Investigation of childhood central nervous system vasculitis: magnetic resonance angiography versus catheter cerebral angiography

Developmental Medicine and Child Neurology
Despina EleftheriouVijeya Ganesan

Abstract

We compared the clinical utility of magnetic resonance angiography (MRA) to catheter cerebral angiography (CA) in the investigation of children with suspected central nervous system (CNS) vasculitis. Single-centre retrospective review of children with a suspected diagnosis of CNS vasculitis studied with both MRA and CA. MRA and CA-detected abnormalities (location, multiplicity, and morphology) were compared; sensitivity and specificity were calculated on a per lesion and per patient basis for MRA, with CA as the reference standard. Findings in fourteen patients (median age at presentation of 5 y 10 mo [range 1 y 5 mo-14 y 5 mo]; eight males, six females) relating to sixteen paired studies of MRA and CA were reviewed. CA-detected lesions were commonly bilateral (13/16 studies, p<0.05), and likely to be proximally distributed (15/16 studies, p<0.05).The sensitivity and specificity of MRA for CA lesion detection was 63% (95% confidence interval [CI] 48-78) and 89% (95% CI 81-93), respectively with moderate agreement between the two modalities (kappa=0.51, 95% CI 0.37-0.66). The majority of the false negative observations involved the posterior circulation (9/14). The overall sensitivity for MRA diagnosis of vasculitis per patient ...Continue Reading

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Citations

Jan 23, 2013·Current Pain and Headache Reports·J Ivan LopezJulio Chalela
Dec 21, 2011·Nature Reviews. Rheumatology·Marinka Twilt, Susanne M Benseler
Dec 14, 2011·Current Opinion in Rheumatology·Carlo SalvaraniGene G Hunder
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