A Comparative Study Of MRA And DSA In Dioagnosis Of MCA Stenosis

Objective: Comparative analysis of 73 cases in ischemic cerebrovascular disease patients, confirmation of the diagnosis of the middle cerebral artery M1 segment stenosis by 3.0T TOF MRA and DSA, discussion of clinical value and limitation in MRA diagnosis of intracranial artery stenosis.Methods: Between january 2007 to December 2008 period, 73 ischemic cerebrovascular disease patients from Neurology Inpatient Ward were chosen, based on the 4th all China cerebrovascular conference diagnosis criteria is TIA, brain infarction, posterior circulation deficiency patients, which had undergone both MRA and DSA examination within 1 week, analyzed the 3.0 TOF MRA diagnosis of middle cerebral artery stenosis with DSA conformation, at the same time DSA as the standard calculation for sensitivity, specificity, accuracy, negative predictive value, and positive predictive value of MRA diagnosis of middle cerebral artery stenosis, and then evaluated the clinical value of MRA diagnosis of intracranial vascular stenosis.Results: In 73 patients, from 146 middle cerebral arteries examined by MRA and DSA, 122 blood vessels showed the same condition, coincidence rate was 83.7 %, MRA diagnosis was slightly higher in 19 blood vessels, with false positive rate for 13.0 %, the diagnosis was slightly decrease in 5 blood vessels, with false negative rate for 3.4 %. The sensitivity, specifity, accuracy ,positive predictive value, negative predictive value in MRA diagnosis of mild degree MCA stenosis were 66.7%,92.7%,90.5%,46.2%,96.7% ; In Moderate degree MCA stenosis ,it were 85.7%,93.6%,93.1%,46.2%,99.0%; In MRA diagnosis of severe degree MCA stenosis,it were 85.7%,95.8%,95.3%,54.5%,99.1%; In MRA diagnosis of MCA obstruction,it were 100%,96.2%,96.6%,75.0%,100%. For mild, moderate, severe degree stenosis, and obstruction of MCA rates according to Youden index were 59.4%,79.3%,81.5%,96.2%; Kappa values were 0.49,0.57,0.64,0.84.Conclusion: The accuracy of 3.0 T TOF MRA evaluation in middle cerebral artery stenosis is very high and has a very good relevancy with DSA. At some point, TOF MRA can replace DSA to become a general choice for cerebrovascular stenosis screening test .