title: Assessment of carotid artery patency on routine spin-echo MR imaging of the brain.
abstract: We retrospectively reviewed the routine spin-echo MR studies of the brain in 12 patients with 13 angiographically demonstrated occlusions and in 14 patients with 16 high-grade stenoses of the carotid arteries. Intraluminal signal that was isointense with adjacent brain on long TR/short TE and long TR/long TE images was 100% specific for atherosclerotic occlusion. Of the 13 proved occlusions, six (46%) had significant degrees of hyperintense intraluminal signal indistinguishable from that observed consequent to slow flow distal to high-grade stenoses. MR detected only five (31%) of the 16 proved high-grade stenoses. Normal flow void does not exclude significant extracranial carotid stenosis. Occlusion cannot always be distinguished from high-grade stenosis when hyperintense intraluminal signal is encountered. However, a reliable diagnosis of atherosclerotic occlusion can be made when isointense intraluminal signal is observed.
authors.affiliation: Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107.
authors.forename: J I
authors.initials: JI
authors.lastname: Lane
authors.forename: A E
authors.initials: AE
authors.lastname: Flanders
authors.forename: H T
authors.initials: HT
authors.lastname: Doan
authors.forename: R D
authors.initials: RD
authors.lastname: Bell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000175:diagnosis; D001921:Brain / Q000473:pathology*; D002339:Carotid Arteries / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000175:diagnosis; D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000175:diagnosis; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D014654:Vascular Patency