Guillaume Gravel1, Patricia Niccoli2, Vincent Rohmer3,4, Guy Moulin5, Françoise Borson-Chazot6,7,8, Pascal Rousset9, Anne Pasco-Papon10, Claude Marcus11, Frédérique Dubrulle12, Hervé Gouya13, François Bidault14, Benoit Dupas15, Jean Gabrillargues16, Aurore Caumont-Prim17,18, Anne Hernigou1, Anne-Paule Gimenez-Roqueplo19,20,21, Philippe Halimi1,22. 1. Assistance Publique-Hôpitaux de Paris, Service de Radiologie, Hôpital Européen Georges Pompidou, F-75015, Paris, France. 2. Assistance Publique-Hôpitaux de Marseille, Service d'Endocrinologie, Diabète et Maladies Métaboliques, Centre Hospitalier Universitaire la Timone, F-13000, Marseille, France. 3. Service d'Endocrinologie, Diabétologie, Nutrition, Centre Hospitalier Universitaire d'Angers, F-49933, Angers, France. 4. LUNAM Université, INSERM, U1063, F-49933, Angers, France. 5. Assistance Publique-Hôpitaux de Marseille, Service de Radiologie, Centre Hospitalier Universitaire la Timone, F-13000, Marseille, France. 6. Hospices civils de Lyon, Groupement Hospitalier Est, Fédération d'Endocrinologie, F-69003, Lyon, France. 7. Faculté de Médecine Lyon-Est, Université de Lyon, F-69372, Lyon, France. 8. INSERM UMR1052, UMR CNRS 5286, Cancer Research Center of Lyon, F-69008, Lyon, France. 9. Groupement Hospitalier Est, Service de Radiologie, Hospices civils de Lyon, F-69003, Lyon, France. 10. Service de Radiologie, Centre Hospitalier Universitaire d'Angers, F-49933, Angers, France. 11. Service de Radiologie, Centre Hospitalo-Universitaire de Reims, F-51000, Reims, France. 12. Service de Radiologie, Centre Hospitalo-Universitaire de Lille, F-59000, Lille, France. 13. Assistance Publique-Hôpitaux de Paris, Service de Radiologie, Hôpital Cochin, F-75006, Paris, France. 14. Service de Radiologie, Institut Gustave Roussy, F-94800, Villejuif, France. 15. Service de Radiologie, Centre Hospitalo-Universitaire de Nantes, F-44000, Nantes, France. 16. Service de Neuroradiologie, Centre Hospitalo-Universitaire de Clermont-Ferrand, F-63000, Clermont Ferrand, France. 17. Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Unité d'Épidémiologie et de Recherche Clinique, F-75015, Paris, France. 18. INSERM, Centre d'investigation Épidémiologique 4, F-75015, Paris, France. 19. Assistance Publique-Hôpitaux de Paris, Service de Génétique, Hôpital Européen Georges Pompidou, 20-40, rue Leblanc, 75015, Paris, France. anne-paule.gimenez-roqueplo@egp.aphp.fr. 20. INSERM, UMR970, Paris Cardiovascular Research Center, F-75015, Paris, France. anne-paule.gimenez-roqueplo@egp.aphp.fr. 21. Sorbonne Paris Cité, Faculté de Médecine, Université Paris Descartes, F-75006, Paris, France. anne-paule.gimenez-roqueplo@egp.aphp.fr. 22. Sorbonne Paris Cité, Faculté de Médecine, Université Paris Descartes, F-75006, Paris, France.
Abstract
OBJECTIVES: To assess the performance of a simplified MRI protocol consisting of a contrast-enhanced three-dimensional MR angiography (CE-MRA) in association with a post-contrast T1-weighted sequence (T1WIV) for the detection of HNPGLs in SDHx mutation carriers. METHODS: This retrospective sub-study is based on the multicenter PGL.EVA cohort, which prospectively enrolled SDHx mutation carriers from 2005 to 2009; 157 index cases or relatives were included. CE-MRA and the T1WIV images were read solely with knowledge of the clinical data but blind to the diagnosis. Sensitivity, specificity and likelihood ratios for the simplified MRI protocol were compared to the full MRI protocol reading results and to the gold standard status obtained through the consensus of an expert committee. RESULTS: The sensitivity and specificity of the readings of the simplified MRI protocol were, respectively, 88.7 % (95 % CI = 78.1-95.3) and 93.7 % (95 % CI = 86.8-97.7) versus 80.7 % (95 % CI = 68.6-89.6) and 94.7 % (95 % CI = 88.1-98.3) for the readings of the full MRI protocol. CONCLUSIONS: The simplified post-contrast MRI with shorter duration (5 to 10 minutes) showed no performance difference compared to the lengthy standard full MRI and can be proposed for the detection of head and neck paragangliomas (HNPGLs) in SDHx mutation carriers. KEY POINTS: • Rapid angio-MRI protocol and the usual lengthy protocol show equal diagnostic performance. • The CE-MRA is the key sequence for the detection of HNPGLs. • The T1WIV sequence assists in localizing HNPGLs.
OBJECTIVES: To assess the performance of a simplified MRI protocol consisting of a contrast-enhanced three-dimensional MR angiography (CE-MRA) in association with a post-contrast T1-weighted sequence (T1WIV) for the detection of HNPGLs in SDHx mutation carriers. METHODS: This retrospective sub-study is based on the multicenter PGL.EVA cohort, which prospectively enrolled SDHx mutation carriers from 2005 to 2009; 157 index cases or relatives were included. CE-MRA and the T1WIV images were read solely with knowledge of the clinical data but blind to the diagnosis. Sensitivity, specificity and likelihood ratios for the simplified MRI protocol were compared to the full MRI protocol reading results and to the gold standard status obtained through the consensus of an expert committee. RESULTS: The sensitivity and specificity of the readings of the simplified MRI protocol were, respectively, 88.7 % (95 % CI = 78.1-95.3) and 93.7 % (95 % CI = 86.8-97.7) versus 80.7 % (95 % CI = 68.6-89.6) and 94.7 % (95 % CI = 88.1-98.3) for the readings of the full MRI protocol. CONCLUSIONS: The simplified post-contrast MRI with shorter duration (5 to 10 minutes) showed no performance difference compared to the lengthy standard full MRI and can be proposed for the detection of head and neck paragangliomas (HNPGLs) in SDHx mutation carriers. KEY POINTS: • Rapid angio-MRI protocol and the usual lengthy protocol show equal diagnostic performance. • The CE-MRA is the key sequence for the detection of HNPGLs. • The T1WIV sequence assists in localizing HNPGLs.
Entities:
Keywords:
Head and neck; Magnetic resonance angiography; Paraganglioma; SDH; Screening
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