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Nonenhanced ECG-gated time-resolved 4D Steady-state free precession (SSFP) MR angiography (MRA) for assessment of cerebral collateral flow: comparison with digital subtraction angiography (DSA)

  • Vascular-Interventional
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Abstract

Objectives

To evaluate a nonenhanced time-resolved 4D SSFP MRA for dynamic visualization of intracranial collateral blood flow.

Methods

22 patients (59.0 ± 11.8 years) with steno-occlusive disease of brain-supplying arteries were included in this study. 4D SSFP MRA of the intracranial arteries was acquired with 15 temporal phases and a temporal resolution of 115 ms using 1.5 T MR. Cerebral DSA served as the reference standard and was available in all patients.

Results

Nonenhanced 4D SSFP MRA allowed for detailed dynamic visualization of blood flow in the circle of Willis and its branches in 21 of 22 (95.5%) patients. Collateral flow was excluded with both 4D SSFP MRA and DSA in 4 patients. In 17 patients, DSA detected anterior collateral flow (n = 8), posterior collateral flow via the right (n = 8) and left (n = 7) posterior communicating artery as well as patent EC-IC bypasses (n = 8). 29 of 31 collateral flow pathways were visualized by 4D SSFP MRA. As compared to DSA, 4D SSFP MRA showed a high sensitivity (92.3%), specificity (100%), positive predictive value (100%) and negative predictive value (95.2%) for visualization of intracranial collateral flow.

Conclusions

4D SSFP MRA is a promising non-invasive imaging technique for dynamic visualization of intracranial collateral flow.

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Acknowledgement

Peter Schmitt is an employee of Siemens AG, Healthcare section, Erlangen, Germany.

Xiaoming Bi is an employee of Siemens Healthcare, Chicago, IL, USA. Both helped with the development of the imaging sequences.

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Authors and Affiliations

  1. Department of Radiology, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany

    Rotem Shlomo Lanzman, Patric Kröpil, Falk R. Miese, Axel Scherer, Bernd Turowski & Dirk Blondin

  2. Siemens AG, Healthcare Section, Erlangen, Germany

    Peter Schmitt

  3. Siemens Healthcare, Chicago, IL, USA

    Xiaoming Bi

  4. Department of Neurology, University Hospital Düsseldorf, Düsseldorf, Germany

    Michael Gliem

  5. Department of Neurosurgery, University Hospital Düsseldorf, Düsseldorf, Germany

    Daniel Hänggi & Marcel Kamp

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  1. Rotem Shlomo Lanzman
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Correspondence to Rotem Shlomo Lanzman.

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Lanzman, R.S., Kröpil, P., Schmitt, P. et al. Nonenhanced ECG-gated time-resolved 4D Steady-state free precession (SSFP) MR angiography (MRA) for assessment of cerebral collateral flow: comparison with digital subtraction angiography (DSA). Eur Radiol 21, 1329–1338 (2011). https://doi.org/10.1007/s00330-010-2051-9

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  • DOI: https://doi.org/10.1007/s00330-010-2051-9

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