PMID- 11499642
OWN - NLM
STAT- MEDLINE
DCOM- 20011212
LR  - 20190901
IS  - 0340-5354 (Print)
IS  - 0340-5354 (Linking)
VI  - 248
IP  - 6
DP  - 2001 Jun
TI  - Ultrasonography and contrast-enhanced MRA in ICA-stenosis: is conventional 
      angiography obsolete?
PG  - 506-13
AB  - BACKGROUND: The standard techniques for the screening and staging of internal 
      carotid artery (ICA) stenosis are Doppler (continuous wave) and Duplex 
      sonography. For the imaging of ICA occlusive disease, magnetic resonance 
      angiography (MRA) is replacing digital subtraction angiography (DSA). The purpose 
      of this observational study was to assess whether contrast enhanced MRA (CE-MRA) 
      combined with ultrasound provided sufficient information for the planning of 
      surgical treatment. METHODS: CE-MRA was performed in 195 patients (mean age 67.5 
      years) with sonographic evidence of severe ICA stenosis. The MRA examination 
      protocol contained a heavily T1-weighted contrast bolus enhanced 3D-gradient echo 
      sequence. The degree of stenosis was estimated retrospectively by two experienced 
      neuroradiologists who were blinded to the sonographic findings. RESULTS: The 
      consistency of MRA and ultrasound was sufficient to plan thrombendarterectomy in 
      182/195 patients. The estimations of the degree of stenosis were congruent 
      between MRA and ultrasound in 91% of 197 vessels with high-degree carotid artery 
      stenosis. CE-MRA evaluation had a high interobserver agreement. In 3 cases 
      ultrasound examination diagnosed a filiform ICA stenosis which was not visible 
      with MRA. In all these cases, DSA and the intraoperative findings revealed very 
      short (1-2 mm), high-grade, excentric stenosis. CE-MRA correctly detected patency 
      in 5 patients with high-grade and low-flow carotid artery stenosis, which had 
      been regarded as occluded by ultrasound. Conversely with, in CE-MRA two occluded 
      vessels were falsely considered as open. CONCLUSION: The combination of 
      sonography and CE-MRA is a powerful tool for the non-invasive presurgical 
      evaluation of the carotid arteries. DSA should be reserved for selected cases.
FAU - Friese, S
AU  - Friese S
AD  - Department of Neuroradiology, University Hospital Tuebingen, Germany. 
      sdfriese@med.uni-tuebingen.de
FAU - Krapf, H
AU  - Krapf H
FAU - Fetter, M
AU  - Fetter M
FAU - Klose, U
AU  - Klose U
FAU - Skalej, M
AU  - Skalej M
FAU - Kuker, W
AU  - Kuker W
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - J Neurol
JT  - Journal of neurology
JID - 0423161
RN  - 0 (Contrast Media)
SB  - IM
MH  - Aged
MH  - Carotid Stenosis/*diagnosis/*diagnostic imaging
MH  - Contrast Media/administration & dosage
MH  - Diagnosis, Differential
MH  - Female
MH  - Humans
MH  - *Magnetic Resonance Angiography
MH  - Male
MH  - Middle Aged
MH  - Patient Care Planning
MH  - Sensitivity and Specificity
MH  - *Ultrasonography, Doppler
EDAT- 2001/08/14 10:00
MHDA- 2002/01/05 10:01
CRDT- 2001/08/14 10:00
PHST- 2001/08/14 10:00 [pubmed]
PHST- 2002/01/05 10:01 [medline]
PHST- 2001/08/14 10:00 [entrez]
AID - 10.1007/s004150170161 [doi]
PST - ppublish
SO  - J Neurol. 2001 Jun;248(6):506-13. doi: 10.1007/s004150170161.