title: Initial experience with balanced turbo field echo in depicting carotid artery stenosis: comparison with multiple overlapping thin slab acquisition and 3D contrast-enhanced magnetic resonance angiography.
abstract: OBJECTIVE
  To compare balanced turbo field echo (bTFE) with multiple overlapping thin slice acquisition (MOTSA) and contrast-enhanced MR angiography (CE-MRA) in depicting carotid artery stenosis.
  
  
  METHODS
  In this study 86 patients with cerebrovascular disease, who had been referred for a carotid examination, were imaged. All of the patients underwent MOTSA and one of four bTFE sequences followed by CE-MRA. Formatted maximum intensity projections (MIPs) and source images were read in a blinded fashion by a radiologist. Inter- and intrasequence statistical analyses were performed.
  
  
  RESULTS
  We first compared image quality (IQ) and fat, background, and venous suppression using four distinct bTFE protocols in 118 carotid arteries, and found that bTFE4 performed the best. We then compared IQ, grades of stenosis, and background and venous suppression among bTFE4, MOTSA, and CE-MRA. bTFE produced significantly better IQ and venous suppression (P < 0.001), and higher SNR and CNR (P < 0.05) when compared to MOTSA.
  
  
  CONCLUSIONS
  The bTFE sequence is robust and provides high-quality images in patients with mild to moderate carotid artery stenosis. Even though there is a tendency to overestimate stenosis with bTFE compared to CE-MRA, the shorter scan time of bTFE coupled with enhanced SNR and CNR measurements validates it as a clinically useful adjunct to MOTSA, if not a replacement.
authors.affiliation: University of Medicine and Dentistry of New Jersey, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Gupta
authors.forename: Srirama V
authors.initials: SV
authors.lastname: Swaminathan
authors.forename: J Kevin
authors.initials: JK
authors.lastname: DeMarco
mesh_terms: D000368:Aged; D016893:Carotid Stenosis / Q000175:diagnosis*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged