Department of Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, 25, rue Manin, 75019 Paris, France; Department of Neuroradiology,University Hospital of Martinique, Fort-de-France, Martinique, France.
Department of Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, 25, rue Manin, 75019 Paris, France.
J Neuroradiol. 2020 Jun;47(4):278-283. doi: 10.1016/j.neurad.2019.02.011. Epub 2019 Mar 7.
To compare the accuracy and utility of contrast enhanced magnetic resonance angiography (MRA) (CEMRA) to Time of Flight MRA (TOF MRA) during detection and evaluation of occlusions on patients diagnosed with acute ischemic stroke (AIS).
This single-center study was approved by our local institutional research ethics board. From August 2014 to July 2016, 131 consecutive adult patients with confirmed AIS were included. Detection of an arterial occlusion and its characterization were evaluated independently with CEMRA or TOF MRA by two blinded neuroradiologists, then by consensus using all available MR sequences. A Cohen's Kappa coefficient (κ) and intra-class correlation coefficients (ICC) were used to compare the two techniques.
There was substantial concordance in the detection of arterial occlusion between CEMRA and TOF MRA (κ = 0.75). TOF MRA was more likely to show an arterial occlusion than CEMRA (63 versus 52 patients respectively). There were 13 and 1 false positive arterial occlusion with TOF MRA and CEMRA respectively, and 1 false negative with TOF MRA. There was excellent concordance between the location of arterial occlusions and CEMRA and TOF MRA [κ = 0.89 (0.72-0.97)]. CEMRA was significantly more likely to allow measurement of the thrombus than was TOF MRA [38 (75%) versus 14 (22%)] (P < 0.0001).
Our study showed that CEMRA imaging detected arterial occlusions better than TOF MRA in AIS patients and more precisely such that thrombus length and location could be known, which improves the patient's management and care.
比较对比增强磁共振血管造影（CEMRA）与时间飞跃磁共振血管造影（TOF MRA）在诊断急性缺血性脑卒中（AIS）患者时检测和评估闭塞中的准确性和实用性。
这项单中心研究得到了我们当地机构研究伦理委员会的批准。2014 年 8 月至 2016 年 7 月，连续纳入 131 例确诊为 AIS 的成年患者。两名盲法神经放射科医生分别使用 CEMRA 或 TOF MRA 独立评估动脉闭塞的检测及其特征，并使用所有可用的 MR 序列进行共识评估。采用 Cohen's Kappa 系数（κ）和组内相关系数（ICC）比较两种技术。
CEMRA 和 TOF MRA 在检测动脉闭塞方面具有较高的一致性（κ=0.75）。TOF MRA 比 CEMRA 更有可能显示动脉闭塞（分别为 63 例和 52 例）。TOF MRA 有 13 例和 1 例假阳性动脉闭塞，CEMRA 有 1 例假阴性动脉闭塞。动脉闭塞的位置与 CEMRA 和 TOF MRA 之间具有极好的一致性[κ=0.89（0.72-0.97）]。CEMRA 比 TOF MRA 更有可能测量血栓[38（75%）比 14（22%）]（P<0.0001）。
我们的研究表明，CEMRA 成像在 AIS 患者中比 TOF MRA 更能检测到动脉闭塞，并且更准确地了解血栓的长度和位置，从而改善患者的管理和护理。
