[Stenosis-occlusion of the carotid bifurcation. Angiography with MR and contrast media versus digital angiography].
OBJECTIVE
To evaluate the comparative sensitivity, specificity and diagnostic accuracy of contrast enhanced magnetic resonance angiography (CE MRA) and digital subtraction angiography (DSA) in the study of carotid bifurcation stenoses.


METHODS
Twenty-three patients with suspected cerebrovascular insufficiency by carotid stenosis were examined with CE MRA and DSA within 24 hours of each other. A 1.5 superconductive unit (Signa, General Electric) was used for CE MRA; fast spoiled gradient echo recalled (SPGR) images were acquired on the coronal plane 12 s after contrast medium injection, with the following parameters: TR/TE/FA 8/1/60, MA 256 x 128, NEX 1, FOV 18 x 13, slices/slab 28, slice thickness 1 mm, TA 32 s. The images were postprocessed with the maximum intensity projection (MIP) and the targeted MIP algorithms. A Siemens Politron 1000 VR unit was used for DSA examinations.


RESULTS
DSA diagnosed 21 true positives, namely 4 grade II, 4 grade III, 10 grade IV and 3 grade V stenoses. CE MRA scored 100% in stenosis identification and grading, accurately diagnosing all the true negatives and the true positives and was always in agreement with DSA as to stenosis site.


CONCLUSIONS
CE MRA can be considered the technique of choice to study stenosis occlusion in the epiaortic vessels, because it permits a rapid panoramic study of the neck vessels and accurate stenosis grading with similar patterns to those of DSA. Thus, CE MRA appears to be a valid alternative to DSA.
Scarabino
T
T
Dipartimento di Diagnostica per Immagini, IRCSS Casa Sollievo della Sofferenza, San Giovanni Rotondo, FG.
Carriero
A
A
Balzano
S
S
Sciannelli
V
V
Bonomo
L
L
Salvolini
U
U
D000368:Aged; D015901:Angiography, Digital Subtraction; D016893:Carotid Stenosis / Q000175:diagnosis*; D003287:Contrast Media; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D003287:Contrast Media
Steno-occlusione della biforcazione carotidea. Confronto tra angiografia con RM e mdc versus angiografia digitale.