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Song HK, Yan L, Smith RX, Xue Y, Rapacchi S, Srinivasan S, Ennis DB, Hu P, Pouratian N, Wang DJJ. Noncontrast enhanced four-dimensional dynamic MRA with golden angle radial acquisition and K-space weighted image contrast (KWIC) reconstruction. Magn Reson Med 2013; 72:1541-51. [PMID: 24338944 DOI: 10.1002/mrm.25057] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 10/30/2013] [Accepted: 11/04/2013] [Indexed: 12/11/2022]
Abstract
PURPOSE To explore the feasibility of 2D and 3D golden-angle radial acquisition strategies in conjunction with k-space weighted image contrast (KWIC) temporal filtering to achieve noncontrast enhanced dynamic MRA (dMRA) with high spatial resolution, low streaking artifacts and high temporal fidelity. METHODS Simulations and in vivo examinations in eight normal volunteers and an arteriovenous malformation patient were carried out. Both 2D and 3D golden angle radial sequences, preceded by spin tagging, were used for dMRA of the brain. The radial dMRA data were temporally filtered using the KWIC strategy and compared with matched standard Cartesian techniques. RESULTS The 2D and 3D dynamic MRA image series acquired with the proposed radial techniques demonstrated excellent image quality without discernible temporal blurring compared with standard Cartesian based approaches. The image quality of radial dMRA was equivalent to or higher than that of Cartesian dMRA by visual inspection. A reduction factor of up to 10 and 3 in scan time was achieved for 2D and 3D radial dMRA compared with the Cartesian-based counterparts. CONCLUSION The proposed 2D and 3D radial dMRA techniques demonstrated image quality comparable or even superior to those obtained with standard Cartesian methods, but within a fraction of the scan time.
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Affiliation(s)
- Hee Kwon Song
- Department of Radiology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, USA
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Lim HK, Choi CG, Kim SM, Kim JL, Lee DH, Kim SJ, Suh DC. Detection of residual brain arteriovenous malformations after radiosurgery: diagnostic accuracy of contrast-enhanced four-dimensional MR angiography at 3.0 T. Br J Radiol 2012; 85:1064-9. [PMID: 22294705 DOI: 10.1259/bjr/30618275] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate the diagnostic accuracy of four-dimensional MR angiography (4D-MRA) at 3.0 T for detecting residual arteriovenous malformations (AVMs) after Gamma Knife (Elekta Instrument AB, Stockholm, Sweden) radiosurgery (GKRS). METHODS We assessed 36 angiographically confirmed AVMs in 36 patients who had been treated with GKRS. 4D-MRA was performed after GKRS and the time intervals were 39.4 ± 26.0 months [mean ± standard deviation (SD)]. 4D-MRA was obtained at 3.0 T after contrast injection, with a measured voxel size of 1 × 1 × 1 mm and a temporal resolution of 1.1 s (13 patients) or a voxel size of 1 × 1 × 2 mm and a temporal resolution of 0.98 s (23 patients). X-ray angiography was performed as the standard reference within 53 ± 47 days (mean ± SD) after MRA. To determine a residual AVM, the 4D-MRA results were independently reviewed by two readers blinded to the X-ray angiography results. We evaluated diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 4D-MRA for detection of a residual AVM. RESULTS A residual AVM was identified in 13 patients (13/36, 36%) on X-ray angiography. According to Readers 1 and 2, 4D-MRA had a sensitivity of 79.6% and 64.3%, a specificity of 90.9% and 100%, a PPV of 84.6% and 100% and an NPV of 90% and 81.5%, respectively, and a diagnostic accuracy of 86.1% for Readers 1 and 2, for detecting residual AVMs after GKRS. CONCLUSION The diagnostic accuracy of 4D-MRA at 3.0 T seems high, but there is still the possibility of further improving the spatiotemporal resolution of this technique.
