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80% vs. 57.32%, p 0.05), and demonstrated better consistency with surgical findings (k= 0.794 vs. k= 0.365, p 0.05). For the type of compressing vessel and the location of conflict, both methods were highly accurate and agreed to a similar extent with surgical findings (p = 0.987, compressing vessel; p = 0.665, location of conflict). MR subtraction proved reliable in NVC pre-operative evaluation, with increased accuracy when estimating severity. This result strongly supports the wider use of MR subtraction as the preferred choic