Introduction: Cerebral amyloid angiopathy-related inflammation (CAA-ri) is a disease subtype characterized by rapidly progressive cognitive decline, seizures, headaches, T2-hyperintense MRI lesions, and neuropathologic evidence of CAA-associated vascular inflammation. CAA-ri is an important diagnosis to reach in clinical practice, as many patients respond to immunosuppressive therapy. Definitive diagnosis of CAA-ri generally requires brain biopsy, however, highlighting the importance of developing noninvasive diagnostic criteria. Objectives: To test the sensitivity and specificity of modified criteria (Table 1) for possible and probable CAA-ri in groups of subjects with histologically proven CAA-ri and non-CAA-ri. Methods: After refining previously proposed clinical- radiological criteria we retrospectively analyzed clinical charts and MRI FLAIR and gradient-echo scans obtained from 17 subjects with pathologically confirmed CAA-ri and 37 control subjects with pathologic diagnosis of non-inflammatory CAA. The control group was further divided into those with past intracerebral hemorrhage (ICH) (n=21) and those with cerebral microbleeds (CMB) only and no history of ICH (n=16). Results: In the CAA-ri group 14/17 (82.4%) met criteria for both probable and possible CAA-ri. One (4.7%) of the subjects in the control CAA-ICH group (n=21) met the criteria for possible and none met criteria for probable CAA-ri. In the control CAA-no ICH group 1/16 (6.25%) and 11/16 (68.75%) met criteria for probable and possible CAA-ri respectively. This yields sensitivity and specificity of 82% and of 97.3% respectively for the probable criteria and sensitivity and specificity of 82% and 67.6% respectively for the possible criteria. Conclusions: Our data suggest that a reliable diagnosis of CAA-ri can be reached from basic clinical and radiographic information alone with good sensitivity and excellent specificity.
Auriel, E., Gurol, M.E., Ni, J., Van Etten, E., Martinez-Remirez, S., Piazza, F., et al. (2014). Validation of Clinical-Radiological Criteria for the Diagnosis of Cerebral Amyloid Angiopathy-related Inflammation. Intervento presentato a: International Stroke Conference (ISC) February 12 - 14, San Diego, California.
Citazione: | Auriel, E., Gurol, M.E., Ni, J., Van Etten, E., Martinez-Remirez, S., Piazza, F., et al. (2014). Validation of Clinical-Radiological Criteria for the Diagnosis of Cerebral Amyloid Angiopathy-related Inflammation. Intervento presentato a: International Stroke Conference (ISC) February 12 - 14, San Diego, California. | |
Tipo: | abstract | |
Carattere della pubblicazione: | Scientifica | |
Presenza di un coautore afferente ad Istituzioni straniere: | Si | |
Titolo: | Validation of Clinical-Radiological Criteria for the Diagnosis of Cerebral Amyloid Angiopathy-related Inflammation | |
Autori: | Auriel, E; Gurol, ME; Ni, J; Van Etten, E; Martinez-Remirez, S; Piazza, F; Di Francesco, J; Frosch, M; Pontes-Neto, O; Vashkevich, A; Ayers, A; Shoamanesh, A; Schwab, K; Viswanathan, A; Greenberg, S | |
Autori: | ||
Data di pubblicazione: | 2014 | |
Lingua: | English | |
Nome del convegno: | International Stroke Conference (ISC) February 12 - 14 | |
Rivista: | STROKE | |
Appare nelle tipologie: | 02 - Intervento a convegno |