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Affiliation(s)
- H K Lim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Eddleman CS, Jeong HJ, Hurley MC, Zuehlsdorff S, Dabus G, Getch CG, Batjer HH, Bendok BR, Carroll TJ. 4D radial acquisition contrast-enhanced MR angiography and intracranial arteriovenous malformations: quickly approaching digital subtraction angiography. Stroke 2009; 40:2749-53. [PMID: 19478223 PMCID: PMC2743532 DOI: 10.1161/strokeaha.108.546663] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The current gold standard for imaging intracranial AVMs involves catheter-based techniques, namely cerebral digital subtraction angiography (DSA). However, DSA presents some procedural risks to the patient. Unfortunately, AVM patients usually undergo multiple DSA exams throughout their diagnostic and therapeutic course, significantly increasing their procedural risk exposure. As such, high-quality noninvasive imaging is desired. We hypothesize that 4D radial acquisition contrast-enhanced MRA approximates the vascular architecture and hemodynamics of AVMs compared to conventional angiography. METHODS Thirteen consecutive AVM patients were assessed by 4D radial acquisition contrast-enhanced MRA and DSA. The 4D rCE-MRA images were independently assessed regarding the location, nidal size, Spetzler-Martin grade, and identification of arterial feeders, drainage pattern, and any other vascular anomalies. RESULTS 4D rCE-MRA correctly depicted the size, venous drainage pattern, and prominent arterial feeders in all cases. Spetzler-Martin grade was correctly determined between reviewers and between the different imaging modalities in all cases except 1. The nidus size was in good correlation between the reviewers, where r=0.99, P<0.000001. There was very good agreement between reviewers regarding the individual scans (kappa=0.63 to 1), whereas the agreement between the DSA and 4D rCE-MRA images was also good (kappa=0.61 to 0.85). CONCLUSIONS We have developed a 4D radial acquisition contrast-enhanced MRA sequence capable of imaging intracranial AVMs approximating that of DSA. Image analysis demonstrates equivalency in terms of grading AVMs using the Spetzler-Martin grading scale. This 4D rCE-MRA sequence has the potential to avoid some applications of DSA, thus saving patients from potential procedural risks.
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Affiliation(s)
- Christopher S Eddleman
- Department of Neurological Surgery Feinberg School of Medicine, Northwestern University, 676 North St Clair Ste 2210, Chicago, IL 60611, USA.
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Beranek-Chiu J, Froehlich JM, Wentz KU, Doert AN, Zollikofer CL, Eckhardt BP. Improved vessel delineation in keyhole time-resolved contrast-enhanced MR angiography using a gadolinium doped flush. J Magn Reson Imaging 2009; 29:1147-53. [PMID: 19388120 DOI: 10.1002/jmri.21761] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To prospectively assess the influence of a gadolinium doped saline flush compared with a pure saline flush on the image quality of the supra-aortic vessels using time-resolved contrast-enhanced MR angiography (4D CE-MRA) in a randomized double blind clinical trial. MATERIALS AND METHODS Twenty-two patients scheduled for contrast-enhanced craniocerebral MRI underwent a supplemental 4D CE-MRA covering the carotids to the superior sinus consisting of 30 dynamics of a T1-weighted 3D gradient-echo sequence (FFE) in sagittal direction. The temporal resolution of 1.1 s per dataset was achieved using the keyhole technique with the reference scan acquired at the end. Immediately after the intravenous (IV) injection of 0.1 mmol Gd/kg body weight of gadoterate, our patients received a 50-mL flush consisting either of a 0.9% saline solution (n = 11) or doped with 50 mM gadolinium (n = 11; total Gd: 0.11 mmol/kg) at a flow-rate of 2 mL/s. Vessel delineation, image quality, signal-to-noise- (SNR) and contrast-to-noise (CNR) ratios over time were compared. RESULTS Both vessel delineation (internal carotid artery [ICA]: slope(saline) = 308.5; slope(Gd) = 528.9; P = 0.006; superior sagittal sinus [SSS]: slope(saline) = 505.3; slope(Gd) = 674.9; P = 0.007) and CNR (ICA: CNR(saline) = 57.3; CNR(Gd) = 80.55; P = 0.0417; SSS: CNR(saline) = 74.15; CNR(Gd) = 117.4; P = 0.0331) of the ICA and SSS were significantly increased using the gadolinium doped flush. CONCLUSION A low concentrated gadolinium flush in comparison to a pure saline flush improves significantly vessel contrast and their delineation in time-resolved CE-MRA using the keyhole technique.
