Measurement precision and biological variation of cranial arteries using automated analysis of 3 T magnetic resonance angiography
Tóm tắt
Non-invasive magnetic resonance angiography (MRA) has facilitated repeated measurements of human cranial arteries in several headache and migraine studies. To ensure comparability across studies the same automated analysis software has been used, but the intra- and interobserver, day-to-day and side-to-side variations have not yet been published. We hypothesised that the observer related, side-to-side, and day-to-day variations would be less than 10%.
Ten female participants were studied using high-resolution MRA on two study days separated by at least one week. Using the automated LKEB-MRA vessel wall analysis software arterial circumferences were measured by blinded observers. Each artery was analysed twice by each of the two different observers. The primary endpoints were to determine the intraclass correlation coefficient (ICC) and intra- an inter-observer, the day-to-day, and side-to-side variations of the circumference of the middle meningeal (MMA) and middle cerebral (MCA) arteries.
We found an excellent intra- and interobserver agreement for the MMA (ICC: 0.909-0.987) and for the MCA (ICC: 0.876-0.949). The coefficient of variance within observers was ≤1.8% for MMA and ≤3.1% for MCA; between observers ≤3.4% (MMA) and ≤4.1% (MCA); between days ≤6.0% (MMA) and ≤8.0% (MCA); between sides ≤9.4% (MMA) and ≤6.5% (MCA).
The present study demonstrates a low (<5%) inter- and intraobserver variation using the automated LKEB-MRA vessel wall analysis software. Furthermore, the study also suggests that the day-to-day and side-to-side variations of the MMA and MCA circumferences are less than 10%.
Từ khóa
Tài liệu tham khảo
Davis WL, Blatter DD, Harnsberger HR, Parker DL: Intracranial MR angiography: comparison of single-volume three-dimensional time-of-flight and multiple overlapping thin slab acquisition techniques. AJR Am J Roentgenol 1994, 163: 915–920. 10.2214/ajr.163.4.8092035
Schoonman GG, van der Grond J, Kortmann C, van der Geest RJ, Terwindt GM, Ferrari MD: Migraine headache is not associated with cerebral or meningeal vasodilatation–a 3 T magnetic resonance angiography study. Brain 2008, 131: 2192–2200. 10.1093/brain/awn094
Asghar MS, Hansen AE, Kapijimpanga T, van der Geest RJ, de Koning P, Larsson HBW, Olesen J, Ashina M: Dilatation by CGRP of middle meningeal artery and reversal by sumatriptan in normal volunteers. Neurology 2010, 75: 1520–1526. 10.1212/WNL.0b013e3181f9626a
Asghar MS, Hansen AE, Amin FM, van der Geest RJ, van der Koning P, Larsson HBW, Olesen J, Ashina M: Evidence for a vascular factor in migraine. Ann Neurol 2011, 69: 635–645. 10.1002/ana.22292
Amin FM, Asghar MS, Guo S, Hougaard A, Hansen AE, Schytz HW, van der Geest RJ, de Koning PJH, Larsson HBW, Olesen J, Ashina M: Headache and prolonged dilatation of the middle meningeal artery by PACAP38 in healthy volunteers. Cephalalgia 2012, 32: 140–149. 10.1177/0333102411431333
Amin FM, Asghar MS, Hougaard A, Hansen AE, Larsen VA, de Koning PJH, Larsson HB, Olesen J, Ashina M: Magnetic resonance angiography of intracranial and extracranial arteries in patients with spontaneous migraine without aura: a cross-sectional study. Lancet Neurol 2013, 12: 454–461. 10.1016/S1474-4422(13)70067-X
Amin FM, Asghar MS, Ravneberg JW, de Koning PJH, Larsson HBW, Olesen J, Ashina M: The effect of sumatriptan on cephalic arteries: A 3 T MR-angiography study in healthy volunteers. Cephalalgia 2013, 33: 1009–1016. 10.1177/0333102413483374
Amin FM, Hougaard A, Schytz HW, Asghar MS, Lundholm E, Parvaiz AI, de Koning PJ, Andersen MR, Larsson HB, Fahrenkrug J, Olesen J, Ashina M: Investigation of the pathophysiological mechanisms of migraine attacks induced by pituitary adenylate cyclase-activating polypeptide-38. Brain 2014, 137: 779–794. 10.1093/brain/awt369
de Koning PJH, Schaap JA, Janssen JP, Westenberg JJM, van der Geest RJ, Reiber JHC: Automated segmentation and analysis of vascular structures in magnetic resonance angiographic images. Magn Reson Med 2003, 50: 1189–1198. 10.1002/mrm.10617
Aaslid R, Markwalder TM, Nornes H: Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. J Neurosurg 1982, 57: 769–774. 10.3171/jns.1982.57.6.0769
Thomsen LL, Iversen HK: Experimental and biological variation of three-dimensional transcranial Doppler measurements. J Appl Physiol 1993, 75: 2805–2810.
Ackerstaff RGA, Keunen RWM, van Pelt W, van Swijndregt ADM, Stijnen T: Influence of biological factors on changes in mean cerebral in mean cerebral blood flow velocity in normal ageing: a transcranial Doppler study. Neurol Res 1990, 12: 187–191.
Arnolds BJ, von Reutern GM: Transcranial doppler-sonography. Examination technique and normal reference values. Ultrasound Med Biol 1986, 12: 115–123. 10.1016/0301-5629(86)90016-5
Grolimund P, Seiler RW: Age dependence of the flow velocity in the basal cerebral arteries—a transcranial Doppler ultrasound study. Ultrasound Med Biol 1988, 14: 191–198. 10.1016/0301-5629(88)90139-1
Lindegaard KF, Bakke SJ, Grolimund P, Aaslid R, Huber P, Nornes H: Assessment of intracranial hemodynamics in carotid artery disease by trancranial doppler ultrasound. J Neurosurg 1985, 63: 890–898. 10.3171/jns.1985.63.6.0890
Vriens EM, Kraaier V, Musbach M, Wrienke GH, Huffelen AC: Transcranial pulsed Doppler measurements of blood velocity in the middle cerebral artery: reference values at rest and during hyperventilation in healthy volunteers in relation to age and sex. Ultrasound Med Biol 1989, 15: 1–8.
Brass LM, Pavlakis SG, de Vivo D, Piomelli S, Mohr JP: Transcranial doppler measurements of the middle cerebral artery effect of hematocrit. Stroke 1988, 19: 1466–1469. 10.1161/01.STR.19.12.1466
Markwalder TM, Grolimund P, Seiler RF, Roth F, Aaslid R: Dependency of blood flow velocity in the middle cerebral artery on end-tidal carbon dioxide partial pressure—a transcranial ultrasound Doppler study. J Cereb Blood Flow Metab 1984, 4: 368–372. 10.1038/jcbfm.1984.54