Ruolo attuale dell'angio RM senza mezzo di contrasto (TOF 3D) nella valutazione della steno occlusione della carotide interna

Purpose. To evaluate the diagnostic accuracy, sensitivity and specificity of MRA (3D TOF) in comparison to contrast-enhanced MRA using DSA as the gold standard in the study of steno-occlusive disease of the internal carotid artery, in order to determine if this technique still has a diagnostic value. Materials and methods. Three radiologists blindly and independently evaluated either the unenhanced MRA, CE MRA, or DSA images of 23 consecutive patients, assessing the stenosis based on a NASCET five-class classification. Results. The sensitivity, specificity, and diagnostic accuracy of CE MRA and unenhanced MRA were 100% and 100%, 100% and 95.5% and 100% and 93.2%, respectively. These differences were not statistically significant. Conclusions. Unenhanced MRA should be still considered a valid alternative for studying the extracranial section of the internal carotid arteries especially in patients who refuse or whose laboratory results exclude the use of contrast medium or in patients in whom continuous monitoring of a clinical condition is required but a repeated and/or frequent use of contrast medium is not possible.