For a variety of reasons, small vessels have low signal intensity in m
agnetic resonance angiography. When the vessel signal intensity is low
er than the signal intensity of background tissues, these vessels tend
not to be visible on maximum-intensity-projection images. The authors
developed a nonlinear second-difference spatial filtering technique t
hat enhances the details of small vessels while suppressing both noise
and uniform background tissue. Two similar nonlinear second-differenc
e filters are presented and compared with the linear Laplacian second-
difference filter. To evaluate the performance of these filters, they
were applied to intracranial three-dimensional time-of-flight MR angio
graphic data and the results compared with the vessel enhancement obta
ined with a simple second-difference Laplacian filter and with magneti
zation transfer contrast (MTC) techniques. The comparisons demonstrate
d that nonlinear filtering and MTC techniques result in similar improv
ement in small-vessel visibility and apparent continuity. A quantitati
ve comparison demonstrated that the improvement in the contrast-to-noi
se ratio is much greater with the nonlinear filters than the Laplacian
filter.