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Affiliation(s)
- Jan Beranek-Chiu
- Cantonal Hospital, Department of Radiology, Winterthur, Switzerland
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Petkova M, Gauvrit JY, Trystram D, Nataf F, Godon-Hardy S, Munier T, Oppenheim C, Meder JF. Three-dimensional dynamic time-resolved contrast-enhanced MRA using parallel imaging and a variable rate k-space sampling strategy in intracranial arteriovenous malformations. J Magn Reson Imaging 2009; 29:7-12. [PMID: 19097095 DOI: 10.1002/jmri.21483] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To evaluate the effectiveness of three-dimensional (3D) dynamic time-resolved contrast-enhanced MRA (TR-CE-MRA) using a combination of a parallel imaging technique (ASSET: array spatial sensitivity encoding technique) and a time-resolved method (TRICKS: time-resolved imaging of contrast kinetics) and to compare it with 3D dynamic TR-CE-MRA using ASSET alone in the assessment of intracranial arteriovenous malformations (AVMs). MATERIALS AND METHODS Twenty consecutive patients with angiographically confirmed AVMs were investigated using both 3D dynamic TR-CE-MRA techniques. Examinations were compared with respect to image quality, spatial resolution, number and type of feeders and drainers, nidus size, presence of early venous filling and temporal resolution. Digital subtraction angiography was used as standard of reference. RESULTS The higher temporal and spatial resolution of 3D dynamic TR-CE-MRA TRICKS ASSET allowed a better assessment of intracranial vascular malformations, namely better depiction of feeders, drainers and better detection of early venous drainage. There was no significant difference between them in terms of nidus size. CONCLUSION 3D dynamic TR-CE-MRA combining parallel imaging and a time-resolved method with subsecond and submillimeter resolution could become the first-line investigation technique in both diagnosis and follow-up of intracranial AVMs.
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Affiliation(s)
- Mina Petkova
- Department of Neuroradiology and Neurosurgery, Sainte-Anne Hospital, Paris 5 University, Paris, France
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Willinek WA, Hadizadeh DR, von Falkenhausen M, Urbach H, Hoogeveen R, Schild HH, Gieseke J. 4D time-resolved MR angiography with keyhole (4D-TRAK): more than 60 times accelerated MRA using a combination of CENTRA, keyhole, and SENSE at 3.0T. J Magn Reson Imaging 2008; 27:1455-60. [PMID: 18504736 DOI: 10.1002/jmri.21354] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To present a new 4D method that is designed to provide high spatial resolution MR angiograms at subsecond temporal resolution by combining different techniques of view sharing with parallel imaging at 3.0T. MATERIALS AND METHODS In the keyhole-based method, a central elliptical cylinder in k-space is repeated n times (keyhole) with a random acquisition (CENTRA), and followed by the readout of the periphery of k-space. 4D-MR angiography with CENTRA keyhole (4D-TRAK) was combined with parallel imaging (SENSE) and partial Fourier imaging. In total, a speed-up factor of 66.5 (6.25 [CENTRA keyhole] x 8 [SENSE] x 1.33 [partial Fourier imaging]) was achieved yielding a temporal resolution of 608 ms and a spatial resolution of (1.1 x 1.4 x 1.1) mm(3) with whole-brain coverage 4D-TRAK was applied to five patients and compared with digital subtraction angiography (DSA). RESULTS 4D-TRAK was successfully completed with an acceleration factor of 66.5 in all five patients. Sharp images were acquired without any artifacts possibly created by the transition of the central cylinder and the reference dataset. MRA findings were concordant with DSA. CONCLUSION 4D time-resolved MRA with keyhole (4D-TRAK) is feasible using a combination of CENTRA, keyhole, and SENSE at 3.0T and allows for more than 60 times accelerated MRA with high spatial resolution.
