title: The comparative evaluation of three-dimensional magnetic resonance for carotid artery disease.
abstract: Conventional angiography is the current standard for the evaluation of carotid artery disease. The excellent resolution of this invasive study is offset by the potential for contrast-related, embolic, and puncture site complications. Three-dimensional magnetic resonance angiography may offer a noninvasive diagnostic alternative. We examined this possibility by performing both conventional angiography and three-dimensional magnetic resonance angiography in 13 patients. Cervical duplex scans were also obtained in these patients. Contiguous transverse cervical magnetic resonance images were acquired in a 1.5 tesla magnet, by use of a posterior neck coil and a gradient echo pulse sequence. These "raw" data were transferred to a real-time workstation where three-dimensional cervical arterial images were reformatted, magnified, and examined from multiple angles. Total study time from patient positioning to image generation was approximately 30 minutes. In all patients, on three-dimensional magnetic resonance angiography the common, external, and internal carotid arteries and distal vertebral arteries were easily discernable and correctly identified as patent, stenotic, or occluded. Three-dimensional magnetic resonance angiography was not accurate in detecting carotid ulcers. The degree of internal carotid artery stenosis measured from the three-dimensional magnetic resonance angiography studies correlated well with the internal carotid artery stenosis measured with conventional angiography (r = 0.866, r2 = 75.1%, p = less than or equal to 0.0001). This recent technologic advance represents significant progress toward achieving the goal of completely noninvasive vascular assessment in this patient population.
authors.affiliation: Division of Vascular Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick 08903-0019.
authors.forename: D K
authors.initials: DK
authors.lastname: Wilkerson
authors.forename: I
authors.initials: I
authors.lastname: Keller
authors.forename: R
authors.initials: R
authors.lastname: Mezrich
authors.forename: W B
authors.initials: WB
authors.lastname: Schroder
authors.forename: D
authors.initials: D
authors.lastname: Sebok
authors.forename: J
authors.initials: J
authors.lastname: Gronlund-Jacobs
authors.forename: R
authors.initials: R
authors.lastname: Conway
authors.forename: M A
authors.initials: MA
authors.lastname: Zatina
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014463:Ultrasonography