Gadolinium-enhanced 3D MRA of the aortic arch vessels in the detection of atherosclerotic cerebrovascular occlusive disease
Our goal was to evaluate non-breath-hold Gd-enhanced 3D MR angiography (MRA) for the detection of atherosclerotic occlusive disease of the aortic arch vessels and to compare image quality with two breath-hold techniques. One hundred sixty consecutive patients with known or clinically suspected ather...
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| Veröffentlicht in: | Journal of computer assisted tomography 1998-03, Vol.22 (2), p.167-178 |
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| creator | KRINSKY, G MAYA, M LITT, A WEINREB, J ROFSKY, N LEBOWITZ, J NELSON, P. K AMBROSINO, M KAMINER, E EARLS, J MASTERS, L GIANGOLA, G |
| description | Our goal was to evaluate non-breath-hold Gd-enhanced 3D MR angiography (MRA) for the detection of atherosclerotic occlusive disease of the aortic arch vessels and to compare image quality with two breath-hold techniques.
One hundred sixty consecutive patients with known or clinically suspected atherosclerotic cerebrovascular occlusive disease underwent Gd-enhanced 3D MRA of the aortic arch and great vessels. One hundred twenty-six examinations were performed with the body coil after infusion of 40 ml of Gd-DTPA; 89 of these were performed without breath-holding and 37 were acquired during suspended respiration. Thirty-four examinations were performed in a body phased-array coil with breath-holding, a timing examination, and 20 ml of contrast agent by manual (n = 17) or power (n = 17) injection. Images were evaluated for the presence of blurring and ghosting artifacts and venous enhancement. Of the 27 patients who underwent non-breath-hold MRI and digital subtraction angiography (DSA), two readers blinded to the DSA results retrospectively evaluated the MRA examinations for the presence of occlusive disease of the innominate, carotid, subclavian, and vertebral arteries. DSA correlation was not evaluated for the 71 breath-hold studies.
Sensitivity and specificity for arch vessel occlusive disease with non-breath-hold MRA were 38 and 94% for Reader A and 38 and 95% for Reader B. Breath-holding significantly reduced blurring and ghosting artifacts (p < 0.001) when compared with non-breath-hold imaging, and use of 20 ml of contrast medium, with a timing examination, resulted in significantly less venous enhancement than seen with 40 ml (p < 0.001).
Non-breath-hold Gd-enhanced 3D MRA is insensitive for detecting arch vessel occlusive disease. Breath-hold imaging, in conjunction with a timing examination and a lower dose of contrast agent, improves image quality, but further studies are needed to assess diagnostic accuracy. |
| doi_str_mv | 10.1097/00004728-199803000-00003 |
| format | Article |
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One hundred sixty consecutive patients with known or clinically suspected atherosclerotic cerebrovascular occlusive disease underwent Gd-enhanced 3D MRA of the aortic arch and great vessels. One hundred twenty-six examinations were performed with the body coil after infusion of 40 ml of Gd-DTPA; 89 of these were performed without breath-holding and 37 were acquired during suspended respiration. Thirty-four examinations were performed in a body phased-array coil with breath-holding, a timing examination, and 20 ml of contrast agent by manual (n = 17) or power (n = 17) injection. Images were evaluated for the presence of blurring and ghosting artifacts and venous enhancement. Of the 27 patients who underwent non-breath-hold MRI and digital subtraction angiography (DSA), two readers blinded to the DSA results retrospectively evaluated the MRA examinations for the presence of occlusive disease of the innominate, carotid, subclavian, and vertebral arteries. DSA correlation was not evaluated for the 71 breath-hold studies.
Sensitivity and specificity for arch vessel occlusive disease with non-breath-hold MRA were 38 and 94% for Reader A and 38 and 95% for Reader B. Breath-holding significantly reduced blurring and ghosting artifacts (p < 0.001) when compared with non-breath-hold imaging, and use of 20 ml of contrast medium, with a timing examination, resulted in significantly less venous enhancement than seen with 40 ml (p < 0.001).
