title: Assessment of carotid stenosis using three-dimensional T2-weighted dark blood imaging: Initial experience.
abstract: OBJECTIVE
  To evaluate the use of a T2-weighted SPACE sequence (T2w-SPACE) to assess carotid stenosis via several methods and compare its performance with contrast-enhanced magnetic resonance angiography (ceMRA).
  
  
  METHODS
  Fifteen patients with carotid atherosclerosis underwent dark blood (DB)-MRI using a 3D turbo spin echo with variable flip angles sequence (T2w-SPACE) and ceMRA. Images were coregistered and evaluated by two observers. Comparisons were made for luminal diameter, luminal area, degree of luminal stenosis (NASCET: North American Symptomatic Endarterectomy Trial; ECST: European Carotid Surgery Trial, and area stenosis), and vessel wall area. Degree of NASCET stenosis was clinically classified as mild (<50%), moderate (50%-69%), or severe (>69%).
  
  
  RESULTS
  Excellent agreement was seen between ceMRA and T2w-SPACE and between observers for assessment of lumen diameter, lumen area, vessel wall area, and degree of NASCET stenosis (r > 0.80, P < 0.001). ECST stenosis was consistently higher than NASCET stenosis (48 ± 14% vs. 24 ± 22%, P < 0.001). Area stenosis (72 ± 2%) was significantly higher (P < 0.001) than both ESCT and NASCET stenosis.
  
  
  CONCLUSIONS
  DB-MRI of carotid arteries using T2w-SPACE is clinically feasible. It provides accurate measurements of lumen size and degree of stenosis in comparison with ceMRA and offers a more reproducible measure of ECST stenosis than ceMRA.
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Medicine, Ohio State University, Columbus, Ohio, USA. georgeta.mihai@osumc.edu
authors.forename: Georgeta
authors.initials: G
authors.lastname: Mihai
authors.forename: Marshall W
authors.initials: MW
authors.lastname: Winner
authors.forename: Subha V
authors.initials: SV
authors.lastname: Raman
authors.forename: Sanjay
authors.initials: S
authors.lastname: Rajagopalan
authors.forename: Orlando P
authors.initials: OP
authors.lastname: Simonetti
authors.forename: Yiu-Cho
authors.initials: YC
authors.lastname: Chung
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA