From the Institute of Diagnostic and Interventional Radiology, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, 600 Yi Shan Rd, Shanghai 200233, China.
Radiology. 2014 May;271(2):553-60. doi: 10.1148/radiol.14122770. Epub 2014 Feb 1.
To evaluate the diagnostic accuracy of three-dimensional (3D) time-of-flight (TOF) magnetic resonance (MR) angiography at 3.0 T in the detection of small cerebral aneurysms.
The institutional review board approved the study protocol, and patients or qualifying family members provided informed consent. A total of 403 consecutive patients undergoing 3D TOF MR angiography and digital subtraction angiography (DSA) were prospectively enrolled. Small aneurysms were those 5 mm in diameter or smaller. DSA served as the reference standard. Three observers were blinded to clinical and DSA results, and they independently analyzed all 3D TOF MR angiographic data sets. Interobserver agreement was expressed in terms of Cohen κ value for categorical variables. Accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 3D TOF MR angiography in the detection of cerebral aneurysms were determined by using patient-, aneurysm-, and location-based evaluations.
Of 403 patients, 273 aneurysms were detected with DSA in 230 patients. Patient-based evaluation with 3D TOF MR angiography at 3.0 T yielded an accuracy of 96%-97%, a sensitivity of 98.2%-98.7%, a specificity of 93.2% -94.8%, a PPV of 94.9%-96.2%, and an NPV of 97.6%-98.2% in the detection of cerebral aneurysms. Aneurysm-based evaluation yielded an accuracy of 96.4%-97.3%, a sensitivity of 98.5%-98.9%, a specificity of 93.2%-94.9%, a PPV of 95.7%-96.8%, and an NPV of 97.6%-98.2%. Aneurysm-location evaluations yielded similar results.
Three-dimensional TOF MR angiography is a noninvasive method that shows promising diagnostic accuracy in the detection of small cerebral aneurysms.
评价 3.0T 三维时间飞跃（3D-TOF）磁共振血管成像（MRA）检测小颅内动脉瘤的诊断准确性。
本研究经机构审查委员会批准，所有患者或符合条件的家属均签署了知情同意书。前瞻性纳入 403 例连续行 3D-TOF MRA 和数字减影血管造影（DSA）检查的患者。小动脉瘤是指直径为 5mm 及以下的动脉瘤。DSA 为参考标准。3 名观察者对临床和 DSA 结果均不知情，独立分析所有 3D-TOF MRA 数据集。分类变量的观察者间一致性采用 Cohen κ 值表示。采用患者、动脉瘤和部位为基础的评估方法，确定 3D-TOF MRA 检测颅内动脉瘤的准确性、敏感度、特异度、阳性预测值（PPV）和阴性预测值（NPV）。
在 403 例患者中，273 个动脉瘤在 230 例患者中经 DSA 检出。3D-TOF MRA 在 3.0T 下的患者基础评估的准确性为 96%-97%，敏感度为 98.2%-98.7%，特异度为 93.2%-94.8%，PPV 为 94.9%-96.2%，NPV 为 97.6%-98.2%。动脉瘤基础评估的准确性为 96.4%-97.3%，敏感度为 98.5%-98.9%，特异度为 93.2%-94.9%，PPV 为 95.7%-96.8%，NPV 为 97.6%-98.2%。基于动脉瘤位置的评估也得到了类似的结果。
3D-TOF MRA 是一种非侵入性方法，在检测小颅内动脉瘤方面具有良好的诊断准确性。
