Accuracy of three-dimensional gadolinium-enhanced MR in the assessment of extracranial carotid artery disease

J. M. Serfaty, P. Chirossel, J. M. Chevallier, R. Ecochard, J. C. Froment, P. C. Douek

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. The purpose of this study was to assess three-dimensional (3D) gadolinium-enhanced MR angiography, used alone or in association with duplex Doppler sonography, with a fast acquisition time (8 sec) for evaluating the extracranial carotid arteries. SUBJECTS AND METHODS. In this prospective study, 48 successive patients with carotid artery stenoses were examined with 3D gadolinium-enhanced MR angiography and 3D time-of-flight MR angiography. Of the 44 eligible patients, conventional angiography was available in 33 and duplex sonography in 27. We used the North American Symptomatic Carotid Endarterectomy Trial technique to quantify stenosis on all angiograms, and a 250 cm/sec threshold at duplex sonography to diagnose stenoses greater than 70%. Image quality of 3D gadolinium-enhanced MR angiography and 3D time-of-flight MR angiography was assessed, as well as sensitivity and specificity for each technique alone and in combination with duplex sonography. Conventional angiography was the gold standard. RESULTS. Three-dimensional gadolinium-enhanced MR angiography yielded good image quality in 90% of cases. When used alone, it yielded a sensitivity and a specificity of 94% and 85%, respectively, in screening stenoses greater than 70% (70-99%), when combined with duplex Doppler sonography, it provided a 100% sensitivity and specificity for detection of stenoses between 70% and 99% and would have obviated 61% of conventional angiography. In comparison, 3D time-of-flight MR angiography used alone yielded a sensitivity of 88% and a specificity of 94%. In combination with duplex Doppler sonography, its use would have obviated conventional angiography in 74% of cases. Three-dimensional gadolinium-enhanced MR angiography provided accurate results in the diagnosis of occlusions and ulcers and can visualize distant stenoses. CONCLUSION. Used alone, 3D gadolinium-enhanced MR angiography is not accurate enough to replace conventional angiography in the evaluation of extracranial carotid arteries. In association with duplex Doppler sonography, however, it is accurate and may obviate a significant number of conventional angiographic examinations.

Original languageEnglish (US)
Pages (from-to)455-463
Number of pages9
JournalAmerican Journal of Roentgenology
Volume175
Issue number2
StatePublished - Aug 2000

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Carotid Artery Diseases
Gadolinium
Angiography
Doppler Duplex Ultrasonography
Pathologic Constriction
Ultrasonography
Carotid Arteries
Sensitivity and Specificity
Carotid Endarterectomy
Carotid Stenosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Serfaty, J. M., Chirossel, P., Chevallier, J. M., Ecochard, R., Froment, J. C., & Douek, P. C. (2000). Accuracy of three-dimensional gadolinium-enhanced MR in the assessment of extracranial carotid artery disease. American Journal of Roentgenology, 175(2), 455-463.

Accuracy of three-dimensional gadolinium-enhanced MR in the assessment of extracranial carotid artery disease. / Serfaty, J. M.; Chirossel, P.; Chevallier, J. M.; Ecochard, R.; Froment, J. C.; Douek, P. C.

In: American Journal of Roentgenology, Vol. 175, No. 2, 08.2000, p. 455-463.

Research output: Contribution to journalArticle

Serfaty, JM, Chirossel, P, Chevallier, JM, Ecochard, R, Froment, JC & Douek, PC 2000, 'Accuracy of three-dimensional gadolinium-enhanced MR in the assessment of extracranial carotid artery disease', American Journal of Roentgenology, vol. 175, no. 2, pp. 455-463.
Serfaty JM, Chirossel P, Chevallier JM, Ecochard R, Froment JC, Douek PC. Accuracy of three-dimensional gadolinium-enhanced MR in the assessment of extracranial carotid artery disease. American Journal of Roentgenology. 2000 Aug;175(2):455-463.
Serfaty, J. M. ; Chirossel, P. ; Chevallier, J. M. ; Ecochard, R. ; Froment, J. C. ; Douek, P. C. / Accuracy of three-dimensional gadolinium-enhanced MR in the assessment of extracranial carotid artery disease. In: American Journal of Roentgenology. 2000 ; Vol. 175, No. 2. pp. 455-463.
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abstract = "OBJECTIVE. The purpose of this study was to assess three-dimensional (3D) gadolinium-enhanced MR angiography, used alone or in association with duplex Doppler sonography, with a fast acquisition time (8 sec) for evaluating the extracranial carotid arteries. SUBJECTS AND METHODS. In this prospective study, 48 successive patients with carotid artery stenoses were examined with 3D gadolinium-enhanced MR angiography and 3D time-of-flight MR angiography. Of the 44 eligible patients, conventional angiography was available in 33 and duplex sonography in 27. We used the North American Symptomatic Carotid Endarterectomy Trial technique to quantify stenosis on all angiograms, and a 250 cm/sec threshold at duplex sonography to diagnose stenoses greater than 70{\%}. Image quality of 3D gadolinium-enhanced MR angiography and 3D time-of-flight MR angiography was assessed, as well as sensitivity and specificity for each technique alone and in combination with duplex sonography. Conventional angiography was the gold standard. RESULTS. Three-dimensional gadolinium-enhanced MR angiography yielded good image quality in 90{\%} of cases. When used alone, it yielded a sensitivity and a specificity of 94{\%} and 85{\%}, respectively, in screening stenoses greater than 70{\%} (70-99{\%}), when combined with duplex Doppler sonography, it provided a 100{\%} sensitivity and specificity for detection of stenoses between 70{\%} and 99{\%} and would have obviated 61{\%} of conventional angiography. In comparison, 3D time-of-flight MR angiography used alone yielded a sensitivity of 88{\%} and a specificity of 94{\%}. In combination with duplex Doppler sonography, its use would have obviated conventional angiography in 74{\%} of cases. Three-dimensional gadolinium-enhanced MR angiography provided accurate results in the diagnosis of occlusions and ulcers and can visualize distant stenoses. CONCLUSION. Used alone, 3D gadolinium-enhanced MR angiography is not accurate enough to replace conventional angiography in the evaluation of extracranial carotid arteries. In association with duplex Doppler sonography, however, it is accurate and may obviate a significant number of conventional angiographic examinations.",
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T1 - Accuracy of three-dimensional gadolinium-enhanced MR in the assessment of extracranial carotid artery disease

