Contrast-enhanced MR angiography of the supra-aortic vessels in 24 seconds: a feasibility study

A contrast-enhanced, gradient-echo 3D pulse sequence providing angiographic information in 24 s was tested in five healthy subjects and used prospecti vely in 21 patients for the investigation of the cervical arteries. Indicat ions included suspected stenosis of the carotid (in 13), or vertebral arter ies (in 1), carotid dissection (3), variants of the branches of the aortic arch (2) and extracranial carotid aneurysms (2). The results in all patient s were compared with those of intra-arterial digital subtraction angiograph y (DSA). In patients with carotid stenosis, they were also compared with hi gh-resolution 3D time-of-flight (TOF) MR angiography (MRA). Good quality MR angiograms of the neck vessels were obtained with the fast 3D sequence in 20 of the 21 patients. One claustrophobic patient was unable to cooperate. The degree of internal carotid artery (ICA) stenosis was graded correctly ( compared to DSA) in 21 of 24 cases (87.5 %). Two mild stenoses were overest imated as moderate using the fast MR sequence and one high-grade stenosis w as misdiagnosed as a complete occlusion. Carotid dissection was confirmed i n one case and correctly excluded in two. Four extracranial ICA aneurysms i n two patients, arterial variants and stenosis of the origin of the vertebr al artery were correctly diagnosed using the contrast-enhanced MR angiogram . Three-dimensional TOF MRA was unsuccessful due to motion artefacts in hal f of the cases of ICA stenosis.