Contrast-enhanced MR angiography of the craniocervical vessels: a review

The use of MR angiography (MRA) with injection of contrast medium enables imaging of a large volume with a very short acquisition time, providing angiographic images similar to those obtained with catheter angiography. This makes possible investigation of patients in the acute phase of stroke, with examination of the entire length of the cervical arteries from the aortic arch to the circle of Willis. However, the parameters of the sequence must be carefully chosen to optimise image quality, with a compromise between spatial resolution, acquisition time and image contrast. An overview of the technical aspects is presented, including current developments. Different protocol strategies are discussed, including their advantages and limits. Finally, we review the preliminary results of contrast-enhanced MRA for assessment of atherosclerotic lesions of supra-aortic vessels.