Radiology, Vol 177, 45-50, Copyright © 1990 by Radiological Society of North America

ARTICLES

Extracranial carotid arteries: evaluation with "black blood" MR angiography

RR Edelman, HP Mattle, B Wallner, R Bajakian, J Kleefield, C Kent, JJ Skillman, JB Mendel and DJ Atkinson
Department of Radiology, Beth Israel Hospital, Boston, MA.

The authors evaluated the accuracy of "black blood" magnetic resonance (MR) angiography for depicting disease involving the extracranial carotid arteries. Two- and three-dimensional flow-compensated gradient- echo sequences were employed to create "bright blood" images. A thin- section spin-echo sequence with flow presaturation allowed the creation of black blood images. Projection angiograms were made from bright and black blood images with application of a maximum- or minimum-intensity projection algorithm, respectively. These methods were used in 13 healthy volunteers and 17 patients, and a prospective blinded comparison of MR angiography and conventional angiography was performed. Normal carotid arteries were well shown with both bright and black blood methods; in patients, both methods were sensitive for detecting carotid disease. However, bright blood angiography exaggerated the severity of carotid lesions in 13 of 33 arteries, mostly in severe disease; this problem was not encountered with black blood angiography. The authors conclude that bright blood angiography is a sensitive method for screening carotid disease; when a significant abnormality is found, black blood angiography should be performed for more precise delineation of the lesion.

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