Diagnostic ability of 3 dimensional contrast enhanced MR angiography in identifying vertebral basilar artery stenosis
BACKGROUND Vertebral basilar artery stenosis is associated with posterior circulation infarction. So correct detection of vertebral basilar artery stenosis is very important. Studies concerning the sensitivity and specificity of 3 dimensional contrast enhanced MR angiography (3D CE MRA) in detecting vertebral basilar artery stenosis is generally lacking. METHODS Retrospectively reviewed the imagines of consecutive one hundred and forty nine Chinese patients with ischemic stroke or vertigo/dizziness who underwent 3D CE MRA and DSA. DSA and CE MRA images were studied separately and to determine the presence of mild, moderate, or severe stenosis of the vertebral basilar arteries. Analysis combined with vascular origin image was applied when evaluating the vertebral artery origin stenosis. Sensitivity, specificity, positive and negative predictive values, and the accuracy of 3D CE MRA in detecting and grading of vertebral basilar artery stenosis were calculated. RESULTS Compared with DSA, sensitivity, specificity and accuracy of 3D CE MRA in detecting of vertebral artery origin =70% stenosis or occlusion was 97.1% 77.4% and 81.9% but diagnostic consistency was poor (K=0.59) Analysis combined with vascular origin images, the specificity (97.8% accuracy (92.9% and consistency (K=0.826) was significantly improved. CONCLUSIONS 3D CE MRA is a sensitive and noninvasive technique for the detection of vertebral artery origin stenosis. Furthermore, analysis combined with vascular origin image would improve the diagnostic accuracy.
Journal of the Neurological Sciences