Advanced

AJNR - American Journal of Neuroradiology

Publication Preview: Published March 13, 2008

American Journal of Neuroradiology 2008;29:883.

This Article Full Text (PDF) All Versions of this Article: ajnr.A0948v1 29/5/883    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Neves, F. Articles by Guichard, J.P. Search for Related Content PubMed PubMed Citation Articles by Neves, F. Articles by Guichard, J.P.

American Journal of Neuroradiology
DOI 10.3174/ajnr.A0948

HEAD & NECK

Head and Neck Paragangliomas: Value of Contrast-Enhanced 3D MR Angiography

F. Neves, L. Huwart, G. Jourdan, D. Reizine, P. Herman, E. Vicaut and J.P. Guichard

From the Departments of Neuroradiology (F.N., L.H., G.J., D.R., J.P.G.), Otorhinolaryngology (P.H.), and Statistics (E.V.), Groupe Hospitalier Lariboisière-Fernand-Widal AP-HP, Paris, France.

Please address correspondence to Jean-Pierre Guichard, MD, Service de Neuroradiologie, Hôpital Lariboisière, 2 rue Ambroise Paré, 75010 Paris, France; e-mail: jean-pierre.guichard{at}lrb.ap-hop-paris.fr

BACKGROUND AND PURPOSE: The purpose of this study was to determine whether the combination of elliptic centric contrast-enhanced MR angiography (CE-MRA) and unenhanced and enhanced spin-echo imaging (conventional MR imaging) is more accurate than conventional MR imaging alone to assess paragangliomas in the head and neck.

MATERIALS AND METHODS: Three radiologists retrospectively and independently reviewed CE-MRA and conventional MR imaging in 27 patients with suspected paragangliomas. The overall image quality and the probability of paraganglioma were recorded. The results of each technique and their combination were analyzed for sensitivity and specificity. Receiver operating characteristic (ROC) analyses were performed by using histologic analysis, imaging, and/or clinical findings as the reference standard.

RESULTS: Forty-six lesions were found in 27 patients. In the assessment of paragangliomas, the combination of conventional MR imaging and CE-MRA was significantly superior to conventional MR imaging alone. Sensitivity and specificity respectively were the following: for CE-MRA, 100% and 94%; and for conventional MR imaging, 94% and 41%. The specificity of CE-MRA was significantly higher than that of conventional MR imaging (P = .004). There was good-to-excellent interobserver agreement for the paraganglioma probability with CE-MRA (nonweighted , 0.67–0.77), whereas there was fair-to-good interobserver agreement with conventional MR imaging (nonweighted , 0.50–0.65).

CONCLUSION: In combination with conventional MR imaging, CE-MRA yields an excellent diagnostic value for the assessment of head and neck paragangliomas; hence, the 2 techniques should be regarded as complementary.