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Blood vessel abnormalities are the leading cause of bleeding in the brain (known as intracerebral haemorrhage) in young adults. Early detection of blood vessel abnormalities may improve outcome if treatment can prevent bleeding recurrence. This review looked at different tests used to identify blood vessel abnormalities in the brain. Intra‐arterial digital subtraction angiography (IADSA) is the standard test used and involves positioning a tube, introduced through a blood vessel in the groin, into blood vessels near the brain. Dye is directly injected into the brain's blood vessels using this tube. Computed tomographic angiography (CTA) and magnetic resonance angiography (MRA) are newer tests that may be done without any injections (MRA) or only through an injection into the arm (CTA and MRA). This review investigated the accuracy of CTA or MRA, or both, compared with IADSA after intracerebral haemorrhage. We found eight studies (involving 526 participants) that compared CTA with IADSA and three studies (involving 401 participants) that compared MRA with IADSA. Both CTA and MRA appear to have good accuracy when compared with IADSA. However, the studies were small and were limited in many cases by their design. Further research that looks at accuracy, practicality, and costs is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: September 1, 2014

Lower limb peripheral arterial disease (PAD) is characterised by atheromatous narrowing or occlusion of one or more of the arteries of the leg. Symptoms include intermittent claudication (pain on walking), ischaemic rest pain, ulceration and gangrene. This review concerns the assessment of symptomatic PAD. Intervention decisions utilise information regarding the degree, length and location of stenoses or occlusions. This review summarises the evidence on the role of duplex ultrasound (DUS), magnetic resonance angiography (MRA), and computed tomography angiography (CTA), as alternatives to contrast angiography (CA), for the assessment of PAD.

NIHR Health Technology Assessment programme: Executive Summaries - NIHR Journals Library.

Version: 2007

OBJECTIVE: Diabetes is a leading risk factor for the development of peripheral arterial disease (PAD). The optimal imaging modality for patients with diabetes and PAD is uncertain. We sought to analyse the literature to determine the accuracy of contrast enhanced magnetic resonance angiography (CE-MRA) in differentiating extent of disease in patients with infragenicular PAD and diabetes, using digital subtraction angiography (DSA) as the gold standard.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

PURPOSE: To compare the diagnostic performances of computer tomography angiography (CTA) and magnetic resonance angiography (MRA) for detection and assessment of stenosis in patients with autologuous hemodialysis access.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

OBJECTIVE: To evaluate the diagnostic performance of computed tomography angiography (CTA) and contrast-enhanced magnetic resonance angiography (CE-MRA) in detecting haemodynamically significant arterial stenosis or occlusion in patients with critical limb ischaemia (CLI) or intermittent claudication (IC).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Pulmonary embolism is a blood clot that blocks blood flow to a portion of the lungs. Pregnant women are at high risk of pulmonary embolism, and it is a leading cause of death during pregnancy. Women at risk are treated with blood thinning medication. It is important that no cases are missed, and that treatment is prevented in women without the disease. Pulmonary embolism can be diagnosed through different scanning techniques. Little is known about the performance of these tests during pregnancy, which might be different from their performance outside pregnancy. We performed this review to establish the accuracy of the following imaging tests for diagnosing pulmonary embolism during pregnancy: computed tomography pulmonary angiography, lung scintigraphy and magnetic resonance angiography.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: January 26, 2017

Study finds that magnetic resonance with diffusion-weighted imaging is not cost-effective for routine transient ischaemic attack/minor stroke investigation.

Health Technology Assessment - NIHR Journals Library.

Version: April 2014

RATIONALE AND OBJECTIVES: The objective of this study was to determine the diagnostic accuracy of contrast-enhanced magnetic resonance angiography (MRA) when used in the preoperative evaluation of hepatic vascular anatomy in living liver donors.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Magnetic Resonance Imaging (MRI) scanners are used in many clinical applications for patients of all ages. In Canada, patients are most likely to be scanned with a 1.5 T MRI scanner; however, more powerful magnet strengths such as 3.0 T MRI are now available for clinical applications. With the stronger magnet field strengths comes the potential for increased imaging capabilities.

CADTH Optimal Use Report - Canadian Agency for Drugs and Technologies in Health.

Version: May 2011

Study found that late gadolinium-enhanced cardiac magnetic resonance imaging, stress echocardiography, single photon emission computed tomography and positron emission tomography were all cost-effective strategies to test patients prior to revscularisation of patients with ischaemic cardiomyopathy. However, the cost-effectiveness analyses suggested that late gadolinium-enhanced cardiac magnetic resonance imaging and revascularising everyone without prior screening were the optimal strategies.

Health Technology Assessment - NIHR Journals Library.

Version: September 2014

Hepatocellular carcinoma (HCC) is the most common primary malignant neoplasm of the liver, and accurate diagnosis and staging of HCC are important for guiding treatment and other clinical decisions. A number of imaging modalities are available for detection of HCC in surveillance and nonsurveillance settings, evaluation of focal liver lesions to identify HCC, and staging of HCC. The purpose of this review is to compare the effectiveness of imaging techniques for HCC on test performance, clinical decisionmaking, clinical outcomes, and harms.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: October 2014

This review concluded that time-of-flight and contrast-enhanced magnetic resonance angiography showed high accuracy for detecting high grade internal coronary artery stenosis and occlusions, but not moderately severe stenosis. Given that most studies were small and retrospective, potential for error and bias during the review process and some uncertainties regarding the analysis, the results should be interpreted with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

This generally well-conducted review concluded that magnetic resonance angiography had high accuracy for identifying or excluding clinically relevant arterial stenosis or occlusion in adults with symptomatic peripheral artery disease. Despite some limitations of the available evidence, the conclusion of the review is likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

This review found that magnetic resonance angiography (MRA) has a better discriminatory power than duplex ultrasound (DUS) for diagnosing 70-99% stenosis and is sensitive and specific compared with digital subtraction angiography (reference standard). It is difficult to evaluate the conclusions because of lack of detail about the included studies and analysis, and because comparisons of MRA and DUS were indirect.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

The authors concluded that contrast-enhanced magnetic resonance angiography appeared to have the highest diagnostic accuracy and, if available, may be a reasonable alternative to computed angiography. This was a well-conducted review and the authors' conclusions are likely to be robust.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

The objective of this report is to review the evidence with respect to clinical effectiveness of computed tomography angiogram (CTA) in the diagnosis of patients presenting with symptoms of stroke or transient ischemic attacks (TIA).

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: November 30, 2016

Hemorrhagic stroke may be caused by primary or secondary intracranial hemorrhage (ICH), Primary ICH is often associated with hypertension or cerebral amyloid angiopathy (CAA); and secondary ICH may be caused by aneurysms, anticoagulation, or hemorrhage due to neoplasm, infarction, or sinus thrombosis. Hyperacute stroke interventions include intensive care unit admission, blood pressure control, correction of coagulopathy, and neurosurgical consultation.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: December 10, 2013

BACKGROUND: The mismatch between perfusion and diffusion lesions on magnetic resonance perfusion-weighted imaging (PWI)/diffusion-weighted imaging (DWI) may help identify patients for thrombolysis. Evidence underlying this hypothesis was assessed.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

OBJECTIVES: To review the evidence for an association of white matter hyperintensities with risk of stroke, cognitive decline, dementia, and death.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

OBJECTIVES: Vascular invasion (VI) is the most important factor in assessing operability for pancreatic cancer. The accuracy of preoperative vascular staging with computed tomography (CT) and magnetic resonance imaging (MRI) was examined using meta-analysis.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

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