Contrast-enhanced magnetic resonance angiography of the cervical vessels: experience with 422 patients.
OBJECTIVE
Contrast-enhanced magnetic resonance angiography (CEMRA) permits acquisition of high-spatial-resolution, venous-suppressed, 3D MR angiograms of the cervical carotid and vertebral arteries. In this study, an elliptic centric-view ordering with either MR fluoroscopic triggering or test bolus timing was used. The use of CEMRA of the cervical vessels has changed our clinical practice and is replacing conventional angiography for the evaluation of most carotid and vertebral artery diseases.


METHODS
We retrospectively reviewed our experience with the use of CEMRA performed in 422 patients from January through December 1999.


RESULTS
CEMRA was performed to evaluate transient ischemic attack and ischemic stroke in 239 patients, asymptomatic carotid bruit in 88 patients, and other neurological symptoms in 95 patients. Carotid endarterectomies were performed in 97 patients (103 procedures), and conventional angiography was performed in 12 of these patients. CEMRA was used to evaluate for the presence of an arterial dissection in 85 of the 239 patients with transient ischemic attack and ischemic stroke. Of this group, 32 patients had cervical arterial dissection, and pseudoaneurysm was detected in 11 of these patients. Compared with ultrasonography of the cervical vessels, CEMRA provided additional information in 43 of 422 patients and led to changes in the decision as to whether to perform carotid endarterectomy in 5 patients.


CONCLUSIONS
Use of CEMRA permits noninvasive evaluation of patients suspected of having carotid or vertebral disease and avoids the potential complications of conventional angiography.
Phan
T
T
Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN 55905, USA.
Huston
J
J
Bernstein
M A
MA
Riederer
S J
SJ
Brown
R D
RD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D007089:Image Enhancement; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009333:Neck; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014463:Ultrasonography; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000473:pathology