Non-breath-hold Gd-enhanced 3D MRA is insensitive for detecting arch vessel occlusive disease. Breath-hold imaging, in conjunction with a timing examination and a lower dose of contrast agent, improves image quality, but further studies are needed to assess diagnostic accuracy.</description><identifier>ISSN: 0363-8715</identifier><identifier>EISSN: 1532-3145</identifier><identifier>DOI: 10.1097/00004728-199803000-00003</identifier><identifier>PMID: 9530375</identifier><identifier>CODEN: JCATD5</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Analysis of Variance ; Angiography, Digital Subtraction - instrumentation ; Angiography, Digital Subtraction - methods ; Angiography, Digital Subtraction - statistics & numerical data ; Aorta, Thoracic - diagnostic imaging ; Aorta, Thoracic - pathology ; Biological and medical sciences ; Contrast Media ; Female ; Gadolinium DTPA ; Humans ; Intracranial Arteriosclerosis - diagnosis ; Investigative techniques, diagnostic techniques (general aspects) ; Magnetic Resonance Angiography - instrumentation ; Magnetic Resonance Angiography - methods ; Magnetic Resonance Angiography - statistics & numerical data ; Male ; Medical sciences ; Middle Aged ; Nervous system ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Sensitivity and Specificity ; Statistics, Nonparametric</subject><ispartof>Journal of computer assisted tomography, 1998-03, Vol.22 (2), p.167-178</ispartof><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c339t-126567a067ade6d4e094a1edc1f0756926b0827d422b853340eeb07d05929e663</citedby><cites>FETCH-LOGICAL-c339t-126567a067ade6d4e094a1edc1f0756926b0827d422b853340eeb07d05929e663</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2206970$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9530375$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>KRINSKY, G</creatorcontrib><creatorcontrib>MAYA, M</creatorcontrib><creatorcontrib>LITT, A</creatorcontrib><creatorcontrib>WEINREB, J</creatorcontrib><creatorcontrib>ROFSKY, N</creatorcontrib><creatorcontrib>LEBOWITZ, J</creatorcontrib><creatorcontrib>NELSON, P. K</creatorcontrib><creatorcontrib>AMBROSINO, M</creatorcontrib><creatorcontrib>KAMINER, E</creatorcontrib><creatorcontrib>EARLS, J</creatorcontrib><creatorcontrib>MASTERS, L</creatorcontrib><creatorcontrib>GIANGOLA, G</creatorcontrib><title>Gadolinium-enhanced 3D MRA of the aortic arch vessels in the detection of atherosclerotic cerebrovascular occlusive disease</title><title>Journal of computer assisted tomography</title><addtitle>J Comput Assist Tomogr</addtitle><description>Our goal was to evaluate non-breath-hold Gd-enhanced 3D MR angiography (MRA) for the detection of atherosclerotic occlusive disease of the aortic arch vessels and to compare image quality with two breath-hold techniques.
One hundred sixty consecutive patients with known or clinically suspected atherosclerotic cerebrovascular occlusive disease underwent Gd-enhanced 3D MRA of the aortic arch and great vessels. One hundred twenty-six examinations were performed with the body coil after infusion of 40 ml of Gd-DTPA; 89 of these were performed without breath-holding and 37 were acquired during suspended respiration. Thirty-four examinations were performed in a body phased-array coil with breath-holding, a timing examination, and 20 ml of contrast agent by manual (n = 17) or power (n = 17) injection. Images were evaluated for the presence of blurring and ghosting artifacts and venous enhancement. Of the 27 patients who underwent non-breath-hold MRI and digital subtraction angiography (DSA), two readers blinded to the DSA results retrospectively evaluated the MRA examinations for the presence of occlusive disease of the innominate, carotid, subclavian, and vertebral arteries. DSA correlation was not evaluated for the 71 breath-hold studies.
Sensitivity and specificity for arch vessel occlusive disease with non-breath-hold MRA were 38 and 94% for Reader A and 38 and 95% for Reader B. Breath-holding significantly reduced blurring and ghosting artifacts (p < 0.001) when compared with non-breath-hold imaging, and use of 20 ml of contrast medium, with a timing examination, resulted in significantly less venous enhancement than seen with 40 ml (p < 0.001).
