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Updated: Aug 9, 2026
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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
MR angiography compared to conventional selective angiography in acute stroke
Anna I Tomanek1, Shelagh B Coutts, Andrew M Demchuk
1Seaman Family MR Research Centre, University of Calgary, Calgary, AB Canada.
Summary
Magnetic resonance angiography (MRA) is a reliable non-invasive tool for evaluating intracranial vessels in acute stroke patients. While MRA shows good accuracy, conventional angiography remains the gold standard for definitive diagnosis.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Intracranial magnetic resonance angiography (MRA) accuracy and interpretation reliability are not well-established compared to conventional catheter angiography.
- Evaluating intracranial vessels in acute stroke and transient ischemic attack (TIA) patients requires accurate diagnostic tools.
Purpose of the Study:
- To determine the accuracy and reliability of MRA in assessing intracranial vessels in patients with acute stroke or TIA.
- To compare MRA findings with conventional selective catheter angiography as the gold standard.
Main Methods:
- Twenty-nine patients with acute stroke/TIA underwent both 3T MRA and conventional angiography within 48 hours.
- Conventional angiography served as the gold standard, interpreted by one neuroradiologist.
- Five observers, blinded to clinical data, rated MRA images; kappa statistics assessed inter-rater reliability.
Main Results:
- Non-enhanced MRA demonstrated 84.2% sensitivity and 84.6% specificity for detecting occluded intracranial vessels.
- Gadolinium-enhanced MRA showed 69.2% sensitivity and 73.6% specificity.
- Good inter-rater agreement was observed for both non-enhanced (kappa=0.50) and enhanced (kappa=0.46) MRA.
Conclusions:
- MRA serves as a valuable non-invasive screening tool for intracranial vessel status in acute ischemic stroke.
- Conventional angiography is still necessary for definitive assessment of intracranial circulation.
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