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European Radiology

, Volume 11, Issue 2, pp 295–302 | Cite as

Preliminary experience with dynamic MR projection angiography in the evaluation of cervicocranial steno-occlusive disease

  • S. G. Wetzel
  • R. Haselhorst
  • D. Bilecen
  • P. A. Lyrer
  • E. Seifritz
  • G. Bongartz
  • E. W. Radue
  • K. Scheffler
NEURO

Abstract

The application of a contrast-enhanced, two-dimensional MR technique, which provides dynamic projection angiograms at a subsecond temporal frame rate for depiction of the cervical and intracranial arteries, was evaluated in three healthy volunteers and seven patients with various cervicocranial steno-occlusive diseases. Intra-arterial digital subtraction angiography (DSA) served as standard of reference for findings in the patients. Magnetic resonance projection angiography (MRPA) was performed on a standard 1.5-T clinical MR imaging system at intravenous injection of a single dose of contrast agent (0.1 mmol/kg GdDTPA-BMA). Sixty consecutive images of the cerebral circulation were acquired at a temporal frame rate of 900 ms per image in the coronal plane. The collateral flow and the perfusion of the compromised vessel territory were readily assessed by MPRA in patients with occlusion of the internal cerebral artery (ICA) or middle cerebral artery (MCA). The leptomeningeal collateralisation of these patients was displayed in a dynamic fashion. Furthermore, quantitative perfusion measurement provided a difference between both MCA territories in the time to peak (ΔDTTP) of the contrast bolus of 1.12 ± 0.28 s in five patients with severe stenosis or occlusion of the ICA (healthy volunteers 0.19 ± 0.05 s). However, important pathological findings, such as the evaluation of carotid artery stenoses and the intracranial collateral flow pattern in patients with severe carotid stenoses, were not sufficiently assessable as compared with DSA. We conclude that the possibility of obtaining simultaneously information about morphology and perfusion dynamics of the cervicocranial vessels is unique in MPRA as compared with other MR techniques. However, in the applied form, the technique is not a reliable tool for the complete evaluation of the cervicocranial vessels in patients with steno-occlusive disease.

Key words Magnetic resonance angiography Time-resolved subtraction technique Digital subtraction angiography Carotid artery disease 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • S. G. Wetzel
    • 1
  • R. Haselhorst
    • 1
  • D. Bilecen
    • 1
  • P. A. Lyrer
    • 2
  • E. Seifritz
    • 3
  • G. Bongartz
    • 4
  • E. W. Radue
    • 1
  • K. Scheffler
    • 5
  1. 1.Section of Neuroradiology, University Hospitals, Kantonsspital Basel, Petersgraben 4, 4031 Basel, SwitzerlandCH
  2. 2.Department of Neurology, University Hospitals, Kantonsspital Basel, Petersgraben 4, 4031 Basel, SwitzerlandCH
  3. 3.Psychiatric University Hospital Basel, Wilhelm Klein Str., 4055 Basel, SwitzerlandCH
  4. 4.Institute for Diagnostic Radiology, Department of Radiology, University Hospitals, Kantonsspital Basel, Petersgraben 4, 4031 Basel, SwitzerlandCH
  5. 5.Department of Diagnostic Radiology, University of Freiburg, Freiburg, GermanyDE

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