno-occlusive disease of the supra-aortic arteries.

Key Words: carotid stenosis • comparative study • magnetic resonance angiography • magnetic resonance imaging • supra-aortic arteries

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