Non-breath-hold Gd-enhanced 3D MRA is insensitive for detecting arch vessel occlusive disease. Breath-hold imaging, in conjunction with a timing examination and a lower dose of contrast agent, improves image quality, but further studies are needed to assess diagnostic accuracy.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis of Variance</subject><subject>Angiography, Digital Subtraction - instrumentation</subject><subject>Angiography, Digital Subtraction - methods</subject><subject>Angiography, Digital Subtraction - statistics & numerical data</subject><subject>Aorta, Thoracic - diagnostic imaging</subject><subject>Aorta, Thoracic - pathology</subject><subject>Biological and medical sciences</subject><subject>Contrast Media</subject><subject>Female</subject><subject>Gadolinium DTPA</subject><subject>Humans</subject><subject>Intracranial Arteriosclerosis - diagnosis</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Magnetic Resonance Angiography - instrumentation</subject><subject>Magnetic Resonance Angiography - methods</subject><subject>Magnetic Resonance Angiography - statistics & numerical data</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Sensitivity and Specificity</subject><subject>Statistics, Nonparametric</subject><issn>0363-8715</issn><issn>1532-3145</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kFFPHCEUhYlpo1v1J5jwYPo29QIDDI_GttbExqTR5wkDd7IYdlCY2aTxz5fV7ZLADeeeA7kfIZTBNwZGX0FdreZdw4zpQNRbs5PEEVkxKXgjWCs_kRUIJZpOM3lCvpTyDMC0EO0xOTZSgNByRd5urU8xTGHZNDit7eTQU_Gd_v5zTdNI5zVSm_IcHLXZrekWS8FYaJjeWx5ndHNI085rq5JTcbGeu4DDjENOW1vcEm2mybm4lLCtsVDQFjwjn0cbC57v6yl5-vnj8eZXc_9we3dzfd84IczcMK6k0hbq9qh8i2Bay9A7NoKWynA1QMe1bzkfOlnnA8QBtAdpuEGlxCn5-vHuS06vC5a534TiMEY7YVpKr41WneFtNXYfRlfnKBnH_iWHjc1_ewb9jnv_n3t_4P4uiRq92P-xDBv0h-AedO1f7vsVh41jrqRDOdg4B2U0iH9EIIsU</recordid><startdate>19980301</startdate><enddate>19980301</enddate><creator>KRINSKY, G</creator><creator>MAYA, M</creator><creator>LITT, A</creator><creator>WEINREB, J</creator><creator>ROFSKY, N</creator><creator>LEBOWITZ, J</creator><creator>NELSON, P. K</creator><creator>AMBROSINO, M</creator><creator>KAMINER, E</creator><creator>EARLS, J</creator><creator>MASTERS, L</creator><creator>GIANGOLA, G</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19980301</creationdate><title>Gadolinium-enhanced 3D MRA of the aortic arch vessels in the detection of atherosclerotic cerebrovascular occlusive disease</title><author>KRINSKY, G ; MAYA, M ; LITT, A ; WEINREB, J ; ROFSKY, N ; LEBOWITZ, J ; NELSON, P. K ; AMBROSINO, M ; KAMINER, E ; EARLS, J ; MASTERS, L ; GIANGOLA, G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c339t-126567a067ade6d4e094a1edc1f0756926b0827d422b853340eeb07d05929e663</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis of Variance</topic><topic>Angiography, Digital Subtraction - instrumentation</topic><topic>Angiography, Digital Subtraction - methods</topic><topic>Angiography, Digital Subtraction - statistics & numerical data</topic><topic>Aorta, Thoracic - diagnostic imaging</topic><topic>Aorta, Thoracic - pathology</topic><topic>Biological and medical sciences</topic><topic>Contrast Media</topic><topic>Female</topic><topic>Gadolinium DTPA</topic><topic>Humans</topic><topic>Intracranial Arteriosclerosis - diagnosis</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Magnetic Resonance Angiography - instrumentation</topic><topic>Magnetic Resonance Angiography - methods</topic><topic>Magnetic Resonance Angiography - statistics & numerical data</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Sensitivity and Specificity</topic><topic>Statistics, Nonparametric</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>KRINSKY, G</creatorcontrib><creatorcontrib>MAYA, M</creatorcontrib><creatorcontrib>LITT, A</creatorcontrib><creatorcontrib>WEINREB, J</creatorcontrib><creatorcontrib>ROFSKY, N</creatorcontrib><creatorcontrib>LEBOWITZ, J</creatorcontrib><creatorcontrib>NELSON, P. K</creatorcontrib><creatorcontrib>AMBROSINO, M</creatorcontrib><creatorcontrib>KAMINER, E</creatorcontrib><creatorcontrib>EARLS, J</creatorcontrib><creatorcontrib>MASTERS, L</creatorcontrib><creatorcontrib>GIANGOLA, G</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of