Purpose: Is to evaluate the accuracy of fused 3D time-of-flight (TOF) MR angiography and 3D Steady-State sequence (FIESTA) versus 3D contrast-enhanced T1 weighted images in evaluation of neurovascular compression via ...Purpose: Is to evaluate the accuracy of fused 3D time-of-flight (TOF) MR angiography and 3D Steady-State sequence (FIESTA) versus 3D contrast-enhanced T1 weighted images in evaluation of neurovascular compression via an inter-observer agreement protocol. Methods: Patients presented with trigeminal neuralgia, tinnitus, or facial hemispasm were examined using 3D-TOF-MRA, 3D-FIESTA, and 3D contrast-enhanced T1WI of the cerebellopontine angle to assess neurovascular compression. Two independent readers assessed the location, signal alteration, offending vascular structure, and grade of neurovascular compression using fused 3D-TOF-MRA and 3D-FIESTA versus contrast-enhanced T1 weighted images. The Kappa test for interobserver agreement was done. Results: The final study cohort consisted of 56 patients (42 females and 14 males) with a mean age of 38.25 ± 1.94. AICA was the offending vessel for 32 (57.1%) patients. The most common offending nerve was the trigeminal nerve in 26 patients, followed by facial/vestibulocochlear complex in 18 patients, and solely the 8th nerve in 12 patients. All three grades of compression were encountered in this study with percentages of 48.2% (27/56), 30.3% (17/56), and 21.4% (12/56) for grades I, II, III respectively. Fused TOF and steady-state images, and contrast-enhanced images showed perfect agreement for detection of the side of compression, the relation between nerve and vascular loop, offended neural segment, and offending vessel, while showing good agreement regarding the degree of compression. Conclusion: Fused TOF and steady-state images provide sufficient data to diagnose and grade microvascular compression syndromes comparable to contrast-enhanced images.展开更多
文摘Purpose: Is to evaluate the accuracy of fused 3D time-of-flight (TOF) MR angiography and 3D Steady-State sequence (FIESTA) versus 3D contrast-enhanced T1 weighted images in evaluation of neurovascular compression via an inter-observer agreement protocol. Methods: Patients presented with trigeminal neuralgia, tinnitus, or facial hemispasm were examined using 3D-TOF-MRA, 3D-FIESTA, and 3D contrast-enhanced T1WI of the cerebellopontine angle to assess neurovascular compression. Two independent readers assessed the location, signal alteration, offending vascular structure, and grade of neurovascular compression using fused 3D-TOF-MRA and 3D-FIESTA versus contrast-enhanced T1 weighted images. The Kappa test for interobserver agreement was done. Results: The final study cohort consisted of 56 patients (42 females and 14 males) with a mean age of 38.25 ± 1.94. AICA was the offending vessel for 32 (57.1%) patients. The most common offending nerve was the trigeminal nerve in 26 patients, followed by facial/vestibulocochlear complex in 18 patients, and solely the 8th nerve in 12 patients. All three grades of compression were encountered in this study with percentages of 48.2% (27/56), 30.3% (17/56), and 21.4% (12/56) for grades I, II, III respectively. Fused TOF and steady-state images, and contrast-enhanced images showed perfect agreement for detection of the side of compression, the relation between nerve and vascular loop, offended neural segment, and offending vessel, while showing good agreement regarding the degree of compression. Conclusion: Fused TOF and steady-state images provide sufficient data to diagnose and grade microvascular compression syndromes comparable to contrast-enhanced images.
