Atherosclerotic disease distribution in carotid and vertebrobasilar arteries: clinical experience in 100 patients undergoing fluoro-triggered 3D Gd-MRA.
OBJECTIVE
To determine how often three-dimensional gadolinium-enhanced magnetic resonance angiography (3D Gd-MRA) shows disease outside of the standard two-dimensional time-of-flight magnetic resonance angiography (2D TOF-MRA) imaging volume.


METHODS
One hundred consecutive patients with known or suspected cerebrovascular disease were examined using fluoro-triggered 3D Gd-MRA with a 1.5 Tesla scanner. All vessel segments from the aortic arch to the circle of Willis were independently evaluated for the presence of occlusive disease, ulceration, aneurysm, and anatomic variations by two radiologists blinded to clinical information. Branch vessel and circle of Willis visibility were also assessed. Kappa statistics were calculated to determine interobserver agreement.


RESULTS
Interobserver agreement for the degree of stenosis was good to excellent (kappa = 0.83-1.0). Disagreement was more frequent in the cases of mild stenoses and was less frequent for stenoses > or = 50%. In 38% of the patients, 3D Gd-MRA demonstrated either ulcerated plaques in carotid arteries (N = 14) or stenosis > or = 50% in great vessel (N = 20) and/or vertebral artery (N = 38) origins, none of which can be readily evaluated on standard TOF-MRA.


CONCLUSIONS
Fluoro-triggered 3D Gd-MRA provides a comprehensive evaluation of the carotid arteries including all vessel segments from the aortic arch to the circle of Willis.
Department of Radiology, Weill Medical College of Cornell University, New York, New York, USA.
Hale
H
Ersoy
Richard
R
Watts
Pina
P
Sanelli
Robert D
RD
Zimmerman
K Craig
KC
Kent
Harry L
HL
Bush
Martin R
MR
Prince
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000175:diagnosis*; D002339:Carotid Arteries / Q000473:pathology*; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D005682:Gadolinium; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D013348:Subclavian Artery / Q000473:pathology*; D014711:Vertebral Artery / Q000473:pathology*
D005682:Gadolinium