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[Cerebrovascular pathology. Comparison of magnetic resonance and magnetic resonance angiography]
A Carriero1, A Iezzi, M Dragani
1Istituto di Scienze Radiologiche e Formazione dell'Immagine, Università, Chieti.
Insights
Magnetic Resonance Angiography (MRA) without contrast media aids in visualizing intracranial circulation. This study highlights MRA
Area of Science:
- Neuroradiology
- Vascular Imaging
- Medical Diagnostics
Background:
- Advancements in Magnetic Resonance Angiography (MRA) enable contrast-free visualization of intracranial circulation.
- Radiologists are exploring the diagnostic utility of various MRA techniques for intracranial vascular diseases.
Purpose of the Study:
- To evaluate the diagnostic role of different MRA techniques in characterizing intracranial vascular diseases.
- To assess the utility of 3D Time-of-Flight (TOF) MRA in detecting and characterizing various vascular lesions.
Main Methods:
- Utilized 3D TOF MRA on 40 patients with 50 vascular lesions identified on MRI.
- Compared MRA findings with conventional MRI and angiography in 20 patients.
- Employed a 1.5 T superconductive magnet with gradient-echo 3D TOF FT sequences and maximum-intensity projection post-processing.
Main Results:
- MRA provided valuable additional information in 27.4% of cases involving aneurysms, arteriovenous malformations, vascular occlusion, and dolichobasilar arteries.
- Detected 17 aneurysms, 3 stenoses, 13 arteriovenous malformations, and 12 dolichobasilar arteries.
- Demonstrated utility in follow-up of treated vascular lesions.
Conclusions:
- 3D TOF MRA is a valuable complementary technique to MRI for evaluating cerebral circulation.
- MRA offers useful insights into intracranial vascular pathologies and aids in post-treatment follow-up.
- MRA is recommended as a preliminary imaging modality before angiography.
Abstract:
After making the visualization of the intracranial circulation possible without contrast media, the radiologist is now evaluating the diagnostic role of the different techniques of MRA. Attempts are also being made to characterize the main patterns of intracranial vascular diseases. The authors examined, with 3D TOF MRA, 40 patients presenting with 50 vascular lesions on MRI scans. Twenty of 40 patients were also studied with angiography. Seventeen aneurysms were detected, together with 3 stenoses of the cerebral arteries, 13 arteriovenous malformations, 12 dolichobasilar arteries, 3 postoperative and 2 post-embolization controls. MRI was performed with a superconductive magnet (1.5 T), a dedicated coil and gradient-echo 3D TOF FT sequences. The refocused sequence for flux, FISP 3DFT, required the following parameters: TR = 0.04 s, TE = 10 ms, flip angle = 15 degrees, 256 x 256 matrix, 1 acquisition. The 64-80 mm volume along the axial plane was divided so that an actual 1-mm thickness was excited. In post-processing, the maximum-intensity projection was employed on the axial plane 0 degrees-90 degrees (15 degrees interval). In the various conditions, the results obtained with MRA were correlated and compared with MRI findings. MRA provided useful additional information in 27.4% of cases in the study of aneurysms, arteriovenous malformations, vascular occlusion and dolichobasilar arteries, as well as in the follow-up of these lesions. MRA is currently suggested in the evaluation of cerebral circulation and is considered a complementary technique to MRI. MRA is also to be used preliminary to angiography.