Quantitative time‐of‐flight MR angiography for simultaneous luminal and hemodynamic evaluation of the intracranial arteries

Background: To evaluate the value of time-of-flight MR angiography (TOF MRA) for the assessment of extracranial-intracranial (EC-IC) bypass in Moyamoya disease in comparison with computed tomography angiography (CTA). Patients and methods: A consecutive series of 23 patients with Moyamoya disease were analyzed retrospectively. Twenty three patients underwent 25 procedures of extracranial-intracranial bypass. Cranial CTA was performed within one week after the surgery to assess bypass patency. Then TOF MRA was scanned within 24 h after CTA on a 3T MRI system. Using 5-point scales (0 = poor to 4 = excellent), two radiologists rated the image quality and vessel integrity of bypass for three segments (extracranial, trepanation, intracranial). Results: Image quality was high in both CTA and TOF MRA (mean quality score 3.84 ± 0.37 and 3.8 ± 0.41), without statistical difference (p = 0.66). Mean scores of TOF MRA with respect to bypass visualization were higher than CTA in the intracranial segment (p = 0.026). No significant difference of bypass visualization regarding the extracranial and trepanation segments was found between TOF MRA and CTA (p = 0.66 and p = 0.34, respectively). For the trepanation segment, TOF MRA showed pseudo lesions in 2 of all 25 cases. Conclusions: 3T TOF MRA, a non-contrast technique not exposing the patients to radiation, proved to be at least equal to CTA for the assessment of EC-IC bypass, and even superior to CTA with respect to the intracranial segment. In addition, readers should be aware of a potential overestimation showing focal pseudo lesions of the bypass at the trepanation segment in TOF MRA.

Download Full-text

Time-of-Flight MR Angiography Targeted to Coiled Intracranial Aneurysms Is More Sensitive to Residual Flow Than Is Digital Subtraction Angiography

Yearbook of Neurology and Neurosurgery ◽

10.1016/s0513-5117(08)70399-5 ◽

2006 ◽

Vol 2006 ◽

pp. 247-248

Author(s):

S.R. Gibbs

Keyword(s):

Digital Subtraction Angiography ◽

Intracranial Aneurysms ◽

Mr Angiography ◽

Time Of Flight ◽

Residual Flow ◽

Digital Subtraction

Download Full-text

Visualization of the lenticulostriate artery with flow-sensitive black-blood acquisition in comparison with time-of-flight MR angiography

Journal of Magnetic Resonance Imaging ◽

10.1002/jmri.21626 ◽

2009 ◽

Vol 29 (1) ◽

pp. 65-69 ◽

Cited By ~ 16

Author(s):

Kimio Gotoh ◽

Tomohisa Okada ◽

Yukio Miki ◽

Masato Ikedo ◽

Ayako Ninomiya ◽

...

Keyword(s):

Mr Angiography ◽

Time Of Flight ◽

Black Blood ◽

Lenticulostriate Artery

Download Full-text

Preoperative single-slab 3D time-of-flight magnetic resonance angiography predicts development of new cerebral ischemic events after carotid endarterectomy

Journal of Neurosurgery ◽

10.3171/2009.2.jns081233 ◽

2009 ◽

Vol 111 (1) ◽

pp. 141-146 ◽

Cited By ~ 5

Author(s):

Taro Suzuki ◽

Kuniaki Ogasawara ◽

Ryonoshin Hirooka ◽

Makoto Sasaki ◽

Masakazu Kobayashi ◽

...

Keyword(s):

At Risk ◽

Mr Imaging ◽

Carotid Endarterectomy ◽

Signal Intensity ◽

Mr Angiography ◽

Time Of Flight ◽

Neurological Deficits ◽

Patients At Risk ◽

Cerebral Ischemic ◽

Ischemic Events

Object Preoperative impairment of cerebral hemodynamics predicts the development of new cerebral ischemic events after carotid endarterectomy (CEA), including neurological deficits and cerebral ischemic lesions on diffusion weighted MR imaging. Furthermore, the signal intensity of the middle cerebral artery (MCA) on single-slab 3D time-of-flight MR angiography (MRA) can assess hemodynamic impairment in the cerebral hemisphere. The purpose of the present study was to determine whether, on preoperative MR angiography, the signal intensity of the MCA can be used to identify patients at risk for development of cerebral ischemic events after CEA. Methods The signal intensity of the MCA ipsilateral to CEA on preoperative MR angiography was graded according to the ability to visualize the MCA in 106 patients with unilateral internal carotid artery stenosis (≥ 70%). Diffusion weighted MR imaging was performed within 3 days of and 24 hours after surgery. The presence or absence of new postoperative neurological deficits was also evaluated. Results Cerebral ischemic events after CEA were observed in 16 patients. Reduced signal intensity of the MCA on preoperative MR angiography was the only significant independent predictor of postoperative cerebral ischemic events. When the reduced MCA signal intensity on preoperative MR angiography was defined as an impairment in cerebral hemodynamics, MR angiography grading resulted in an 88% sensitivity and 63% specificity, with a 30% positive- and a 97% negative-predictive value for the development of postoperative cerebral ischemic events. Conclusions Signal intensity of the MCA on preoperative single-slab 3D time-of-flight MR angiography is useful for identifying patients at risk for cerebral ischemic events after CEA.

Download Full-text