Gadolinium-enhanced fast three-dimensional angiography of the neck: technical aspect

This study sought to assess the feasibility of a contrast-enhanced three-dimensional (3D) magnetic resonance (MR) angiographic sequence for imaging the cervical arteries.

Ninety-eight consecutive patients underwent contrast MR angiography using a 3D sequence in the coronal plane, including both carotid and vertebral arteries. Gadolinium was injected at the beginning of the sequence. When the contrast was not optimal, a second injection was performed 5 to 10 minutes later. Qualitative assessment was performed for each arterial portion in a consensus manner by three radiologists who judged contrast enhancement, imaging coverage, and artifacts.

A second injection was required in 11 patients, and two examinations were not assessable because of motion artifacts. Among the vessels analyzed, 19% were not assessable owing to the limited coverage in 11% and to the low contrast in 9%. Carotid bifurcations were assessable in 95%, whereas vertebral arteries were visualized from their origins to their intradural portions in only 82% of cases. A longitudinal signal-void artifact was found in the center of the arterial lumen of carotid arteries in six patients.

Contrast MR angiography constitutes a promising tool to assess cervical arteries. Some limitations including spatial resolution, timing of injection, and imaging coverage should be overcome in the near future.