|Title||Quantifying Intracranial Internal Carotid Artery Stenosis on MR Angiography.|
|Publication Type||Journal Article|
|Year of Publication||2017|
|Authors||Baradaran H, Patel P, Gialdini G, Al-Dasuqi K, Giambrone A, Kamel H, Gupta A|
|Journal||AJNR Am J Neuroradiol|
|Date Published||2017 May|
|Keywords||Aged, Carotid Artery, Internal, Carotid Stenosis, Female, Humans, Magnetic Resonance Angiography, Male, Middle Aged, Prospective Studies|
BACKGROUND AND PURPOSE: Intracranial atherosclerosis is a common cause of ischemic stroke. Intracranial stenosis is most commonly quantified by the Warfarin-Aspirin Symptomatic Intracranial Disease method, which involves calculating a ratio of luminal diameter measurements on conventional angiography. Our purpose was to determine whether a single linear measurement of the narrowest caliber of the intracranial ICA on MRA can accurately predict Warfarin-Aspirin Symptomatic Intracranial Disease stenosis measurements.
MATERIALS AND METHODS: We identified patients from a prospective stroke registry who had undergone head MRAs to quantitatively evaluate the degree of Warfarin-Aspirin Symptomatic Intracranial Disease-derived stenosis in each intracranial ICA. We also made a single linear millimeter measurement at the site of maximal narrowing of the ICA. We calculated a correlation coefficient between the lumen diameter in millimeters and percentage Warfarin-Aspirin Symptomatic Intracranial Disease stenosis. We performed receiver operating characteristic analysis to determine optimal luminal diameter cutoff values.
RESULTS: In 386 unique intracranial ICAs, we found a strong linear relationship between single lumen measurements and Warfarin-Aspirin Symptomatic Intracranial Disease-style stenosis measurements (R = -0.84, P < .0001). We found that ICA lumen diameters of ≤2.1 and ≤1.3 mm were optimal cutoffs for identifying patients with ≥50% stenosis and ≥70% stenosis, respectively (area under the curve = 0.96 and 0.99, respectively).
CONCLUSIONS: There is a strong linear relationship between the narrowest lumen diameter of the intracranial ICA and percentage stenosis. Our results suggest that a single lumen diameter measurement on MRA allows accurate estimation of Warfarin-Aspirin Symptomatic Intracranial Disease stenosis, which may affect risk stratification and treatment decisions.
|Alternate Journal||AJNR Am J Neuroradiol|
|PubMed Central ID||PMC5433892|
|Grant List||K23 NS082367 / NS / NINDS NIH HHS / United States |
KL2 TR000458 / TR / NCATS NIH HHS / United States