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Head and Neck Imaging |
1 From the Departments of Diagnostic Radiology (J.H., S.B.F., J.T.W., P.H.L., C.H.R., D.J.C., S.J.R., M.A.B.), Neurology (R.D.B.), Neurologic Surgery (F.B.M.), Vascular Surgery (T.C.B.), and Biostatistics (C.D.S.), Mayo Clinic and Foundation, 200 1st St SW, Rochester, MN 55905. Received November 15, 1999; revision requested December 29; final revision received June 12, 2000; accepted June 28. Supported in part by National Institutes of Health grants CA37993 (J.H., S.J.R.) and HL37310 (S.J.R.) and GE Medical Systems, Milwaukee, Wis (S.J.R.). Address correspondence to J.H. (e-mail: jhuston@mayo.edu).
PURPOSE: To determine the accuracy of elliptic centric contrast material–enhanced magnetic resonance (MR) angiography by using conventional angiography as the reference standard.
MATERIALS AND METHODS: Fifty patients were examined prospectively with contrast-enhanced MR angiography and conventional angiography. The two examinations were performed within 1 week of each other. Two patients underwent conventional angiography of only one carotid artery, which yielded 98 arteries for comparison.
RESULTS: With conventional angiography as the reference standard and by using a 70% threshold for internal carotid arterial diameter stenosis, maximum intensity projection (MIP) images had a sensitivity of 93.3%, specificity of 85.1%, and accuracy of 87.6%, whereas reformatted transverse source images had a sensitivity of 83.3%, specificity of 97.0%, and accuracy of 92.8%. Interobserver variability for conventional angiograms was 0.97, for MIP images was 0.91, and for source images was 0.90. The contrast-enhanced MR angiographic technique had a sensitivity of 88.9% and specificity of 58.1% for the presence of irregularity and/or ulceration. All 50 examinations were triggered appropriately so that minimal or no venous signal intensity was depicted.
CONCLUSION: Contrast-enhanced elliptic centric three-dimensional MR angiography offers high-spatial-resolution, venous-suppressed images of the carotid arteries that appear to be adequate to replace conventional angiography in most patients examined prior to carotid endarterectomy.
Index terms: Carotid arteries, MR, 172.12142, 172.12143 • Carotid arteries, stenosis or obstruction, 172.731 • Magnetic resonance (MR), maximum intensity projection, 172.12142, 172.12143 • Magnetic resonance (MR), three-dimensional, 172.12142, 172.12143 • Magnetic resonance (MR), vascular studies, 172.12142, 172.12143
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