Magnetic resonance angiography of the extracranial carotid system.
OBJECTIVE
To discuss the role of magnetic resonance angiography (MRA) in the evaluation of the extracranial carotid system with an emphasis on atherosclerosis and to briefly address the role of magnetic resonance imaging in imaging of carotid atherosclerotic plaque.


METHODS
Literature and institutional review.


CONCLUSIONS
The North American Symptomatic Carotid Endarterectomy Trial and European Carotid Surgery Trial studies have emphasized the importance of recognition and treatment of carotid stenosis in the prevention of ischemic stroke. Magnetic resonance angiography is a viable tool in the screening and quantification of this entity. Both time of flight and contrast-enhanced MRA techniques are available for clinical use, each with distinct advantages and limitations. A thorough understanding of these is vital for correct performance and interpretation of these studies. Plaque imaging with magnetic resonance imaging offers new insights into the pathophysiology of the atherosclerotic process and may be used in the future to monitor response to lipid-lowering drug therapy.


CONCLUSIONS
Magnetic resonance angiography is a robust imaging technique for evaluation of the extracranial carotid circulation. The radiologist must be aware of the advantages and limitations of the different techniques available. Contrast-enhanced MRA is now the most widely performed technique. It can be used to replace digital subtraction angiography in the evaluation of carotid stenosis in most clinical settings.
Raghavan
Prashant
P
Department of Neuroradiology, University of Virginia Health Systems, Charlottesville, VA 22908, USA. pr9k@virginia.edu
Mukherjee
Sugoto
S
Gaughen
John
J
Phillips
C Douglas
CD
D015901:Angiography, Digital Subtraction; D001161:Arteriosclerosis / Q000175:diagnosis*; D002339:Carotid Arteries / Q000473:pathology; D016893:Carotid Stenosis / Q000175:diagnosis*; D002986:Clinical Trials as Topic; D003287:Contrast Media; D006801:Humans; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography / Q000379:methods*; D020521:Stroke / Q000517:prevention & control
D003287:Contrast Media