Radiology, Vol 194, 459-467, Copyright © 1995 by Radiological Society of North America

ARTICLES

Carotid artery stenosis: clinical efficacy of MR phase-contrast flow quantification as an adjunct to MR angiography

RL Vanninen, HI Manninen, PL Partanen, PA Vainio and S Soimakallio
Department of Clinical Radiology, Kuopio University Hospital, Finland.

PURPOSE: To assess the utility of magnetic resonance (MR) flow quantification in the evaluation of suspected carotid artery stenosis. MATERIALS AND METHODS: Fifty-five patients referred for angiography and 10 healthy volunteers underwent Doppler ultrasound, three-dimensional time-of-flight MR angiography, and MR phase-contrast flow quantification to measure peak systolic velocity (PSV) and volumetric flow rate (VFR) in the common and internal carotid arteries distal to the stenosis. RESULTS: PSV and VFR were significantly lower in the severely (> or = 70%) stenosed internal carotid arteries (P < .05). The VFR ratio (internal carotid artery-common carotid artery) achieved 91% overall accuracy for detection of severe stenosis. Combination of flow data with results of MR angiography yielded sensitivity of 100% (95% confidence interval, 78%-100%) with a modest loss in specificity. Doppler and MR measurements of PSV in the common carotid artery showed significant correlation: volunteers, r = .73; patients, r = .64. CONCLUSION: MR flow quantification provides information about the hemodynamic significance of carotid stenosis. As an adjunct to MR angiography, it may be useful in enabling differentiation of occlusions from critical stenoses.

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