Eijun Sueyoshi MD, Presenter: Nothing to Disclose

Ichiro Sakamoto MD, Abstract Co-Author: Nothing to Disclose

Masataka Uetani MD, Abstract Co-Author: Nothing to Disclose

To determine the clinical efficacy of contrast-enhanced magnetic resonance (MR) digital subtraction angiography (DSA) compared with perfusion scintigraphy in the diagnosis of obstructive changes in the pulmonary artery in Takayasu arteritis.

In fourteen patients with Takayasu arteritis, contrast-enhanced pulmonary MR DSA images were acquired using a 2-dimensional fast spoiled gradient-recalled echo sequence (TR/TE; 5.3/1.3 msec, flip angle; 30°, receiver bandwidth; 31.25 kHz/pixel, and acquisition time; 0.7 seconds). Seventy continuous subtracted MR images were evaluated, and the presence or absence of obstructive lesions was determined in segment-based (n=252), lobe-based (n=84), and patient-based (n=14) analyses. The sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) were calculated using perfusion scintigraphy as a standard of reference. The interobserver agreement was quantified using Kappa statistics.

For the segment-based analysis, the sensitivity was 94.6 - 97.3 %, the specificity was 97.2%, and the PPV and NPV were 85.4 - 85.7 % and 96.8 - 99.5 %, respectively. For the lobe-based analysis, the sensitivity was 94.4 %, the specificity was 90.9 - 92.4 %, and the PPV and NPV were 73.9 - 77.3 % and 98.4 %, respectively. For the patient-based analyses, the sensitivity was 100%, the specificity was 71.4%, and the PPV and NPV were 77.8 % and 100 %, respectively. The kappa values for each analyses were between 0.79 - 1.00.

MR DSA has high sensitivity, NPV, and kappa values, and may be used as an alternative to perfusion scintigraphy for screening obstructive lesions in the pulmonary artery in Takayasu arteritis.

Sueyoshi, E, Sakamoto, I, Uetani, M, Diagnosis of Obstructive Lesions of the Pulmonary Artery in Takayasu Arteritis: A Comparison between Contrast-enhanced MR Digital Subtraction Angiography and Perfusion Scintigraphy.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4408345.html