Incidence of postangiographic abnormalities revealed by diffusion-weightedMR imaging

Citation
Pm. Britt et al., Incidence of postangiographic abnormalities revealed by diffusion-weightedMR imaging, AM J NEUROR, 21(1), 2000, pp. 55-59
Citations number
33
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Neurosciences & Behavoir
Journal title
AMERICAN JOURNAL OF NEURORADIOLOGY
ISSN journal
01956108 → ACNP
Volume
21
Issue
1
Year of publication
2000
Pages
55 - 59
Database
ISI
SICI code
0195-6108(200001)21:1<55:IOPARB>2.0.ZU;2-G
Abstract
BACKGROUND AND PURPOSE: Occasionally we have observed anecdotal cases of as ymptomatic hyperintensities on diffusion-weighted MR (DW-MR) examinations o f the brain of patients who previously underwent routine cerebral angiograp hy, These observations, as well as MR imaging and transcranial Doppler data in the literature suggesting a high rate of procedure-associated emboli, r aise concern regarding the underdiagnosis of asymptomatic focal infarction associated with cerebral angiography. In order to determine whether asymptomatic diffusion abnormalities are freq uently associated with procedures, we prospectively obtained DW-MR images b efore and after routine cerebral angiography, METHODS: Twenty consecutive patients, who met protocol criteria and receive d a routine three- or four-vessel diagnostic cerebral angiogram at our inst itution, were evaluated. Using a Bayesian estimate to establish an upper bo und for the incidence of an event with zero occurrences in a study sample, the study group size was selected to exclude a 10% incidence of abnormaliti es revealed by DW-MR imaging of patients who underwent previous cerebral an giography, Two neuroradiologists evaluated imaging studies. RESULTS: Neither clinical signs nor abnormalities on DW-MR images were foun d, which suggested no infarction after angiography in our patient sample, B ased on this data, an upper bound of 9% (95% confidence) is predicted for t he appearance of abnormalities revealed by DW-MR imaging after cerebral ang iography. CONCLUSION: Cerebral angiography is associated with an incidence of asympto matic cerebral infarction of no more than 9%, It well may be substantially lower than this estimate; a more accurate evaluation of the true incidence would require a significantly larger study population, This test provides a convenient noninvasive means of assessing procedure-related cerebral infar ction, such as that which occurs after carotid endarterectomy or vascular a ngioplasty and stenting.