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Santini F, Patil S, Meckel S, Scheffler K, Wetzel SG. Double-reference cross-correlation algorithm for separation of the arteries and veins from 3D MRA time series. J Magn Reson Imaging 2008; 28:646-54. [DOI: 10.1002/jmri.21499] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Wolf RL, Wang J, Detre JA, Zager EL, Hurst RW. Arteriovenous shunt visualization in arteriovenous malformations with arterial spin-labeling MR imaging. AJNR Am J Neuroradiol 2008; 29:681-7. [PMID: 18397967 DOI: 10.3174/ajnr.a0901] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE A reliable quantitative technique for measuring arteriovenous (AV) shunt in vascular malformations is not currently available. Here, we evaluated the hypothesis that continuous arterial spin-labeled (CASL) perfusion MR imaging can be used to detect and measure AV shunt in patients with arteriovenous malformations (AVMs). MATERIALS AND METHODS CASL perfusion MR imaging was performed in 7 patients with AVMs. Semiquantitative AV shunt estimates were generated based on a thresholding strategy by using signal-intensity difference (DeltaM) images to avoid potential errors in cerebral blood flow (CBF) calculation related to abnormal transit times and nonphysiologic blood-tissue water exchange in and around the AVMs. The potential for measuring CBF in regions distant from and near the AVM was explored, as was the relationship of CBF changes related to the size of the shunt. RESULTS In all 7 cases, striking increased intensity was seen on CASL perfusion DeltaM maps in the nidus and venous structures draining the AVM. Shunt estimates ranged from 30% to 0.6%. Mean CBF measurements in structures near the AVMs were not significantly different from the contralateral measurements. However, CBF in adjacent ipsilateral white matter increased relative to the contralateral side as the percent shunt increased (P = .02). Cortical gray matter CBF Delta (contralateral-ipsilateral) values demonstrated the same effect, but the correlation was weak and not significant. Thalamic CBF decreased ipsilaterally with increasing percent AV shunt (P = .01), indicating a possible steal effect. Basal ganglia Delta values showed little change in CBF with the size of the AV shunt. CONCLUSION CASL perfusion MR imaging can demonstrate AV shunting, providing high lesion conspicuity and a novel means for evaluating AVM physiology.
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Affiliation(s)
- R L Wolf
- Department of Radiology, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA.
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Taschner CA, Gieseke J, Le Thuc V, Rachdi H, Reyns N, Gauvrit JY, Leclerc X. Intracranial arteriovenous malformation: time-resolved contrast-enhanced MR angiography with combination of parallel imaging, keyhole acquisition, and k-space sampling techniques at 1.5 T. Radiology 2008; 246:871-9. [PMID: 18195381 DOI: 10.1148/radiol.2463070293] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To prospectively compare the agreement between digital subtraction angiography (DSA) and time-resolved magnetic resonance (MR) angiography with sensitivity encoding (SENSE) in combination with keyhole acquisition and contrast material-enhanced robust-timing angiography (CENTRA) k-space sampling techniques for the characterization of intracranial arteriovenous malformations (AVMs). MATERIALS AND METHODS The institutional review board approved the study; informed consent was obtained from all patients (or their parents). Twenty-eight patients (15 male, 13 female; mean age, 38.6 years; age range, 16-61 years) with 29 previously diagnosed, untreated intracranial AVMs who were referred for stereotactic gamma knife radiosurgery were evaluated. Preinterventional imaging included intraarterial DSA and time-resolved MR angiography. The time-resolved MR angiography sequence included SENSE with a 1.5-T imager and was optimized by applying keyhole acquisition and CENTRA techniques. Time-resolved MR angiograms were reviewed by two independent raters and compared with DSA images with regard to arterial feeders, nidus size, and venous drainage. kappa Statistics were applied to determine interobserver and intermodality agreement. RESULTS MR angiography enabled time-resolved (1.7 seconds per volume) visualization of cerebral vessels from axis to vertex at high spatial resolution (true voxel size, 1 x 1 x 2 mm). All 25 nidi detected at intraarterial DSA were visualized at time-resolved MR angiography. Intermodality agreement was excellent for arterial feeders (kappa = 0.91; 95% confidence interval [CI]: 0.786, 1.000) and venous drainage (kappa = 0.94; 95% CI: 0.814, 1.000) and was good for nidus size (kappa = 0.76; 95% CI: 0.562, 0.950). CONCLUSION The agreement (good to excellent) between time-resolved MR angiographic and DSA findings suggests that time-resolved MR angiography is a reliable tool for the characterization of intracranial AVMs with respect to arterial feeders, nidus size, and venous drainage.
