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Intracranial artery velocity measurement using 4D PC MRI at 3 T: comparison with transcranial ultrasound techniques and 2D PC MRI

  • Diagnostic Neuroradiology
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Abstract

Introduction

4D phase contrast MR imaging (4D PC MRI) has been introduced for spatiotemporal evaluation of intracranial hemodynamics in various cerebrovascular diseases. However, it still lacks validation with standards of reference. Our goal was to compare blood flow quantification derived from 4D PC MRI with transcranial ultrasound and 2D PC MRI.

Methods

Velocity measurements within large intracranial arteries [internal carotid artery (ICA), basilar artery (BA), and middle cerebral artery (MCA)] were obtained in 20 young healthy volunteers with 4D and 2D PC MRI, transcranial Doppler sonography (TCD), and transcranial color-coded duplex sonography (TCCD). Maximum velocities at peak systole (PSV) and end diastole (EDV) were compared using regression analysis and Bland–Altman plots.

Results

Correlation of 4D PC MRI measured velocities was higher in comparison with TCD (r = 0.49–0.66) than with TCCD (0.35–0.44) and 2D PC MRI (0.52–0.60). In mid-BA and ICA C7 segment, a significant correlation was found with TCD (0.68–0.81 and 0.65–0.71, respectively). No significant correlation was found in carotid siphon. On average over all volunteers, PSVs and EDVs in MCA were minimally underestimated compared with TCD/TCCD. Minimal overestimation of velocities was found compared to TCD in mid-BA and ICA C7 segment.

Conclusion

4D PC MRI appears as valid alternative for intracranial velocity measurement consistent with previous reference standards, foremost with TCD. Spatiotemporal averaging effects might contribute to vessel size-dependent mild underestimation of velocities in smaller (MCA), and overestimation in larger-sized (BA and ICA) arteries, respectively. Complete spatiotemporal flow analysis may be advantageous in anatomically complex regions (e.g. carotid siphon) relative to restrictions of ultrasound techniques.

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Acknowledgments

We thank Gabriele Ihorst, Ph.D., Biostatistician, for valuable statistical support. This work was supported in part by a grant from the Swiss National Science Foundation (SNF 320000-113492/1).

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neuroradiology, University Hospital Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany

    Stephan Meckel

  2. Institute of Radiology, University Hospital Basel, Basel, Switzerland

    Lorenz Leitner & Tilman Schubert

  3. Department of Neurology, University Hospital Basel, Basel, Switzerland

    Leo H. Bonati & Philippe Lyrer

  4. Department of Radiological Physics, Institute of Radiology, University Hospital Basel, Basel, Switzerland

    Francesco Santini

  5. Department of Radiology, Xuanwu Hospital—Capital Medical University, Beijing, China

    Aurelien F. Stalder

  6. Departments of Radiology and Biomedical Engineering, Northwestern University Feinberg School of Medicine, Chicago, USA

    Michael Markl

  7. Neuroradiology, Swiss Neuro Institute, Klinik Hirslanden, Zurich, Switzerland

    Stephan G. Wetzel

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  1. Stephan Meckel
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Correspondence to Stephan Meckel.

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Stephan Meckel and Lorenz Leitner contributed equally to content of manuscript.

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Meckel, S., Leitner, L., Bonati, L.H. et al. Intracranial artery velocity measurement using 4D PC MRI at 3 T: comparison with transcranial ultrasound techniques and 2D PC MRI. Neuroradiology 55, 389–398 (2013). https://doi.org/10.1007/s00234-012-1103-z

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