3 T Contrast-Enhanced Magnetic Resonance Angiography for Evaluation of the Intracranial Arteries: Comparison With Time-of-Flight Magnetic Resonance Angiography and Multislice Computed Tomography Angiography

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Purpose:We sought to prospectively evaluate the image quality and visualization of the intracranial arteries using high spatial resolution contrast-enhanced magnetic resonance angiography (CE-MRA) at 3 T and to perform intraindividual comparison with time-of-flight (TOF) MRA and multislice CT angiography (CTA).Materials and Methods:Twelve patients (5 men, 7 women, 37–71 years of age) with suspected cerebrovascular disease prospectively underwent MRA and CTA. MRA was performed on a 3 T MR system, including both 3-dimensional (3D) TOF (Voxel dimension: 0.6 × 0.5 × 0.9 mm3 in 5 minutes and 40 seconds) and 3D CE-MRA (voxel dimension: 0.7 × 0.7 × 0.8 mm3 in 20 seconds, using parallel acquisition with an acceleration factor of 4). CTA images were acquired on a 16-slice CT scanner (voxel dimension: 0.35 × 0.35 × 0.8 mm3 in 17 seconds). The image quality and visualization of up to 26 intracranial arterial segments in each study was evaluated by 2 experienced radiologists. The arterial diameter for selective intracranial arteries was measured independently on each of the 3 studies, and statistical analysis and comparative correlation was performed.Results:A total of 312 arterial segments were examined by CE-MRA, TOF-MRA, and CTA. The majority of intracranial arteries (87%) were visualized with diagnostic image quality on CE-MRA with a significant correlation to TOF (R values = 0.84; 95% confidence interval 0.79–0.86, P < 0.0001), and to CTA (R values = 0.74; 95% confidence interavl 0.68–0.78, P < 0.001). The image quality for small intracranial arteries, including the anterior-inferior cerebellar artery, the posterior communicating artery, and the M3 branch of the middle cerebral artery, was significantly lower on CE-MRA compared with TOF and CTA (P < 0.03). There was a significant correlation for the dimensional measurements of arterial diameters at CE-MRA with TOF (r = 0.88, 95% confidence interval 0.81–0.93), and CTA (r = 0.83, 95% confidence interval 0.73–0.90).Conclusion:The described 3 T CE-MRA protocol, spanning from the cervical to the intracranial vessels, visualized and characterized the majority of intracranial arteries with image quality comparable with that obtained using TOF-MRA and CTA. Further clinical studies are required to establish the accuracy of the technique in a broader clinical setting.

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