[Carotid bifurcation: angiography with magnetic resonance versus carotid angiography]

The reliability of Magnetic Resonance Angiography (MRA) was investigated in the study of stenosis and obstruction of carotid bifurcation; digital carotidography was the gold standard. Twenty-five consecutive patients with clinical suspicion of cerebrovascular insufficiency entered the study. MRA was performed with a 1.5 T superconductive magnet (Magnetom Siemens) and a linear head coil. The TOF 3D (FA 20 degrees, TR 30 ms, TE 7 ms) technique was applied. Images were acquired on the sagittal plane and rotated in postprocessing according to MIP on the z axis from 60 to 120 degrees (step 5). MRA exhibit 80.5% sensitivity, 96% specificity, 89.4% accuracy, 94.7% positive predictive value and 86.3% negative predictive value. When calculating the interrupted flow relative to hemodynamically significant stenoses (range 31%-occlusions), MRA sensitivity was 80.5%, specificity 100%, negative predictive value 86.3%, positive predictive value 94.7% and overall diagnostic accuracy 91.2%. MRA is to be considered a diagnostically reliable procedure in the study of carotid bifurcation and its diagnostic accuracy may even be increased in the future by the possible assessment of over- and underestimated cases.