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The role of CE-MRA of the supraortic vessels in the detection of associated intracranial pathology

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Abstract

Background

Contrast-enhanced magnetic resonance angiography (CE-MRA) has become a very popular imaging technique in the evaluation of the extracranial vessels pathology, while it is not commonly used to rule out intracranial vascular pathology. On the contrary, 3D time of flight MRA (TOF-MRA) has a solid role in the study of intracranial arterial vessels disease.

Materials and methods

One hundred and eight patients were consecutively included in the study. All patients were submitted to a 3 Tesla 3D CE-MRA imaging to rule out extracranial vessels pathology. A comparison was made with a 3D-TOF sequence acquired at the same time in the assessment of intracranial vessels diseases such as steno-occlusion, dissection, and aneurysms.

Results

With regard to steno-occlusive disease, Spearman’s rank correlation coefficient was of 0.56 for stenosis detection and of 0.57 for occlusive disease detection. The two techniques shared similar results in the evaluation of anterior circulation, while 3D-TOF found higher grades of stenosis for posterior circulation. With regard to dissection, Spearman’s rank correlation coefficient was of 0.7. 3D-TOF depicted more intramural hematoma (Spearman’s rank = 0.46), while CE-MRA showed more pseudo-aneurysms (Spearman’s rank = 0.56). Both the technique equally evaluated the presence of intracranial aneurysms (Spearman’s rank = 1).

Conclusion

CE-MRA can be considered a reliable tool to rule out intracranial pathology associated to supraortic steno-occlusive disease, also allowing time reduction. In the suspicion of dissection a T1-weighted sequence has to be added to detect the presence of a subacute vessel wall hematoma.

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Authors and Affiliations

  1. Department of Neuroradiology, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy

    Sonia Francesca Calloni, Pietro Panni, Anna del Poggio, Paolo Quintiliano Vezzulli, Andrea Falini & Nicoletta Anzalone

  2. Department of Neuroradiology, Umberto I Hospital, Salerno, Italy

    Marianna Perrotta

  3. Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Luisa Roveri

  4. Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Massimo Filippi

  5. Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Massimo Filippi

  6. Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Massimo Filippi

  7. Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy

    Massimo Filippi

Authors
  1. Sonia Francesca Calloni
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  2. Marianna Perrotta
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  3. Luisa Roveri
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  4. Pietro Panni
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  6. Paolo Quintiliano Vezzulli
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  7. Massimo Filippi
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  8. Andrea Falini
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  9. Nicoletta Anzalone
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Contributions

Calloni Sonia Francesca: Contributed substantially to the acquisition of data, the analysis and interpretation- Drafted the manuscript.

Perrotta Marianna: conributed to the acquisition of data and the analysis.

Roveri Luisa: provided critical revision of the article. Provided final approval of the version to publish.

Panni Pietro: provided critical revision of the article and made a great contributions to the statistical analysis.

Del Poggio Anna: provided critical revision of the article.

Vezzulli Paolo Quintiliano: provided critical revision of the article.

Filippi Massimo: provided final approval of the version to publish.

Falini Andrea: Provided final approval of the version to publish.

Anzalone Nicoletta: Contributed substantially to the conception and design of the study, the acquisition of data, the analysis, and interpretation. Provided critical revision of the article. Provided final approval of the version to publish.

Corresponding author

Correspondence to Nicoletta Anzalone.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The authors declare no compeing interests.

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Informed consent was obtained from all individual participants included in the study.

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Calloni, S.F., Perrotta, M., Roveri, L. et al. The role of CE-MRA of the supraortic vessels in the detection of associated intracranial pathology. Neurol Sci 42, 5131–5137 (2021). https://doi.org/10.1007/s10072-021-05222-1

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  • DOI: https://doi.org/10.1007/s10072-021-05222-1

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