MR angiography as a screening tool for intracranial aneurysms: feasibility, test characteristics, and interobserver agreement
| Autor: | L. M. P. Ramos, Patrick M.M. Bossuyt, Erik Buskens, T. D. Witkamp, B. Verbeeten, G. J. Bonsel, M. Limburg, J. van Gijn, A. Gorissen, C. M. Vonk, A. Algra, G. J. F. Rinkel, Kees W. Albrecht, C. A. F. Tulleken, Paut Greebe, Theodora W M Raaymakers, Willem P.Th.M. Mali, F J Hulsmans, P. C. Buys |
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| Přispěvatelé: | Other departments |
| Jazyk: | angličtina |
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male medicine.medical_specialty Subarachnoid hemorrhage Magnetic resonance angiography Aneurysm Radiologic sign Risk Factors Image Processing Computer-Assisted medicine Humans Mass Screening Genetic Predisposition to Disease Radiology Nuclear Medicine and imaging cardiovascular diseases Mass screening Observer Variation medicine.diagnostic_test business.industry Vascular disease Intracranial Aneurysm General Medicine Cerebral Arteries Middle Aged Subarachnoid Hemorrhage medicine.disease Confidence interval Angiography Feasibility Studies Female Radiology business Magnetic Resonance Angiography |
| Zdroj: | AJR. American journal of roentgenology, 173(6), 1469-1475. American Roentgen Ray Society |
| ISSN: | 0361-803X |
| Popis: | 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 the standard 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 resulted in 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 assess MR angiograms |
| Databáze: | OpenAIRE |
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