Comparison of Doppler Ultrasound, Magnetic Resonance Angiographic Techniques and Catheter Angiography in Evaluation of Carotid Stenosis

Johnson, Maria; Wilkinson, Iain D.; Wattam, John; Venables, G.S.; Griffiths, Paul D.

doi:10.1053/crad.2000.0518

Cited by 49 publications

(16 citation statements)

References 15 publications

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“…439 Use of TCD to assess children with other conditions has not been adequately studied. 441 Direct evaluation of cervical vessels with ultrasound has been used extensively to detect atherosclerosis in adults 442,443 and to gauge the success of revascularization techniques such as endarterectomy, angioplasty, and stenting. The application of such techniques in children, however, has been limited.…”

Section: Ultrasound and Doppler Sonographymentioning

confidence: 99%

Management of Stroke in Infants and Children

Roach¹,

Golomb²,

Adams³

et al. 2008

Stroke

872

377

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Purpose— The purpose of this statement is to review the literature on childhood stroke and to provide recommendations for optimal diagnosis and treatment. This statement is intended for physicians who are responsible for diagnosing and treating infants, children, and adolescents with cerebrovascular disease. Methods— The Writing Group members were appointed by the American Heart Association Stroke Council’s Scientific Statement Oversight Committee. The panel included members with several different areas of expertise. Each of the panel’s recommendations was weighted by applying the American Heart Association Stroke Council’s Levels of Evidence grading algorithm. After being reviewed by panel members, the manuscript was reviewed by 4 expert peer reviewers and by members of the Stroke Council Leadership Committee and was approved by the American Heart Association Science Advisory and Coordinating Committee. We anticipate that this statement will need to be updated in 4 years. Results— Evidence-based recommendations are provided for the prevention of ischemic stroke caused by sickle cell disease, moyamoya disease, cervicocephalic arterial dissection, and cardiogenic embolism. Recommendations on the evaluation and management of hemorrhagic stroke also are provided. Protocols for dosing of heparin and warfarin in children are suggested. Also included are recommendations on the evaluation and management of perinatal stroke and cerebral sinovenous thrombosis in children.

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Section: Ultrasound and Doppler Sonographymentioning

confidence: 99%

Management of Stroke in Infants and Children

Roach¹,

Golomb²,

Adams³

et al. 2008

Stroke

872

377

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“…26,27,33,35,37 CE MRA was more accurate than TOF MRA with a higher sensitivity and a similar specificity to TOF MRA (Table 3). TOF MRA produced a pooled sensitivity of 89.6% (82.2% to 94.7%) and a pooled specificity of 92.7% (88.5% to 95.7%), whereas CE MRA produced a pooled sensitivity of 96.2% (90.5% to 99.0%) and a pooled specificity of 92.7% (88.6% to 95.7%).…”

Section: Studies Comparing Time-of-flight Magnetic Resonance Angiogramentioning

confidence: 92%

“…Of these papers, 37 TOF MRA 17,18,26 -60 and 21 CE MRA papers 16,26,27,33,35,37,[61][62][63][64][65][66][67][68][69][70][71][72][73][74][75] fulfilled the inclusion criteria (Tables 1 and 2). Of the TOF papers, 11 used 2D TOF MRA, 14 used 3D TOF MRA, and 12 included both 2D and 3D TOF data (Table 1).…”

Section: Included Studiesmentioning

confidence: 99%

Diagnostic Accuracy of Magnetic Resonance Angiography for Internal Carotid Artery Disease

Debrey

Lynch

et al. 2008

Stroke

165

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Background and Purpose-Accurate diagnosis of the degree of internal carotid artery (ICA) stenosis is needed for decisions regarding optimal stroke prevention. Noninvasive magnetic resonance angiography (MRA) is being proposed and used as a replacement for the gold standard, intra-arterial angiography. Our purpose was to perform a systematic review and diagnostic meta-analysis to determine the sensitivity and specificity of time-of-flight (TOF) MRA and contrast-enhanced (CE) MRA for the detection of (1) high-grade (Ն70% to 99%) ICA stenoses; (2) ICA occlusions; (3) moderately severe (50% to 69%) ICA stenoses; and (4) compare the overall accuracy of the 2 MRA techniques. Methods-The medical literature on MRA and the diagnosis of ICA steno-occlusive disease was reviewed through the PubMed, EMBASE, and SCOPUS databases. All publication years were included through to November 2006. Studies were eligible for inclusion if they compared the accuracy of TOF or CE MRA for the detection of ICA disease against intra-arterial angiography and reported sufficient data. Results-The overall sensitivity of TOF MRA for the detection of Ն70% to 99% ICA stenoses was 91.2% (95% CI: 88.9% to 93.1%) with a specificity of 88.3% (86.7% to 89.7%), whereas the sensitivity of CE MRA was 94.6% (92.4% to 96.4%) with a specificity of 91.9% (90.3% to 93.4%). For the detection of ICA occlusions, the sensitivity of TOF MRA was 94.5% (91.2% to 96.8%) and the specificity was 99.3% (98.9% to 99.6%), whereas the sensitivity and specificity values for CE MRA were 99.4% (96.8% to 100%) and 99.6% (99.2% to 99.9%), respectively. For moderately severe (50% to 69%) stenoses, TOF MRA had a sensitivity of only 37.9% (29.3% to 47.1%) and a specificity of 92.1% (89.6% to 94.1%); for CE MRA, the pooled sensitivity value was somewhat better at 65.9% (57.0% to 74.0%), whereas the specificity was 93.5% (91.3% to 95.3%). Conclusions-TOF MRA and CE MRA showed high accuracy for the detection of high-grade ICA stenoses and occlusions with CE MRA having the edge over TOF MRA, but had only poor (TOF MRA) to fair (CE MRA) sensitivity for the detection of moderately severe stenoses.

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“…Serfaty et al concludono che l'associazione tra le due tecniche identifica stenosi >70% con il 100% di sensibilità e di specificità [28]. D'altra parte ci sono molti studi in letteratura che concordano nell'affermare che la CE-MRA da sola è la metodica più accurata, essendo più affidabile del Doppler US se entrambe sono confrontate con l'angiografia [7,8,17,25,26,[29][30][31].…”

Section: Discussioneunclassified