Comparison of MRI and MRA findings in children with a variety of neurologic conditions

The role of MRA in the evaluation of children is evolving, We compared MRA and MRI in children with a variety of neurologic conditions to determine wh en MRA provides positive, cost-beneficial information. A total of 114 patie nts were retrospectively studied. MRA and MRI were performed and compared. MRA was abnormal in 34 (30%) of 114 patients: five (83%) of six with Menkes ' disease, four (33%) of 12 with sickle cell disease, 12 (38%) of 32 with v ascular malformations, one (6%) of 17 with headaches, seven (24%) of 24 wit h new focal deficits, one (10%) of 10 with seizures, and four (31%) of 13 w ith miscellaneous diagnoses. MRA and MRI were concordant in 73 (64%) of 114 . Maximum concordance was in patients with Menkes' disease (100%) and minim um in those with new focal deficits (50%), The best MRA cost/benefit ratios were obtained in patients with Menkes' disease, vascular malformations, an d sickle cell disease. A normal MRI usually forecasted a normal MRA. Howeve r, abnormal MRI findings did not always predict MRA abnormalities, Positive , cost-beneficial information is provided by MRA mostly in conditions known to involve the cerebral vasculature. Indications to perform MRA should be based on the neurologic diagnosis and MRI findings. (C) 2000 by Elsevier Sc ience inc. All rights reserved.