Standard Diffusion-weighted MRI for the Diagnosis of Central Retinal Artery Occlusion
- PDF / 451,193 Bytes
- 8 Pages / 612.419 x 808.052 pts Page_size
- 89 Downloads / 160 Views
ORIGINAL ARTICLE
Standard Diffusion-weighted MRI for the Diagnosis of Central Retinal Artery Occlusion A Case-Control Study L. A. Danyel1
· G. Bohner2 · F. Connolly1 · E. Siebert2
Received: 14 April 2020 / Accepted: 14 August 2020 © The Author(s) 2020
Abstract Purpose To evaluate diffusion abnormalities of the retina and optic nerve in patients with central retinal artery occlusion (CRAO) using standard stroke diffusion-weighted magnetic resonance imaging (DWI). Methods In this case-control study, DWI scans of patients with nonarteritic CRAO were retrospectively assessed for acute ischemia of the retina and optic nerve. Two neuroradiologists, blinded for patient diagnosis, randomly evaluated DWI of CRAO patients and controls (a collective of stroke and transient ischemic attack [TIA] patients) for restrictions of the retina and optic nerve. We calculated statistical quality criteria and analyzed inter-rater reliability using unweighted Kappa statistics. Results 20 CRAO patients (60,6 ± 17 years) and 20 controls (60,7 ± 17 years) were included in the study. Sensitivity, specificity, positive and negative predictive values for retinal DWI restrictions were 75%/80%/79%/76% (reader 1) and 75%/100%/100%/80% (reader 2), respectively. Unweighted Kappa was κ = 0,70 (95% CI 0,48-0,92), indicating “substantial” interrater reliability. In comparison, sensitivity, specificity, PPV and NPV (positive and negative predictive values) for restrictions of the optic nerve in CRAO were 55%/70%/65%/61% (reader 1) and 25%/100%/100%/57% (reader 2). Inter-rater reliability was “fair” with unweighted Kappa κ = 0,32 (95% CI 0,09-0,56). Conclusions Retinal diffusion restrictions were present in a majority of CRAO patients and detectable with reasonable sensitivity, high specificity and substantial inter-rater reliability. Further studies are necessary to study time dependency of retinal diffusion restrictions, improve image quality and investigate the reliability of retinal DWI to discern CRAO from other causes of acute loss of vision.
Keywords Cerebrovascular disease · Stroke · Ischemia · Magnetic resonance imaging · Retinopathy · Blindness · Embolism
Introduction F. Connolly and E. Siebert contributed equally to the manuscript. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00062-020-00955-6) contains supplementary material, which is available to authorized users. L. A. Danyel
[email protected] 1
Dept. of Neurology, University Hospital Charité, Augustenburger Platz 1, 13353 Berlin, Germany
2
Institute of Neuroradiology, University Hospital Charité, Berlin, Germany
Nonarteritic central retinal artery occlusion (NA-CRAO) is a medical emergency characterized by a sudden onset of painless, monocular amaurosis due to retinal ischemia. Diagnosis of CRAO is commonly established through clinical and ophthalmologic examination whereby patients present with decreased visual acuity and impairment of visual field, mostly central scotoma [1]. Frequent ophthalmoscopic findings include reti
Data Loading...
