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Titolo:
MR angiography as a screening tool for intracranial aneurysms: Feasibility, test characteristics, and interobserver agreement
Autore:
Raaymakers, TWM; Buys, PC; Verbeeten, B; Ramos, LMP; Witkamp, TD; Hulsmans, FJ; Mali, WPTM; Algra, A; Bonsel, GJ; Bossuyt, PMM; Vonk, CM; Buskens, E; Limburg, M; van Gijn, J; Gorissen, A; Greebe, P; Albrecht, KW; Tulleken, CAF; Rinkel, GJE;
Indirizzi:
Univ Utrecht Hosp, Dept Neurol, NL-3584 CX Utrecht, Netherlands Univ Utrecht Hosp Utrecht Netherlands NL-3584 CX CX Utrecht, Netherlands Univ Utrecht Hosp, Dept Radiol, NL-3508 GA Utrecht, Netherlands Univ Utrecht Hosp Utrecht Netherlands NL-3508 GA GA Utrecht, Netherlands Univ Amsterdam, Acad Med Ctr, Dept Radiol, NL-1105 AZ Amsterdam, Netherlands Univ Amsterdam Amsterdam Netherlands NL-1105 AZ Z Amsterdam, Netherlands Univ Utrecht Hosp, Julius Ctr Patient Oriented Res, NL-3508 GA Utrecht, Netherlands Univ Utrecht Hosp Utrecht Netherlands NL-3508 GA GA Utrecht, Netherlands Univ Amsterdam, Acad Med Ctr, Dept Clin Epidemiol & Biostat, NL-1105 AZ Amsterdam, Netherlands Univ Amsterdam Amsterdam Netherlands NL-1105 AZ Z Amsterdam, Netherlands Univ Amsterdam, Acad Med Ctr, Dept Neurol, NL-1105 AZ Amsterdam, Netherlands Univ Amsterdam Amsterdam Netherlands NL-1105 AZ Z Amsterdam, Netherlands Univ Amsterdam, Acad Med Ctr, Dept Neurosurg, NL-1105 AZ Amsterdam, Netherlands Univ Amsterdam Amsterdam Netherlands NL-1105 AZ Z Amsterdam, Netherlands Univ Utrecht Hosp, Dept Neurosurg, NL-3508 GA Utrecht, Netherlands Univ Utrecht Hosp Utrecht Netherlands NL-3508 GA GA Utrecht, Netherlands
Titolo Testata:
AMERICAN JOURNAL OF ROENTGENOLOGY
fascicolo: 6, volume: 173, anno: 1999,
pagine: 1469 - 1475
SICI:
0361-803X(199912)173:6<1469:MAAAST>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
MAGNETIC-RESONANCE ANGIOGRAPHY; TIME-OF-FLIGHT; POLYCYSTIC KIDNEY-DISEASE; DIGITAL SUBTRACTION ANGIOGRAPHY; SUBARACHNOID HEMORRHAGE; CEREBRAL ANEURYSMS; CONVENTIONAL ANGIOGRAPHY; DIAGNOSTIC-ACCURACY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: Rinkel, GJE Univ Utrecht Hosp, Dept Neurol, H2-128,Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands Univ Utrecht Hosp H2-128,Heidelberglaan 100 Utrecht Netherlands NL-3584 CX
Citazione:
T.W.M. Raaymakers et al., "MR angiography as a screening tool for intracranial aneurysms: Feasibility, test characteristics, and interobserver agreement", AM J ROENTG, 173(6), 1999, pp. 1469-1475

Abstract

OBJECTIVE. MR angiography may be an appropriate tool to screen for unruptured intracranial aneurysms. Feasibility, test characteristics, and interobserver agreement in evaluation of MR angiograms were assessed by members of the MARS (Magnetic resonance Angiography in Relatives of patients with Subarachnoid hemorrhage) Study Group. SUBJECTS AND METHODS. We screened 626 first-degree relatives of a consecutive series of 193 patients with subarachnoid hemorrhage examined at two institutions. We used MR imaging and MR angiography (three-dimensional time-of-flight imaging at both institutions and additional three-dimensional phase-contrast imaging at one institution). Three observers independently assessed the MR angiograms. Conventional angiography was performed in relatives with possible or definite aneurysms on MR angiography and was considered thestandard of reference. RESULTS, Thirty-three aneurysms were found in 25 (4%; 95% confidence interval [CI], 3-6%) of 626 relatives. Thirteen (8%) of 169 relatives who refused screening had MR-related reasons; an additional six persons could not be screened because of contraindications for MR imaging (pregnancy, n = 1; claustrophobia, n = 5). The positive predictive value of MR angiography was 100% (95% CI, 79-100%) for "definite" aneurysms and 58% (95% CI, 28-85%) for "possible" aneurysms. Sensitivity of MR angiography was estimated at 83% (95% CI, 65-94%) and specificity at 97% (95% CI, 94-98%). Interobserver agreement in the evaluation of MR angiograms was poor (kappa < .30), probably because different diagnostic strategies used by individual observers resultedin different use of the assessment category "possible aneurysm. "CONCLUSION. MR angiography is a feasible screening tool for detection of intracranial aneurysms. Positive predictive value, sensitivity, and specificity are acceptable when at least two neuroradiologists independently assessMR angiograms.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 07/07/20 alle ore 16:48:07