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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2025; 44(03): e182-e187
DOI: 10.1055/s-0045-1809962
Original Article

Comparative Efficacy of TOF MRA and CT Angiography in Cerebrovascular Disease Diagnostics

Eficácia comparativa da TOF MRA e da angiografia por tomografia computadorizada no diagnóstico de doenças cerebrovasculares

Authors

  • Khoroushi Farzaneh 

    1   Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

  • Farrokh Seilanian Toosi

    1   Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

  • Fathabadi Amirhossein

    2   Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
    3   Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran

  • Aminzadeh Behzad

    1   Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

  • Jarrahi Lida

    4   Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

  • Sheibak Narges

    3   Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran

Funding The author(s) received no financial support for the research.
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Abstract

Objective

To compare the diagnostic value of 3D Time-of-Flight Magnetic Resonance Angiography (3D TOF MRA) with Computed Tomography Angiography (CTA) in assessing cerebrovascular disease (CVD).

Methods

A retrospective observational study included 205 adult patients who underwent both TOF MRA and CTA scans. Demographic data, clinical symptoms, and imaging findings were analyzed. Diagnostic parameters were calculated for TOF MRA using CTA as the reference standard.

Results

Among 205 patients (mean age: 60 ± 11.67 years), TOF MRA detected more vessel occlusions (45.9%) than CTA (39%). CTA, however, identified more aneurysms (2.9% versus 1.5%). TOF MRA showed a sensitivity of 88%, specificity of 76%, and overall diagnostic efficacy of 84%. A significant association between CVD changes detected by MRA and CTA was observed (p < 0.001).

Conclusions

TOF MRA demonstrated a higher detection rate for vessel occlusions but was less effective than CTA in detecting vessel stenosis and aneurysms. TOF MRA is safer for repeated use and in patients with renal insufficiency due to the absence of contrast agents and ionizing radiation. However, its lower spatial resolution may lead to misclassification.

Resumo

Objetivo

Comparar o valor diagnóstico da Angiografia por Ressonância Magnética com Técnica de Tempo de Voo 3D (3D TOF MRA) com a Angiografia por Tomografia Computadorizada (CTA) na avaliação de doenças cerebrovasculares (DCV).

Métodos

Um estudo observacional retrospectivo incluiu 205 pacientes adultos que realizaram exames de TOF MRA e CTA. Dados demográficos, sintomas clínicos e achados de imagem foram analisados. Os parâmetros diagnósticos foram calculados para TOF MRA usando CTA como padrão de referência.

Resultados

Entre os 205 pacientes (idade média: 60 ± 11,67 anos), a TOF MRA detectou mais oclusões vasculares (45,9%) do que a CTA (39%). No entanto, a CTA identificou mais aneurismas (2,9% contra 1,5%). A TOF MRA apresentou uma sensibilidade de 88%, especificidade de 76% e eficácia diagnóstica global de 84%. Observou-se uma associação significativa entre as alterações de DCV detectadas pela MRA e pela CTA (p < 0,001).

Conclusões

A TOF MRA demonstrou uma taxa de detecção superior para oclusões vasculares, mas foi menos eficaz que a CTA na detecção de estenoses vasculares e aneurismas. A TOF MRA é mais segura para uso repetido e para pacientes com insuficiência renal, devido à ausência de agentes de contraste e radiação ionizante. No entanto, sua menor resolução espacial pode levar a erros de classificação.

Keywords

cerebrovascular disease - image quality - CTA - time-of-flight MRA

Palavras-chave

doença cerebrovascular - qualidade de imagem - CTA - angiografia por tempo de voo

Authors' Contributions

FK, FST, BA, NS, ZBK, LJ, AF: material preparation, data collection, and data analysis; AF, NS: writing — original draft. All authors contributed to the conception and design of the study, critical review of the manuscript, and final approval.




Publication History

Received: 29 October 2024

Accepted: 22 May 2025

Article published online:
08 October 2025

© 2025. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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