Fluoroscopically triggered contrast-enhanced 3D MR DSA and 3D time-of-flight turbo MRA of the carotid arteries: first clinical experiences in correlation with ultrasound, x-ray angiography, and endarterectomy findings

The aim of this article was to obtain initial experiences with fluoroscopic ally triggered contrast-enhanced (CE) 3D MR DSA with elliptical centric k-s pace order and 3D time-of-flight (TOF) turbo MRA of the carotid arteries. I n this prospective study we examined 16 consecutive patients with suspicion of atherosclerotic disease involving the carotid arteries. Ultrasound was available in all, x-ray angiography in 12, surgical correlation in 9, and i ntraoperative x-ray angiography in 4 patients. All examinations were done o n a 1.5 T unit applying: transverse plain 3D TOF turbo MRA and coronal CE M RA with fluoroscopic triggering. Combining head and neck array coils allowe d the visualization of supraaortic arteries from the aortic arch to the cir cle of Willis. MRA results (maximum intensity projections) were compared wi th x-ray angiography, ultrasound, and inspection of endarterectomy specimen s. Volume rendering was performed in selected cases additionally. Agreement between CE MRA, 3D TOF turbo MRA and x-ray angiography regarding stenoses of the internal and external carotid artery was very good. CE MRA was able to detect correctly intracranial stenoses, but delineation of the aortic ar ch and proximal common carotid arteries was sometimes reduced. Volume rende ring was suited for visualization of MRA images providing a realistic three -dimensional impression. In conclusion, high-resolution fluoroscopically tr iggered CE MRA as non-invasive technique is another important step on the w ay to replace invasive x-ray angiography for the evaluation of atherosclero tic carotid artery disease. High resolution 3D TOF turbo MRA might be a hel pful adjunct to increase the diagnostic reliability for the carotid bifurca tion. (C) 2000 Elsevier Science Inc. All rights reserved.