Der Radiologe

, Volume 44, Issue 10, pp 975–984 | Cite as

Stellenwert der MR-Angiographie zur Diagnose bei Karotisstenosen

  • H. J. Michaely
  • K. A. Herrmann
  • H. Kramer
  • G. Laub
  • M. F. Reiser
  • S. O. Schoenberg
Karotisstenosen

Zusammenfassung

Arteriosklerose der hirnversorgenden Gefäße ist ein nachgewiesener Risikofaktor für zerebrovaskuläre Erkrankungen. Große Multicenterstudien wie NASCET und ECST belegen den protektiven Nutzen chirurgischer Therapie von schweren (>70%) Karotisstenosen. Die genaue Detektierung und Graduierung von Karotisstenosen ist die Voraussetzung für eine erfolgreiche Therapie. Neben dem Goldstandard, der digitalen Subtraktionsangiographie (DSA), wird hierfür immer häufiger die MR-Angiographie (MRA) angewandt, mit der nichtinvasiv und ohne ionisierende Strahlung eine hochauflösende Gefäßdarstellung der Halsgefäße in nur 20 s durchgeführt werden kann. Dieser Beitrag erläutert zunächst die hierfür verwendeten MRA-Techniken, die Anwendungsmöglichkeiten und Limitationen. Anschließend wird die diagnostische Genauigkeit der MRA verglichen mit der DSA sowie dem Ultraschall. Die klinische Wertigkeit der MRA für die Diagnostik der Karotisstenosen wird dann anhand von Beispielen kritisch diskutiert.

Schlüsselwörter

MRA Karotisstenose Digitale Subtraktionsangiographie Ultraschall Parallele Bildgebung 

The significance of MR angiography for the diagnosis of carotid stenoses

Abstract

Arteriosclerosis of the supra-aortic vessels is a known risk factor for cerebrovascular disease. Large multicenter studies like NASCET and ECST have proven the protective effects of the surgical treatment of severe (>70%) carotid artery stenoses. The exact detection and grading of stenoses of the carotid arteries is a prerequisite for a successful therapy. Besides the gold-standard examination, digital subtraction angiography (DSA), MR angiography (MRA) is being used increasingly. MRA allows a non-invasive, high-resolution depiction of the supra-aortic vessels without ionizing radiation in only 20 s. This article first illustrates the MRA-techniques, and the indications and limitations of MRA. Next, the diagnostic accuracy of MRA is compared to DSA and ultrasound. The clinical value of MRA for the detection of stenoses of the carotid arteries is discussed on the basis of clinical examples.

Keywords

MRA Carotid artery stenosis Digital subtraction angiography Ultrasound Parallel imaging 
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Notes

Interessenkonflikt:

Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen.

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Copyright information

© Springer Medizin Verlag 2004

Authors and Affiliations

  • H. J. Michaely
    • 1
    • 3
  • K. A. Herrmann
    • 1
  • H. Kramer
    • 1
  • G. Laub
    • 2
  • M. F. Reiser
    • 1
  • S. O. Schoenberg
    • 1
  1. 1.Institut für Klinische RadiologieKlinikum der Universität München—Großhadern
  2. 2.Siemens Medical SolutionsMalvernUSA
  3. 3.Institut für Klinische RadiologieKlinikum der Universität München—GroßhadernMünchen

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