High-resolution contrast-enhanced magnetic resonance angiography of the carotid arteries using fluoroscopic monitoring of contrast arrival: diagnostic accuracy and interobserver variability.
OBJECTIVE
To evaluate the diagnostic accuracy of high-resolution contrast-enhanced magnetic resonance angiography (CE-MRA) of the supra-aortic arteries using the CareBolus technique. Digital subtraction angiography was the standard of reference.


METHODS
Fifty consecutive patients with suspected internal carotid artery stenosis underwent CE-MRA and digital subtraction angiography. CE-MRA was performed on a 1.5-T superconducting scanner with the CareBolus technique. CareBolus combines a nearly real-time 2D-FLASH (fast low angle shot) sequence for fluoroscopic triggering and a high-resolution 3D-FLASH with elliptical centric view order for the angiographic pulse sequence (6.0/2.16 ms [TR/TE], 30 degrees flip angle, 30.98 s acquisition time, 0.88 mm effective (interpolated) partition thickness and a 160 x 512 matrix). Intra-arterial digital subtraction angiography and CE-MRA studies were evaluated independently by four blinded readers. Internal carotid artery stenoses were graded according to the NASCET criteria.


RESULTS
CE-MRA had an accuracy of 92.53%, a sensitivity of 95.64%, and a specificity of 90.39% for the identification of carotid artery stenoses > or = 70% (grade 3). Image quality for suppression of stationary tissue and venous contrast was good, but was reduced in five cases due to patient motion.


CONCLUSIONS
The CareBolus technique is a useful non-invasive method for high-resolution imaging of the supra-aortic vessels because of its easy application and high sensitivity and specificity. Limitations can occur in non-compliant patients due to motion artifacts during the measurement time.
Butz
B
B
Department of Radiology, University of Regensburg Hospital, Regensburg, Germany. bebu0000@t-online.de
Dorenbeck
U
U
Borisch
I
I
Zorger
N
N
Lenhart
M
M
Feuerbach
S
S
Link
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000175:diagnosis*; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D005471:Fluoroscopy; D019786:Gadolinium DTPA / Q000008:administration & dosage*; D006801:Humans; D016014:Linear Models; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015641:Radiography, Interventional; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
D003287:Contrast Media; D019786:Gadolinium DTPA