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Quantitative MRA detects intracranial in-stent stenoses
Quantitative magnetic resonance imaging is able to detect intracranial in-stent stenosis, according to recent study results.
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Researchers conducted a retrospective review of 14 patients with intracranial stent placement for cerebral aneurysm or intracranial stenosis. The researchers screened all patients using quantitative magnetic resonance angiography (MRA) scan performed within one year of the stent placements. A blinded interventional neurologist reviewed the angiograms for the presence of >50% in-stent stenosis. Lesions were located in the intracranial arteries (n=8; 57.2%), the middle cerebral artery (n=2; 14.3%) and vertebrobasilar arteries (n=4; 28.6%).
According to the study abstract, a >20% reduction in vessel-specific blood flow by quantitative MRA was associated with presence of >50% in-stent stenosis on angiography (P=.033). The researchers reported that as a screening tool used to predict >50% in-stent stenosis, sensitivity was 100%, the specificity was 92%, the positive predictive value was 67% and the negative predictive value was 100%.
“Given the potentially deadly consequences of in-stent stenosis, a test with high sensitivity and an acceptably low false-positive rate is desirable,” Shyam Prabhakaran, MD, section head of cerebrovascular disease and neurological critical care at Rush University in Chicago, said in a press release. “In addition, none of the patients with normal quantitative MRA results had stenosis on angiography, suggesting that patients with normal quantitative MRA results may not require follow-up catheter-based angiography.”
For more information:
- Prabhakaran S. Stroke. 2009;doi:10.1161/STROKEAHA.108.522391.