Comparative study between ultrasound, computed tomography, intra-arterial digital subtraction angiography, and magnetic resonance imaging in the differentiation of tumors of the liver

1990 ◽  
Vol 15 (1) ◽  
pp. 102-106 ◽  
Author(s):  
L. Vlachos ◽  
S. Trakadas ◽  
A. Gouliamos ◽  
S. Lazarou ◽  
D. Mourikis ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Comparative Study ◽  
Digital Subtraction Angiography ◽  
Digital Subtraction ◽  
Resonance Imaging ◽  
Ultrasound Computed Tomography ◽  
Differentiation Of Tumors ◽  
Tumors Of The Liver

Arterial Spin Labeling for the Etiological Workup of Intracerebral Hemorrhage in Children

Stroke ◽  
2021 ◽  
Author(s):  
Jean François Hak ◽  
Grégoire Boulouis ◽  
Basile Kerleroux ◽  
Sandro Benichi ◽  
Sarah Stricker ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Intracerebral Hemorrhage ◽  
Computed Tomography Angiography ◽  
Arterial Spin Labeling ◽  
Diagnostic Performance ◽  
Spin Labeling ◽  
Digital Subtraction ◽  
Resonance Imaging

Background and Purpose: Pediatric nontraumatic intracerebral hemorrhage accounts for half of stroke in children. Early diagnostic of the causative underlying lesion is the first step toward prevention of hemorrhagic recurrence. We aimed to investigate the performance of arterial spin labeling sequence (ASL) in the acute phase etiological workup for the detection of an arteriovenous shunt (AVS: including malformation and fistula), the most frequent cause of pediatric nontraumatic intracerebral hemorrhage. Methods: Children with a pediatric nontraumatic intracerebral hemorrhage between 2011 and 2019 enrolled in a prospective registry were retrospectively included if they had undergone ASL-magnetic resonance imaging before any etiological treatment. ASL sequences were reviewed using cerebral blood flow maps by 2 raters for the presence of an AVS. The diagnostic performance of ASL was compared with admission computed tomography angiography, other magnetic resonance imaging sequences including contrast-enhanced sequences and subsequent digital subtraction angiography. Results: A total of 121 patients with pediatric nontraumatic intracerebral hemorrhage were included (median age, 9.9 [interquartile range, 5.8–13]; male sex 48.8%) of whom 76 (63%) had a final diagnosis of AVS. Using digital subtraction angiography as an intermediate reference, visual ASL inspection had a sensitivity and a specificity of, respectively, 95.9% (95% CI, 88.5%–99.1%) and 79.0% (95% CI, 54.4%–94.0%). ASL had a sensitivity, specificity, and accuracy of 90.2%, 97.2%, and 92.5%, respectively for the detection of the presence of an AVS, with near perfect inter-rater agreement (κ=0.963 [95% CI, 0.912–1.0]). The performance of ASL alone was higher than that of other magnetic resonance imaging sequences, individually or combined, and higher than that of computed tomography angiography. Conclusions: ASL has strong diagnostic performance for the detection of AVS in the initial workup of intracerebral hemorrhage in children. If our findings are confirmed in other settings, ASL may be a helpful diagnostic imaging modality for patients with pediatric nontraumatic intracerebral hemorrhage. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifiers: 3618210420, 2217698.

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