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Affiliation(s)
- Christian A Taschner
- Department of Neuroradiology, Hôpital Roger Salengro, University Hospital Lille, Rue Emile Laine, F-59037 Lille Cédex, France.
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Hadizadeh DR, von Falkenhausen M, Gieseke J, Meyer B, Urbach H, Hoogeveen R, Schild HH, Willinek WA. Cerebral arteriovenous malformation: Spetzler-Martin classification at subsecond-temporal-resolution four-dimensional MR angiography compared with that at DSA. Radiology 2007; 246:205-13. [PMID: 17951352 DOI: 10.1148/radiol.2453061684] [Citation(s) in RCA: 106] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To prospectively test the hypothesis that subsecond-temporal-resolution four-dimensional (4D) contrast material-enhanced magnetic resonance (MR) angiography at 3.0 T enables the same Spetzler-Martin classification (nidus size, venous drainage, eloquence) of cerebral arteriovenous malformation (AVM) as that at digital subtraction angiography (DSA). MATERIALS AND METHODS Institutional ethics committee approval and written informed consent were obtained. In a prospective intraindividual comparative study, 18 consecutive patients with cerebral AVM (nine men, nine women; mean age, 41.9 years +/- 14.0 [standard deviation]; range, 23-69 years) were examined with 4D contrast-enhanced MR angiography and DSA. Four-dimensional contrast-enhanced MR angiography combined randomly segmented central k-space ordering, keyhole imaging, sensitivity encoding, and half-Fourier imaging, which yielded a total acceleration factor of 60. Fifty dynamic scans were obtained every 608 msec at an acquired spatial resolution of 1.1 x 1.4 x 1.1 mm. Four-dimensional contrast-enhanced MR angiograms were independently reviewed by one neuroradiologist and one neurosurgeon according to Spetzler-Martin classification, overall diagnostic quality, and level of confidence. Kendall W coefficients of concordance (K) were computed to compare reader assessment of image quality, level of confidence, and Spetzler-Martin classification by using 4D contrast-enhanced MR angiography and to compare Spetzler-Martin classification as determined with DSA with that at 4D contrast-enhanced MR angiography. RESULTS Spetzler-Martin classification of cerebral AVM at 4D contrast-enhanced MR angiography and at DSA matched in 18 of 18 patients for both readers, which yielded 100% interobserver agreement (K = 1). Image quality of 4D contrast-enhanced MR angiography was judged to be at least adequate for diagnosis in all patients by both readers. In three of 18 patients, DSA depicted additional arterial feeders of cerebral AVM. CONCLUSION Subsecond-temporal-resolution 4D contrast-enhanced MR angiography at 3.0 T had 100% agreement with DSA with regard to Spetzler-Martin classification of cerebral AVM. SUPPLEMENTAL MATERIAL radiology.rsnajnls.org/cgi/content/full/2453061684/DC1.
