Comparative Study Of Contrast-enhanced Magnetic Resonance Angiography And Digital Subtraction Angiography In The Diagnosis Of Supra-aortic Arteries Stenosis

Objective: Compared with digital subtraction angiography (DSA)， study the sensitivityand specificity of contrast-enhanced magnetic resonance angiography (3DCE-MRA) in thediagnosis of supra-aortic arteries stenosis.Methods: One hundred and forty-nine patients with arteries sclerosis diagnosed by3D-CE-MR were also professed by DSA examination. We dopted MIP、 MPR to imageprocessing.Combined with source of imgage and flow void signal of axial T2WI view when analyzethe siphon of carotid artery. Combined with source of imgage when analyze the extracranial portionof vertebral artery. Golden standard as DSA，The degree of seriousness and location of the stenosisshown by3D-CE-MRA were confirmed by two doctors.Results:Of the149cases，113places of≥50%stenosis of carotid artery were assessedby3D-CE MRA, among them75stenosises were diagnosed with both examinations,38stenosises were highly suspected by3D CE-MRA.When combined with other series of MR,95places of≥50%stenosis of carotid artery were assessed by3D-CE MRA,20stenosises werehighly suspected by3D CE-MRA.61places of≥50%stenosis of middle cerebral arterywere assessed by3D CE-MRA, mong them32stenosises were diagnosed with bothexaminations,29stenosises were highly suspected by3D CE-MRA.188places of≥50%stenosis of vertebral artery were assessed by3D-CE MRA, among them122stenosises werediagnosed with both examinations,63stenosises were highly suspected by3D CE-MRA.Whencombined with other series of MR,137places of≥50%stenosis of vertebral artery wereassessed by3D-CE MRA, among them121stenosises were diagnosed with bothexaminations,12stenosises were highly suspected by3D CE-MRA.Detecting of≥70%arteriostenosis,for first portion of carotid artery, the sensitivity of3D CE-MRA was100%，thespecificity97.27%and the accuracy97.7%(K=0.909);for siphon portion of carotid artery,the sensitivity was100%，the specificity94%and the accuracy95%(K=0.333); for middle cerebral artery the sensitivity was100%，the specificity97%and the accuracy97%(K=0.909;for extracranial portion of vertebral artery, the sensitivity was97%，the specificity77%and the accuracy82%(K=0.591); for intracranial portion of vertebral artery, the sensitivity was100%，the specificity96.72%and the accuracy97%(K=0.657);for basilar artery, the sensitivitywas100%，the specificity99.28%and the accuracy99.49%(K=0.657).When combined withother series, for siphon portion of carotid artery, the sensitivity was100%，the specificity98.3%and the accuracy98.3%(K=0.608);for extracranial portion of vertebral artery, thesensitivity was100%，the specificity97.83%and the accuracy92.9%(K=0.826);Conclusion：3D-CE-MRA has outstanding sensitivity and specificity for detectingarteriostenosis of first portion of carotid artery、middle cerebral artery、intracranial portion ofvertebral artery、basilar artery，which were equal to DSA.As for motion artifact、blurringeffect、 desphasing effect of blood flow velocity,3DCE-MRA has low sensitivity andspecificity for detecting arteriostenosis of siphon portion of carotid artery、extracranialportion of vertebral artery，which were unequal to DSA,but when combined with the sourceimage, the sensitivity and specificity were heightened,and consistency to DSA were improved.3D CE-MRA has outstanding sensitivity and specificity for detecting craniocervical arterystenosis, so it was and ideal examination for detecting craniocervical artery stenosis.