Comparison of contrast enhanced MRA and DSA on supraaortic vessels

COMPARISON of CONTRAST ENHANCED MRA and DSA onSUPRAAORTİC VESSELSDr. Volkan KAHVECİ8. SUMMARYPurpose:To assess the accuracy of contrast enhanced magnetic resonance angiography(CEMRA) as compared with digital subtraction angiography (DSA) for the evaluation ofsupraaortic vascular stenoocclusive disease.Materials and Methods:We retrospectively reviewed sixty patients underwent both contrast enhanced MRangiography (CEMRA) and digital subtraction angiography (DSA) for supraaortic vascularstenoocclusive disease. CEMRA was performed with 3D SPGR sequence on a 1.5 T MRscanner. For each supraaortic vessel (brachiocephalic, left subclavian, carotid and vertebralarteries) (n=360) stenosis was graded as follows: normal, <%30, %30-49, %50-69, %70-99,%100 (occlusion) for carotid and brachiocephalic-subclavian artery segments and normal,<%50, %50-99, %100 (occlusion.) for vertebral artery V1 segments. 112 of the 120 carotidarteries, 112 of the 120 vertebral arteries and 118 of the 120 brachiocephalic- left subclavianarteries included in this study (n:342). 18 of the 360 arteries excluded.The McNemar test was used to determine possible significant differences in overallaccuracy between MR angiography and DSA results. The degree of agreement betweenMRA and DSA determined by using the Kappa statistic. Sensitivity, spesificity, positive andnegative predictive values of contrast enhanced MR angiography were calculated andcompared with DSA.Results:Differences in overall accuracy (McNemar) and degree of agreement (κ statistics)between MRA and DSA for carotid arteries, vertebral arteries and brachiocephalic-subklavian arteries were, p=1.00, p<0,001, ρ=0,289, κ= 0,768 (p<0,001), κ =0,355 (p<0,001),κ =0,788 ( p<0,001) respectively. The sensitivity and specificity of MRA for detection ofdisease in the entire carotid, vertebral and brachiocephalic- left subclavian arteries were,%97.9, %92.5, %93.9 and %88.2, %48.9, %92.9 respectively.Conclusion:MR angiography is an adequate diagnostic tool for carotid and brachiocephalic-subclavian arteries except vertebral arteries.