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Affiliation(s)
- Dariusch R Hadizadeh
- Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany
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Meckel S, Mekle R, Taschner C, Haller S, Scheffler K, Radue EW, Wetzel SG. Time-resolved 3D contrast-enhanced MRA with GRAPPA on a 1.5-T system for imaging of craniocervical vascular disease: initial experience. Neuroradiology 2006; 48:291-9. [PMID: 16532336 DOI: 10.1007/s00234-006-0052-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2005] [Accepted: 11/02/2005] [Indexed: 11/28/2022]
Abstract
INTRODUCTION For three-dimensional (3D) imaging with magnetic resonance angiography (MRA) of the cerebral and cervical circulation, both a high temporal and a high spatial resolution with isovolumetric datasets are of interest. In an initial evaluation, we analyzed the potential of contrast-enhanced (CE) time-resolved 3D-MRA as an adjunct for neurovascular MR imaging. METHODS In ten patients with various cerebrovascular disorders and vascularized tumors in the cervical circulation, high-speed MR acquisition using parallel imaging with the GeneRalized Autocalibrating Partially Parallel Acquisitions (GRAPPA) algorithm on a 1.5-T system with a temporal resolution of 1.5 s per dataset and a nearly isovolumetric spatial resolution was applied. The results were assessed and compared with those from conventional MRA and digital subtraction angiography (DSA). RESULTS CE time-resolved 3D-MRA enabled the visualization and characterization of high-flow arteriovenous shunts in cases of vascular malformations or hypervascularized tumors. In steno-occlusive disease, the method provided valuable additional information about altered vessel perfusion compared to standard MRA techniques such as time-of-flight (TOF) MRA. The use of a nearly isovolumetric voxel size allowed a free-form interrogation of 3D datasets. Its comparatively low spatial resolution was found to be the major limitation. CONCLUSION In this preliminary analysis, CE time-resolved 3D-MRA was revealed to be a promising complementary MRA sequence that enabled the visualization of contrast flow dynamics in various types of neurovascular disorders and vascularized cervical tumors.
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Affiliation(s)
- Stephan Meckel
- Division of Neuroradiology/Department of Radiology, University Hospital Basel, Petersgraben 4, Basel 4031, Switzerland.
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Cosottini M, Pingitore A, Michelassi MC, Puglioli M, Lazzarotti G, Caniglia M, Parenti G, Bartolozzi C. Redistribution of cerebropetal blood flow in patients with carotid artery stenosis measured non-invasively with fast cine phase contrast MR angiography. Eur Radiol 2004; 15:34-40. [PMID: 15503041 DOI: 10.1007/s00330-004-2524-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2004] [Revised: 07/30/2004] [Accepted: 08/27/2004] [Indexed: 10/26/2022]
Abstract
The purpose was to evaluate the blood flow redistribution in the neck vessels of patients with internal carotid artery (ICA) stenosis. Eighty-six patients with ICA stenosis underwent contrast-enhanced magnetic resonance angiography (CEMRA) and fast 2D phase contrast (2D-PC) sequence to measure the mean blood flow (MBF) of ICA, basilar artery (BA) and middle cerebral artery (MCA). CEMRA revealed 53 severe stenoses, 45 moderate stenoses and 3 occluded vessels. Patients with a unilateral severe ICA stenosis had a significantly reduced MBF of the ICA compared to the control group; the MBF reduction of the severely stenosed ICA was less conspicuous if associated with a controlateral severe stenosis. The MBF of the BA increased significantly in the presence of the bilateral severe ICA stenosis and in the ICA occlusion. The MBF of the MCA was unchanged in the presence of various degrees of ICA stenosis. Measurement of MBF with fast PC MRA permits cerebropethal blood flow assessment and gives additional information in grading ICA stenosis. The reduced MBF of a severe ICA stenosis has to be considered with caution since it depends also on the status of the controlateral ICA and may be considered a confident parameter only in case of unilateral carotid stenosis.
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Affiliation(s)
- Mirco Cosottini
- Department of Neuroscience, University of Pisa, Via Roma no 67, 56100 Pisa, Italy.
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