Publication:

Diagnosis of supra-aortic artery stenosis: comparison of magnetic resonance angiography imaging methods with conventional digital subtraction angiography

Background The aim of this study was to compare conventional digital subtraction angiography (DSA) with the multi-planar reformation (MPR) and maximum intensity projection (MIP) reconstruction of servical magnetic resonance angiography (MRA) in terms of detecting supra-aortic artery stenoses.

Methods In the study, 21 patients who had underwent 3D MRA and conventional DSA were retrospectively assessed. Axial MPR, coronal MIP reconstruction and contrast enhanced 3D MRA subtraction images of a total of 333 artery segments were independently assessed by 2 separate radiologists. Conventional DSA results were accepted as gold standard results. The overall and individual Kappa values of all methods were calculated.

Results Results of the conventional DSA analysis indicated total occlusion in 9 (2.7%), severe stenosis in 16 (4.8%), moderate stenosis in 90 (27.1%), mild stenosis in 105 (31.5%) and no stenosis in 113 (33.9%) arteries. While the k values of all methods were high which demonstrated strong relationships with the DSA method; the coronal MIP reconstruction method was found to be superior to other methods. The 3D MRA subtraction method did not yield better results in any of the individual comparisons.

Conclusions Our results indicate that the coronal MIP reconstruction method has higher correlation with conventional DSA results compared to the other two methods and may be used as an accurate first-line diagnostic method for supra-aortic artery stenoses.