PMID- 19096951
OWN - NLM
STAT- MEDLINE
DCOM- 20090303
LR  - 20090122
IS  - 1600-0455 (Electronic)
IS  - 0284-1851 (Linking)
VI  - 50
IP  - 1
DP  - 2009 Jan
TI  - Association of lumbar arterial stenosis with low back symptoms: a cross-sectional 
      study using two-dimensional time-of-flight magnetic resonance angiography.
PG  - 48-54
LID - 10.1080/02841850802587862 [doi]
AB  - BACKGROUND: Recent studies indicate that diminished blood flow may cause low back 
      symptoms and intervertebral disc degeneration. PURPOSE: To explore the 
      association between lumbar arterial stenosis as detected by two-dimensional 
      time-of-flight magnetic resonance angiography (2D TOF-MRA) and lumbar pain 
      symptoms in an occupational cohort of middle-aged Finnish males. MATERIAL AND 
      METHODS: 228 male subjects aged 36 to 55 years (mean 47 years) were imaged with 
      2D TOF-MRA. Additionally, 20 randomly selected subjects were scanned with 
      contrast-enhanced MRA (ceMRA). In each subject, the first (L1) to fourth (L4) 
      segmental lumbar arteries were evaluated for lumbar artery stenosis using a 
      dichotomic scale. One subject was excluded because of poor image quality, 
      reducing the study population to 227 subjects. Logistic regression analysis was 
      used to evaluate the association between arterial stenosis in 2D TOF-MRA and low 
      back pain and sciatica symptoms (intensity, duration, frequency). RESULTS: 
      Comparing 2D TOF-MRA and ceMRA images, the kappa value (95% confidence interval) 
      was 0.52 (0.31-0.73). The intraobserver reliability kappa value for 2D TOF-MRA 
      was 0.85 (0.77-0.92), and interobserver kappa was 0.57 (0.49-0.65). The 
      sensitivity of 2D TOF-MRA in detecting stenosis was 0.58, the accuracy 0.89, and 
      the specificity 0.94. In 97 (43%) subjects all arteries were normal, whereas 130 
      (57%) had at least one stenosed artery. The left L4 artery was most often 
      affected. The degree of arterial stenosis was associated with intensity of low 
      back and sciatic pain, and sciatica pain duration during the past 3 months. 
      CONCLUSION: 2D TOF-MRA is an acceptable imaging method for arterial stenosis 
      compared to ceMRA. Arterial stenosis was associated with subjective pain 
      symptoms, indicating a role of decreased nutrition in spinal disorders.
FAU - Korkiakoski, A
AU  - Korkiakoski A
AD  - Institute of Clinical Sciences, Department of Physical and Rehabilitation 
      Medicine, University of Oulu, Oulu, Finland. atkorkia@paju.oulu.fi
FAU - Niinimaki, J
AU  - Niinimaki J
FAU - Karppinen, J
AU  - Karppinen J
FAU - Korpelainen, R
AU  - Korpelainen R
FAU - Haapea, M
AU  - Haapea M
FAU - Natri, A
AU  - Natri A
FAU - Tervonen, O
AU  - Tervonen O
LA  - eng
PT  - Journal Article
PL  - England
TA  - Acta Radiol
JT  - Acta radiologica (Stockholm, Sweden : 1987)
JID - 8706123
SB  - IM
MH  - Adult
MH  - Arterial Occlusive Diseases/*complications/*diagnosis/physiopathology
MH  - Cross-Sectional Studies
MH  - Finland
MH  - Humans
MH  - Image Interpretation, Computer-Assisted
MH  - Logistic Models
MH  - Low Back Pain/*etiology/physiopathology
MH  - Lumbosacral Region/*blood supply
MH  - Magnetic Resonance Angiography/*methods
MH  - Male
MH  - Middle Aged
MH  - Pain Measurement
EDAT- 2008/12/20 09:00
MHDA- 2009/03/04 09:00
CRDT- 2008/12/20 09:00
PHST- 2008/12/20 09:00 [entrez]
PHST- 2008/12/20 09:00 [pubmed]
PHST- 2009/03/04 09:00 [medline]
AID - 906991961 [pii]
AID - 10.1080/02841850802587862 [doi]
PST - ppublish
SO  - Acta Radiol. 2009 Jan;50(1):48-54. doi: 10.1080/02841850802587862.