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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 28:439-446, March 2007
© 2007 American Society of Neuroradiology

BRAIN

Detection of Intracranial Atherosclerotic Steno-Occlusive Disease with 3D Time-of-Flight Magnetic Resonance Angiography with Sensitivity Encoding at 3T

C.G. Choi^a, D.H. Lee^a, J.H. Lee^a, H.W. Pyun^a, D.W. Kang^b, S.U. Kwon^b, J.K. Kim^c, S.J. Kim^a and D.C. Suh^a

^a Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
^b Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
^c Department of Radiology, Veterans Hospital, Seoul, Republic of Korea

Address correspondence to Choong Gon Choi, MD, Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-Dong, Songpa-Gu, Seoul 138-736, Republic of Korea; e-mail: cgchoi{at}amc.seoul.kr

BACKGROUND AND PURPOSE: The spatial resolution of 3D time-of-flight MR angiography (TOF-MRA) can be improved within a reasonable examination time by combining 3T and sensitivity encoding technique. We evaluated the diagnostic performance of high-resolution 3D TOF-MRA at 3T in patients with suspected atherosclerotic steno-occlusive disease of the intracranial arteries.

MATERIALS AND METHODS: We assessed 160 arteries in 39 patients: 68 distal internal carotid arteries, 68 middle cerebral arteries, and 24 vertebrobasilar arteries. The measured voxel size of 3D TOF-MRA was 0.28 x 0.56 x 1.2 mm³. Steno-occlusive disease was assessed independently by 2 observers using conventional angiography as the reference standard.

RESULTS: According to observers 1 and 2, respectively, 3D TOF-MRA at 3T had a sensitivity of 78%/85% (21/27, 23/27), a specificity of 95%/95% (126/133, 127/133), a positive predictive value of 75%/79% (21/28, 23/29), and a negative predictive value of 95%/97% (126/132, 127/131), using a 50%–99% threshold of diameter stenosis. For detection of complete occlusion, according to observers 1 and 2, respectively, 3D TOF-MRA at 3T had a sensitivity of 100% (13/13), a specificity of 99% (145/147), a positive predictive value of 87% (13/15), and a negative predictive value of 100% (145/145). Interobserver agreement of 3D TOF-MRA was excellent ( = 0.81).

CONCLUSION: High-resolution 3D TOF-MRA with sensitivity encoding at 3T can be used as a reliable diagnostic tool for the detection of clinically significant steno-occlusive disease of major intracranial arteries.

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