Three-dimensional time-of-flight MR angiography and MR imaging versus conventional angiography in carotid artery dissections

A retrospective analysis comparing the three-dimensional time-of-flight MR angiography, MR imaging and transfemoral digital substraction angiography (DSA) in cases of carotid artery dissection was made. During a 2-year period, 12 cases (11 males and 1 female), aged between 16 and 60 years, were submitted to our Hospital with the symptoms of TIA, stroke or cranial nerve palsies and the suspicion of carotid dissection. Transfemoral angiograms were done in other Institutions, while the MRI and MRA were performed in our diagnostic center. Blind interpretation of MR and angiography images was made by two independent radiologists. MR angiography in combination with MR imaging was more accurate than conventional angiography in the diagnosis of carotid artery dissection. Respective sensitivity and specificity were 100% and 100% for MRI with MRA and 91.6% and 100% for conventional angiography. From the analysis of this small series, we can conclude that MR angiography in combination with MR imaging is a reliable noninvasive method for use in diagnosis of extracranial internal carotid artery dissection.