[MR angiography in fibromuscular dysplasia of the cervical arteries]
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J Link1, J C Steffens, S Müller-Hülsbeck
1Klinik für Radiologische Diagnostik, Christian-Albrechts-Universität zu Kiel.
Purpose:
To determine 3-D time of flight MR angiography for evaluation of fibromuscular dysplasia in cervical vessels.
Material And Methods:
In 386 selective angiograms of cervical vessels fibromuscular dysplasia was revealed in 4 female patients in the age of 30-54 years. FMD was located in the carotid artery (n = 5) and in the vertebral artery (n = 2) with a total of 8 lesions.
Results:
6/8 of the lesions of the seven cervical vessels were located typically in the mid cervical portion of the vessels and 2/6 lesions were located in the atlas loop of the vertebral artery. 4 lesions showed moderate stenosis and 4 vessels showed only mild stenosis. These patterns which demonstrated the typical morphology of fibromuscular dysplasia with alternating irregular zones of widening and narrowing were evaluated well with MR angiography, the others were missed.
Conclusion:
MR angiography is suitable for detection of fibromuscular dysplasia when the characteristic pattern is combined with moderate stenosis of the vessel. Conventional angiography remains the standard of reference.
Insights
Three-dimensional time-of-flight MR angiography effectively detects fibromuscular dysplasia (FMD) in cervical vessels, particularly when moderate stenosis is present. Conventional angiography remains the gold standard for diagnosis.
Area of Science:
- Vascular Imaging
- Radiology
- Medical Diagnostics
Background:
- Fibromuscular dysplasia (FMD) is a non-atherosclerotic vascular disease affecting arteries.
- Cervical vessel involvement is common in FMD, necessitating accurate diagnostic methods.
Purpose of the Study:
- To evaluate the utility of 3-D time-of-flight MR angiography (TOF-MRA) for diagnosing fibromuscular dysplasia in the cervical arteries.
- To compare TOF-MRA findings with conventional angiography in patients with suspected FMD.
Main Methods:
- Retrospective analysis of 386 selective angiograms of cervical vessels.
- Identification of fibromuscular dysplasia in 4 female patients (age 30-54).
- Detailed analysis of 8 FMD lesions located in the carotid and vertebral arteries.
Main Results:
- TOF-MRA accurately visualized characteristic FMD patterns, including alternating zones of widening and narrowing.
- Lesions were predominantly located in the mid-cervical portion and atlas loop of vertebral arteries.
- Moderate and mild stenosis were observed in 4 lesions each; TOF-MRA performed better with moderate stenosis.
Conclusions:
- 3-D TOF-MRA is a suitable imaging modality for detecting fibromuscular dysplasia in cervical vessels, especially when moderate stenosis is present.
- The characteristic "string of beads" or "tassel" appearance aids in diagnosis.
- Conventional angiography remains the definitive standard for FMD diagnosis.