Comparing magnetic resonance angiography (MRA) and computed tomography angiography (CTA) with conventional angiography in the detection of distal territory cerebral mycotic and oncotic aneurysms

Lara Walkoff, Waleed Brinjikji, Aymeric Rouchaud, Jildaz Caroff, David F Kallmes

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background Mycotic and oncotic aneurysms may result in devastating neurologic sequelae if undetected. The objectives of this study were to examine interobserver variability and accuracy of cross-sectional imaging for the detection of distal territory mycotic and oncotic aneurysms. Methods We searched our institutional database for all radiology reports from 2005 to 2015 with an indication or diagnosis of mycotic or oncotic aneurysm. Patients who underwent DSA and either CTA or MRA within 12 weeks of each other were identified. The cross-sectional images from each study were blinded and reviewed by two radiologists. If positive for aneurysm, location and number of aneurysms were reported. Sensitivity, specificity, positive predictive value, negative predictive value, and interobserver variability were determined for MRA and MRA/CTA. Results Twenty-five patients were included in this study. Ten (40%) harbored distal aneurysms. Cross-sectional imaging had a sensitivity of 45.5%, specificity of 90.0%, and kappa value of 0.29 (0.00-0.69) for the detection of cerebral mycotic and oncotic aneurysms. Conclusions Because of the low sensitivity and high interobserver variability of cross-sectional imaging, DSA should remain the gold standard for evaluation of suspected oncotic and mycotic aneurysms. In cases in which cross sectional imaging is negative and there is a high clinical suspicion for mycotic aneurysm, DSA should be strongly considered.

Original languageEnglish (US)
Pages (from-to)524-528
Number of pages5
JournalInterventional Neuroradiology
Volume22
Issue number5
DOIs
StatePublished - Oct 1 2016

Fingerprint

Infected Aneurysm
Magnetic Resonance Angiography
Intracranial Aneurysm
Angiography
Aneurysm
Observer Variation
Sensitivity and Specificity
Radiology
Nervous System
Computed Tomography Angiography
Databases

Keywords

  • Aneurysm
  • angiography
  • mycotic
  • oncotic

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

@article{5234e7ad9be44f959a9d22be233f9616,
title = "Comparing magnetic resonance angiography (MRA) and computed tomography angiography (CTA) with conventional angiography in the detection of distal territory cerebral mycotic and oncotic aneurysms",
abstract = "Background Mycotic and oncotic aneurysms may result in devastating neurologic sequelae if undetected. The objectives of this study were to examine interobserver variability and accuracy of cross-sectional imaging for the detection of distal territory mycotic and oncotic aneurysms. Methods We searched our institutional database for all radiology reports from 2005 to 2015 with an indication or diagnosis of mycotic or oncotic aneurysm. Patients who underwent DSA and either CTA or MRA within 12 weeks of each other were identified. The cross-sectional images from each study were blinded and reviewed by two radiologists. If positive for aneurysm, location and number of aneurysms were reported. Sensitivity, specificity, positive predictive value, negative predictive value, and interobserver variability were determined for MRA and MRA/CTA. Results Twenty-five patients were included in this study. Ten (40{\%}) harbored distal aneurysms. Cross-sectional imaging had a sensitivity of 45.5{\%}, specificity of 90.0{\%}, and kappa value of 0.29 (0.00-0.69) for the detection of cerebral mycotic and oncotic aneurysms. Conclusions Because of the low sensitivity and high interobserver variability of cross-sectional imaging, DSA should remain the gold standard for evaluation of suspected oncotic and mycotic aneurysms. In cases in which cross sectional imaging is negative and there is a high clinical suspicion for mycotic aneurysm, DSA should be strongly considered.",
keywords = "Aneurysm, angiography, mycotic, oncotic",
author = "Lara Walkoff and Waleed Brinjikji and Aymeric Rouchaud and Jildaz Caroff and Kallmes, {David F}",
year = "2016",
month = "10",
day = "1",
doi = "10.1177/1591019916653247",
language = "English (US)",
volume = "22",
pages = "524--528",
journal = "Interventional Neuroradiology",
issn = "1123-9344",
publisher = "Centauro srl",
number = "5",

}

TY - JOUR

T1 - Comparing magnetic resonance angiography (MRA) and computed tomography angiography (CTA) with conventional angiography in the detection of distal territory cerebral mycotic and oncotic aneurysms

AU - Walkoff, Lara

AU - Brinjikji, Waleed

AU - Rouchaud, Aymeric

AU - Caroff, Jildaz

AU - Kallmes, David F

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Background Mycotic and oncotic aneurysms may result in devastating neurologic sequelae if undetected. The objectives of this study were to examine interobserver variability and accuracy of cross-sectional imaging for the detection of distal territory mycotic and oncotic aneurysms. Methods We searched our institutional database for all radiology reports from 2005 to 2015 with an indication or diagnosis of mycotic or oncotic aneurysm. Patients who underwent DSA and either CTA or MRA within 12 weeks of each other were identified. The cross-sectional images from each study were blinded and reviewed by two radiologists. If positive for aneurysm, location and number of aneurysms were reported. Sensitivity, specificity, positive predictive value, negative predictive value, and interobserver variability were determined for MRA and MRA/CTA. Results Twenty-five patients were included in this study. Ten (40%) harbored distal aneurysms. Cross-sectional imaging had a sensitivity of 45.5%, specificity of 90.0%, and kappa value of 0.29 (0.00-0.69) for the detection of cerebral mycotic and oncotic aneurysms. Conclusions Because of the low sensitivity and high interobserver variability of cross-sectional imaging, DSA should remain the gold standard for evaluation of suspected oncotic and mycotic aneurysms. In cases in which cross sectional imaging is negative and there is a high clinical suspicion for mycotic aneurysm, DSA should be strongly considered.

AB - Background Mycotic and oncotic aneurysms may result in devastating neurologic sequelae if undetected. The objectives of this study were to examine interobserver variability and accuracy of cross-sectional imaging for the detection of distal territory mycotic and oncotic aneurysms. Methods We searched our institutional database for all radiology reports from 2005 to 2015 with an indication or diagnosis of mycotic or oncotic aneurysm. Patients who underwent DSA and either CTA or MRA within 12 weeks of each other were identified. The cross-sectional images from each study were blinded and reviewed by two radiologists. If positive for aneurysm, location and number of aneurysms were reported. Sensitivity, specificity, positive predictive value, negative predictive value, and interobserver variability were determined for MRA and MRA/CTA. Results Twenty-five patients were included in this study. Ten (40%) harbored distal aneurysms. Cross-sectional imaging had a sensitivity of 45.5%, specificity of 90.0%, and kappa value of 0.29 (0.00-0.69) for the detection of cerebral mycotic and oncotic aneurysms. Conclusions Because of the low sensitivity and high interobserver variability of cross-sectional imaging, DSA should remain the gold standard for evaluation of suspected oncotic and mycotic aneurysms. In cases in which cross sectional imaging is negative and there is a high clinical suspicion for mycotic aneurysm, DSA should be strongly considered.

KW - Aneurysm

KW - angiography

KW - mycotic

KW - oncotic

UR - http://www.scopus.com/inward/record.url?scp=84988689979&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84988689979&partnerID=8YFLogxK

U2 - 10.1177/1591019916653247

DO - 10.1177/1591019916653247

M3 - Article

C2 - 27298009

AN - SCOPUS:84988689979

VL - 22

SP - 524

EP - 528

JO - Interventional Neuroradiology

JF - Interventional Neuroradiology

SN - 1123-9344

IS - 5

ER -