| [PMID]: | 29030476 |
| [Au] Autor: | Mossa-Basha M; Shibata DK; Hallam DK; de Havenon A; Hippe DS; Becker KJ; Tirschwell DL; Hatsukami T; Balu N; Yuan C |
| [Ad] Endereço: | From the Department of Radiology (M.M.-B., D.K.S., D.K.H., D.S.H., N.B., C.Y.), Department of Neurology (K.J.B., D.L.T.), and Department of Surgery (T.H.), University of Washington, Seattle; and Department of Neurology, University of Utah, Salt Lake City (A.D.H.). mmossab@uw.edu. |
| [Ti] Título: | Added Value of Vessel Wall Magnetic Resonance Imaging for Differentiation of Nonocclusive Intracranial Vasculopathies. |
| [So] Source: | Stroke;48(11):3026-3033, 2017 Nov. |
| [Is] ISSN: | 1524-4628 |
| [Cp] País de publicação: | United States |
| [La] Idioma: | eng |
| [Ab] Resumo: | BACKGROUND AND PURPOSE: Our goal is to determine the added value of intracranial vessel wall magnetic resonance imaging (IVWI) in differentiating nonocclusive vasculopathies compared with luminal imaging alone. METHODS: We retrospectively reviewed images from patients with both luminal and IVWI to identify cases with clinically defined intracranial vasculopathies: atherosclerosis (intracranial atherosclerotic disease), reversible cerebral vasoconstriction syndrome, and inflammatory vasculopathy. Two neuroradiologists blinded to clinical data reviewed the luminal imaging of defined luminal stenoses/irregularities and evaluated the pattern of involvement to make a presumed diagnosis with diagnostic confidence. Six weeks later, the 2 raters rereviewed the luminal imaging in addition to IVWI for the pattern of wall involvement, presence and pattern of postcontrast enhancement, and presumed diagnosis and confidence. Analysis was performed on per-lesion and per-patient bases. RESULTS: Thirty intracranial atherosclerotic disease, 12 inflammatory vasculopathies, and 12 reversible cerebral vasoconstriction syndrome patients with 201 lesions (90 intracranial atherosclerotic disease, 64 reversible cerebral vasoconstriction syndrome, and 47 inflammatory vasculopathy lesions) were included. For both per-lesion and per-patient analyses, there was significant diagnostic accuracy improvement with luminal imaging+IVWI when compared with luminal imaging alone (per-lesion: 88.8% versus 36.1%; <0.001 and per-patient: 96.3% versus 43.5%; <0.001, respectively). There was substantial interrater diagnostic agreement for luminal imaging+IVWI (κ=0.72) and only slight agreement for luminal imaging (κ=0.04). Although there was a significant correlation for both luminal and IVWI pattern of wall involvement with diagnosis, there was a stronger correlation for IVWI finding of lesion eccentricity and intracranial atherosclerotic disease diagnosis than for luminal imaging (κ=0.69 versus 0.18; <0.001). CONCLUSIONS: IVWI can significantly improve the differentiation of nonocclusive intracranial vasculopathies when combined with traditional luminal imaging modalities. |
| [Mh] Termos MeSH primário: |
Arteriosclerose Intracraniana/diagnóstico por imagem
Angiografia por Ressonância Magnética/métodos
Vasculite do Sistema Nervoso Central/diagnóstico por imagem
Vasoespasmo Intracraniano/diagnóstico por imagem
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| [Mh] Termos MeSH secundário: |
Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
|
| [Pt] Tipo de publicação: | CLINICAL TRIAL; JOURNAL ARTICLE |
| [Em] Mês de entrada: | 1710 |
| [Cu] Atualização por classe: | 171116 |
[Lr] Data última revisão:
| 171116 |
| [Sb] Subgrupo de revista: | IM |
| [Da] Data de entrada para processamento: | 171015 |
| [St] Status: | MEDLINE |
| [do] DOI: | 10.1161/STROKEAHA.117.018227 |
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