Magnetic resonance angiography or IADSA for diagnosis of carotid pseudo occlusion?

I.C. Currie , K.P. Murphy , A.J. Jones , S.E.A. Cole , C.J. Wakeley , Y.G. Wilson , R.N. Baird , P.M. Lamont
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引用次数: 12

Abstract

Accurate diagnosis of internal carotid artery (ICA) occlusion is essential in the investigation of carotid disease yet may be difficult using Duplex. Traditionally contrast arteriography has been used to confirm the diagnosis despite its cost and potential dangers. Twenty-one patients with 23 ICA occlusions were evaluated by a 3-dimensional time of flight magnetic resonance angiography (MRA) technique. The cervical carotids and circle of Willis were imaged during the MRA examination which lasted 30 minutes. Confirmatory conventional angiography was performed in all patients. Using angiography as the gold standard, all occlusions were correctly diagnosed by MRA and 22 of 23 occlusions correctly diagnosed by Duplex. There was good agreement between MRA and angiography for all 42 ICAs imaged (Kappa statistic 0.83). Diagnosis of internal carotid artery occlusion is critical as it determines the need for operation. In this situation MRA provides a useful non-invasive complement to Duplex. A combination of non-invasive studies may enable arteriography to be rejected with greater confidence in this high risk group.

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磁共振血管造影还是IADSA诊断颈动脉假性闭塞?
颈内动脉(ICA)闭塞的准确诊断在颈动脉疾病的调查中是必不可少的,但使用Duplex可能是困难的。传统上,对比动脉造影已被用于确诊,尽管它的成本和潜在的危险。采用三维飞行时间磁共振血管造影(MRA)技术对21例23例ICA闭塞患者进行评估。在持续30分钟的MRA检查中,颈颈动脉和威利斯环被成像。所有患者均行常规血管造影。以血管造影为金标准,MRA正确诊断所有闭塞,Duplex正确诊断23例闭塞22例。所有42例ICAs的MRA和血管造影结果吻合良好(Kappa统计量为0.83)。内颈动脉闭塞的诊断是至关重要的,因为它决定了是否需要手术。在这种情况下,MRA为Duplex提供了有用的非侵入性补充。非侵入性研究的结合可能使动脉造影术在这一高危人群中更有信心被拒绝。
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