computer assisted tomography</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>KRINSKY, G</au><au>MAYA, M</au><au>LITT, A</au><au>WEINREB, J</au><au>ROFSKY, N</au><au>LEBOWITZ, J</au><au>NELSON, P. K</au><au>AMBROSINO, M</au><au>KAMINER, E</au><au>EARLS, J</au><au>MASTERS, L</au><au>GIANGOLA, G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Gadolinium-enhanced 3D MRA of the aortic arch vessels in the detection of atherosclerotic cerebrovascular occlusive disease</atitle><jtitle>Journal of computer assisted tomography</jtitle><addtitle>J Comput Assist Tomogr</addtitle><date>1998-03-01</date><risdate>1998</risdate><volume>22</volume><issue>2</issue><spage>167</spage><epage>178</epage><pages>167-178</pages><issn>0363-8715</issn><eissn>1532-3145</eissn><coden>JCATD5</coden><abstract>Our goal was to evaluate non-breath-hold Gd-enhanced 3D MR angiography (MRA) for the detection of atherosclerotic occlusive disease of the aortic arch vessels and to compare image quality with two breath-hold techniques.
One hundred sixty consecutive patients with known or clinically suspected atherosclerotic cerebrovascular occlusive disease underwent Gd-enhanced 3D MRA of the aortic arch and great vessels. One hundred twenty-six examinations were performed with the body coil after infusion of 40 ml of Gd-DTPA; 89 of these were performed without breath-holding and 37 were acquired during suspended respiration. Thirty-four examinations were performed in a body phased-array coil with breath-holding, a timing examination, and 20 ml of contrast agent by manual (n = 17) or power (n = 17) injection. Images were evaluated for the presence of blurring and ghosting artifacts and venous enhancement. Of the 27 patients who underwent non-breath-hold MRI and digital subtraction angiography (DSA), two readers blinded to the DSA results retrospectively evaluated the MRA examinations for the presence of occlusive disease of the innominate, carotid, subclavian, and vertebral arteries. DSA correlation was not evaluated for the 71 breath-hold studies.
Sensitivity and specificity for arch vessel occlusive disease with non-breath-hold MRA were 38 and 94% for Reader A and 38 and 95% for Reader B. Breath-holding significantly reduced blurring and ghosting artifacts (p < 0.001) when compared with non-breath-hold imaging, and use of 20 ml of contrast medium, with a timing examination, resulted in significantly less venous enhancement than seen with 40 ml (p < 0.001).
Non-breath-hold Gd-enhanced 3D MRA is insensitive for detecting arch vessel occlusive disease. Breath-hold imaging, in conjunction with a timing examination and a lower dose of contrast agent, improves image quality, but further studies are needed to assess diagnostic accuracy.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>9530375</pmid><doi>10.1097/00004728-199803000-00003</doi><tpages>12</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Analysis of Variance Angiography, Digital Subtraction - instrumentation Angiography, Digital Subtraction - methods Angiography, Digital Subtraction - statistics & numerical data Aorta, Thoracic - diagnostic imaging Aorta, Thoracic - pathology Biological and medical sciences Contrast Media Female Gadolinium DTPA Humans Intracranial Arteriosclerosis - diagnosis Investigative techniques, diagnostic techniques (general aspects) Magnetic Resonance Angiography - instrumentation Magnetic Resonance Angiography - methods Magnetic Resonance Angiography - statistics & numerical data Male Medical sciences Middle Aged Nervous system Radiodiagnosis. Nmr imagery. Nmr spectrometry Sensitivity and Specificity Statistics, Nonparametric |
| title | Gadolinium-enhanced 3D MRA of the aortic arch vessels in the detection of atherosclerotic cerebrovascular occlusive disease |
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