Contrast-enhanced 3D MR angiography of the carotid artery: comparison with conventional digital subtraction angiography.
OBJECTIVE
Since 1996, several preliminary studies have shown the usefulness of contrast material-enhanced MR angiography for imaging supraaortic vessels. The aim of this study was to compare the accuracy of contrast-enhanced 3D MR angiography with that of digital subtraction angiography (DSA) in the evaluation of carotid artery stenosis.


METHODS
A blinded comparison of first-pass contrast-enhanced MR angiography with conventional DSA was performed in 120 patients (240 arteries). MR angiography was performed with a 1.5-T magnet with gradient overdrive equipment, by using a coronal radiofrequency-spoiled 3D fast low-angle-shot sequence after the intravenous injection of gadodiamide. The guidelines of the North American Symptomatic Carotid Endarterectomy Trial for measuring stenosis of the internal carotid artery were applied on maximum intensity projection (MIP) images and conventional catheter angiograms.


RESULTS
Grading of stenoses on MR angiograms agreed with grading of stenoses on DSA images in 89% of arteries. In the severe stenosis group (70-99%), agreement was 93%. All internal carotid occlusions (n = 28) and seven of nine pseudo-occlusions were accurately detected with contrast-enhanced MR angiography. The correlation between MR angiography and DSA for determination of minimal, moderate, and severe stenoses and occlusion was statistically significant (r = 0.91, P<.001).


CONCLUSIONS
This investigation with a large number of patients confirms that contrast-enhanced MR angiography could become a diagnostic alternative to DSA in the treatment of patients with carotid artery disease.
Remonda
Luca
L
Department of Neuroradiology, Inselspital, University of Bern, Freiburgstrasse 10, CH-3020 Bern, Switzerland.
Senn
Pascal
P
Barth
Alain
A
Arnold
Marcel
M
Lövblad
Karl-Olof
KO
Schroth
Gerhard
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction / Q000592:standards*; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000473:pathology*; D016893:Carotid Stenosis / Q000175:diagnosis*; D002648:Child; D003287:Contrast Media; D004311:Double-Blind Method; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography / Q000592:standards*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity
D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA