Comparison of 3D magnetic resonance imaging and digital subtraction angiography for intracranial artery stenosis

Abstract

Objectives: To compare three-dimensional high-resolution magnetic resonance imaging (3D HR-MRI) and digital subtraction angiography (DSA) for diagnosing and evaluating stenosis in the entire circle of Willis. Methods: The study included 516 intracranial arteries from 43 patients with intracranial artery stenosis (ICAS) who underwent both 3D HR-MRI and DSA within 1 month. Two readers independently diagnosed atherosclerosis, dissection, moyamoya disease and vasculitis, rated their diagnostic confidence for each vessel and measured the luminal diameters. Reference standard was made from clinico-radiologic diagnosis. Diagnostic accuracy, diagnostic confidence, the degree of stenosis and luminal diameter were assessed and compared between both modalities. Results: For atherosclerosis, 3D HR-MRI showed better diagnostic accuracy (P =.03–.003), sensitivity (P =.006–.01) and positive predictive value (P ≤.001–.006) compared to DSA. Overall, the readers were more confident of their diagnosis of ICAS when using 3D HR-MRI (reader 1, P ≤.001–.007; reader 2, P ≤.001–.015). 3D HR-MRI showed similar degree of stenosis (P >.05) and higher luminal diameter (P <.05) compared to DSA. Conclusions: 3D HR-MRI might be useful to evaluate atherosclerosis, with better diagnostic confidence and comparable stenosis measurement compared to DSA in the entire circle of Willis. Key Points: • 3D HR-MRI showed better diagnostic accuracy for atherosclerosiscompared to DSA • 3D HR-MRI showed better overall diagnostic confidence for stenosiscompared to DSA • 3D HR-MRI and DSA showed similar degree of stenosis. © 2017, European Society of Radiology.