Exploration of ostial stenosis of the craniocen,ical vessels: can contrast-enhanced MR angiography, replace digital substraction angiography?

Ostial stenosis of the craniocervical vessels are frequently, associated wi th carotid stenosis. Consequently, exploration of the aortic arch is necess ary, prior to carotid endarterectomy,. Contrast-enhanced AIR angiography, ( gRMA) could replace digital substraction angiography (DSA). The goal of thi s work was to evaluate gRMA for tile detection of ostial stenosis of tile c raniocervical vessels. Twenty, two patients with carotid stenosis > 50 % oi l sonography examination prospectively underwent gRMA and DSA. We analyzed the overall quality, of each gRMA and the degree Of ostial stenosis Of the craniocervical vessels (innominate, left carotid, subclavian and vertebral arteries). Thirteen gRMA examination was considered as good quality and 8 a s adequate for diagnosis. There was significant correlation between gRMA an d DSA for degree of stenosis (k = 0,82, p < 0,0001). gRMA tends to overesti mate degree of ostial stenosis, especially, for vertebral arteries. We conc lude that gRMA is a promising tool but cannot Yet be used as a stand-alone procedure for the evaluation of ostial stenosis of tile cranlocervical vess els.