High-resolution, contrast-enhanced magnetic resonance angiography with elliptical centric k-space ordering of supra-aortic arteries compared with selective X-ray angiography.
OBJECTIVE
The objective of this study was to evaluate the relative value of high-resolution, contrast-enhanced MR angiography (CE MRA) with elliptical centric k-space ordering compared with intra-arterial x-ray angiography for imaging carotid stenosis.


METHODS
Thirty patients with suspected stenosis of the carotid arteries were examined with CE MRA (1.5-T scanner) and x-ray angiography (aortic arch survey and selective imaging of both common carotid arteries). For the first time, not only the extracranial carotid bifurcation but all the vessel segments from the aortic arch to the circle of Willis were assessed by independent investigators.


RESULTS
For the internal carotid artery in the region of the extracranial carotid bifurcation, there was a very close correlation between CE MRA and x-ray angiography (sensitivity, 100%; specificity, 92%). The initially suspected overestimation of stenosis on CE MRA in 3 cases was ultimately revealed to be an underestimation on x-ray angiography. CE MRA showed slightly poorer imaging of the basal vessel segments at the level of the aortic arch (because of breathing artifacts) and the intracranial vessel segments (because of small vessel caliber and venous superimposition due to delayed sequence starts).


CONCLUSIONS
The MRA technique described here provides reliable results in the diagnosis of carotid stenosis and is thus suitable for replacing the invasive conventional x-ray angiography method in most cases. Further technical developments with regard to spatial resolution are still required for improved visualization of small vessels (terminal carotid branches and intracranial vessels).
Wutke
Ralf
R
Institute of Diagnostic Radiology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany. ralf.wutke@idr.imed.uni-erlangen.de
Lang
Werner
W
Fellner
Claudia
C
Janka
Rolf
R
Denzel
Christan
C
Lell
Michael
M
Bautz
Werner
W
Fellner
Franz A
FA
D000368:Aged; D000792:Angiography; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D016893:Carotid Stenosis / Q000145:classification / Q000175:diagnosis*; D002941:Circle of Willis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007089:Image Enhancement; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography