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Selective MR angiography and intracranial collateral blood flow
G Fürst1, H Steinmetz, H Fischer
1Institute of Diagnostic Radiology, Heinrich Heine University, Düsseldorf, Germany.
Journal of Computer Assisted Tomography
|March 1, 1993
Summary
Magnetic Resonance Angiography (MRA) effectively visualizes the circle of Willis's collateral flow in patients with carotid stenosis. This noninvasive technique accurately identifies anatomical variants and hemodynamic significance.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- High-grade carotid stenosis or occlusion compromises cerebral blood flow.
- Collateral circulation via the circle of Willis is crucial for maintaining brain perfusion.
- Noninvasive methods are needed to assess collateral pathways.
Purpose of the Study:
- To evaluate the utility of MR angiography (MRA) in assessing collateral flow dynamics and anatomy of the circle of Willis.
- To compare selective and nonselective MRA with established diagnostic methods.
Main Methods:
- Selective and nonselective MRA of cerebral arteries were performed in 45 patients.
- Presaturation techniques were used to isolate specific arterial territories.
- Results were compared against transcranial Doppler ultrasonography and intraarterial angiography (gold standard).
Main Results:
- Selective MRA showed high sensitivity (95-97%) for detecting collateral flow via communicating arteries.
- Nonselective MRA achieved 100% sensitivity in identifying specific anatomical variants.
- MRA visualization of the posterior communicating artery correlated with pathological collateral flow.
Conclusions:
- Selective and nonselective MRA are powerful noninvasive tools for demonstrating collateral circulation.
- MRA accurately identifies hemodynamically relevant anatomical variants of the circle of Willis.
- MRA enhances the assessment of cerebrovascular compensation mechanisms.