Improved selective visualization of internal and external carotid artery in 4D-MR angiography based on
Makoto Obara1, Osamu Togao2, Michael Helle3
1Philips Japan Ltd, Philips Building, 13-37 Kohnan 2-chome, Minato-ku, Tokyo, 108-8507, Japan.
Purpose:
Four-dimensional magnetic resonance angiography (4D-MRA) based on super-selective pseudo-continuous arterial spin labeling, combined with Keyhole and View-sharing (4D-S-PACK) was introduced for scan-accelerated vessel-selective 4D-MRA. Label selectivity and visualization effectiveness were assessed.
Methods:
Nine healthy volunteers were included in the study. The label selectivity for the imaging of internal carotid artery (ICA) and external carotid artery (ECA) circulation was assessed qualitatively. The contrast-to-noise ratio (CNR) in 4D-S-PACK was measured in four middle cerebral artery (MCA) and superficial temporal artery (STA) segments and compared with that in contrast-inherent inflow-enhanced multi-phase angiography combined with the vessel-selective arterial spin labeling technique (CINEMA-select). Vessel-selective arterial visualization in 4D-S-PACK was assessed qualitatively in a patient with dural arteriovenous fistula and compared with digital subtraction angiography (DSA) and non-vessel selective 4D-PACK.
Results:
4D-S-PACK vessel selectivity was judged to be at a clinically acceptable level in all cases except one ECA-targeted label. The CNR was significantly higher using 4D-S-PACK compared with CINEMA-select in MCA and STA peripheral segments (p < 0.001). In patient examination, territorial flow visualization in feeding artery and draining vein circulation on 4D-S-PACK were comparable with that on DSA and the identification of such responsible vessels was easier on 4D-S-PACK than on 4D-PACK.
Conclusion:
4D-S-PACK showed high vessel-selectivity and higher visualization effectiveness compared with CINEMA-select. One clinical case was performed and ICA and ECA territorial flow was successfully visualized separately, suggesting clinical usefulness.
