Hiratsuka Yoshiyasu, Miki Hitoshi, Kiriyama Ikuko, Kikuchi Keiichi, Takahashi Shizue, Matsubara Ichiro, Sadamoto Kazuhiko, Mochizuki Teruhito
Department of Radiology, Ehime University School of Medicine, Ehime, Japan.
Magn Reson Med Sci. 2008;7(4):169-78. doi: 10.2463/mrms.7.169.
We compared 3-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA) using a 3-tesla (T) MR unit with 64-channel multi-detector row computed tomographic angiography (64-MDCTA) for detection and characterization of angiographically proven unruptured intracranial aneurysms.
Thirty-eight patients with 47 aneurysms and 8 patients without aneurysms underwent 3T, 3D TOF MRA; 64-MDCTA; and intra-arterial angiography. As a first study, 3 radiologists blinded to pertinent clinical information independently reviewed MRA and CTA images. We evaluated diagnostic accuracy using an alternative free-response receiver operating characteristic (AFROC) analysis and evaluated the sensitivity and specificity of each technique. Next, 2 radiologists used volume-rendering images generated from MRA or CTA data to evaluate the morphology of the 47 aneurysms detected, and MRA and CTA results were compared. Three-dimensional digital angiography (DA) images were used as the standard of reference.
On the AFROC analysis, the value of the mean area under the AFROC curve (A(1)) was 0.91 for both modalities. Mean sensitivity of 89% and specificity of 76% for MRA were not significantly different from sensitivity of 87% and specificity of 79% for CTA. Therefore, when used to evaluate aneurysmal morphology, both modalities appear satisfactory for determining these vascular anomalies.
Three-tesla, 3D TOF MRA and 64-MDCTA are excellent modalities with high diagnostic accuracy for evaluating unruptured intracranial aneurysms and no significant difference between them in diagnostic performance.
我们比较了使用3特斯拉（T）磁共振单元的三维时间飞跃磁共振血管造影（3D TOF MRA）与64层多探测器行计算机断层血管造影（64-MDCTA）在检测和表征经血管造影证实的未破裂颅内动脉瘤方面的效果。
38例患有47个动脉瘤的患者和8例无动脉瘤的患者接受了3T、3D TOF MRA；64-MDCTA；以及动脉内血管造影。作为第一项研究，3名对相关临床信息不知情的放射科医生独立审查MRA和CTA图像。我们使用替代自由响应接收器操作特征（AFROC）分析评估诊断准确性，并评估每种技术的敏感性和特异性。接下来，2名放射科医生使用从MRA或CTA数据生成的容积再现图像评估检测到的47个动脉瘤的形态，并比较MRA和CTA的结果。三维数字血管造影（DA）图像用作参考标准。
在AFROC分析中，两种检查方法的AFROC曲线下平均面积值（A(1)）均为0.91。MRA的平均敏感性为89%，特异性为76%，与CTA的敏感性87%和特异性79%无显著差异。因此，在用于评估动脉瘤形态时，两种检查方法在确定这些血管异常方面似乎都令人满意。
3特斯拉3D TOF MRA和64-MDCTA是评估未破裂颅内动脉瘤的诊断准确性高的优秀检查方法，它们在诊断性能上无显著差异。