AU - Serfaty, J. M.

AU - Chirossel, P.

AU - Chevallier, J. M.

AU - Ecochard, R.

AU - Froment, J. C.

AU - Douek, P. C.

PY - 2000/8

Y1 - 2000/8

N2 - OBJECTIVE. The purpose of this study was to assess three-dimensional (3D) gadolinium-enhanced MR angiography, used alone or in association with duplex Doppler sonography, with a fast acquisition time (8 sec) for evaluating the extracranial carotid arteries. SUBJECTS AND METHODS. In this prospective study, 48 successive patients with carotid artery stenoses were examined with 3D gadolinium-enhanced MR angiography and 3D time-of-flight MR angiography. Of the 44 eligible patients, conventional angiography was available in 33 and duplex sonography in 27. We used the North American Symptomatic Carotid Endarterectomy Trial technique to quantify stenosis on all angiograms, and a 250 cm/sec threshold at duplex sonography to diagnose stenoses greater than 70%. Image quality of 3D gadolinium-enhanced MR angiography and 3D time-of-flight MR angiography was assessed, as well as sensitivity and specificity for each technique alone and in combination with duplex sonography. Conventional angiography was the gold standard. RESULTS. Three-dimensional gadolinium-enhanced MR angiography yielded good image quality in 90% of cases. When used alone, it yielded a sensitivity and a specificity of 94% and 85%, respectively, in screening stenoses greater than 70% (70-99%), when combined with duplex Doppler sonography, it provided a 100% sensitivity and specificity for detection of stenoses between 70% and 99% and would have obviated 61% of conventional angiography. In comparison, 3D time-of-flight MR angiography used alone yielded a sensitivity of 88% and a specificity of 94%. In combination with duplex Doppler sonography, its use would have obviated conventional angiography in 74% of cases. Three-dimensional gadolinium-enhanced MR angiography provided accurate results in the diagnosis of occlusions and ulcers and can visualize distant stenoses. CONCLUSION. Used alone, 3D gadolinium-enhanced MR angiography is not accurate enough to replace conventional angiography in the evaluation of extracranial carotid arteries. In association with duplex Doppler sonography, however, it is accurate and may obviate a significant number of conventional angiographic examinations.

AB - OBJECTIVE. The purpose of this study was to assess three-dimensional (3D) gadolinium-enhanced MR angiography, used alone or in association with duplex Doppler sonography, with a fast acquisition time (8 sec) for evaluating the extracranial carotid arteries. SUBJECTS AND METHODS. In this prospective study, 48 successive patients with carotid artery stenoses were examined with 3D gadolinium-enhanced MR angiography and 3D time-of-flight MR angiography. Of the 44 eligible patients, conventional angiography was available in 33 and duplex sonography in 27. We used the North American Symptomatic Carotid Endarterectomy Trial technique to quantify stenosis on all angiograms, and a 250 cm/sec threshold at duplex sonography to diagnose stenoses greater than 70%. Image quality of 3D gadolinium-enhanced MR angiography and 3D time-of-flight MR angiography was assessed, as well as sensitivity and specificity for each technique alone and in combination with duplex sonography. Conventional angiography was the gold standard. RESULTS. Three-dimensional gadolinium-enhanced MR angiography yielded good image quality in 90% of cases. When used alone, it yielded a sensitivity and a specificity of 94% and 85%, respectively, in screening stenoses greater than 70% (70-99%), when combined with duplex Doppler sonography, it provided a 100% sensitivity and specificity for detection of stenoses between 70% and 99% and would have obviated 61% of conventional angiography. In comparison, 3D time-of-flight MR angiography used alone yielded a sensitivity of 88% and a specificity of 94%. In combination with duplex Doppler sonography, its use would have obviated conventional angiography in 74% of cases. Three-dimensional gadolinium-enhanced MR angiography provided accurate results in the diagnosis of occlusions and ulcers and can visualize distant stenoses. CONCLUSION. Used alone, 3D gadolinium-enhanced MR angiography is not accurate enough to replace conventional angiography in the evaluation of extracranial carotid arteries. In association with duplex Doppler sonography, however, it is accurate and may obviate a significant number of conventional angiographic examinations.

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