3 T contrast-enhanced magnetic resonance angiography for evaluation of the intracranial arteries - Comparison with time-of-flight magnetic resonance angiography and multislice computed tomography angiography

Purpose: We sought to prospectively evaluate the image quality and visualization of the intracranial arteries using high spatial resolution contrast-enhanced magnetic resonance angiography (CE-MRA) at 3 T and to perform intraindividual comparison with time-of-flight (TOF) MRA and multislice CT angiography (CTA). Materials and Methods: Twelve patients (5 men, 7 women, 37-71 years of age) with suspected cerebrovascular disease prospectively underwent MRA and CTA. MRA was performed on a 3 T MR system, including both 3-dimensional (3D) TOF (Voxel dimension: 0.6 X 0.5 X 0.9 mm(3) in 5 minutes and 40 seconds) and 3D CE-MRA (voxel dimension: 0.7 X 0.7 X 0.8 mm(3) in 20 seconds, using parallel acquisition with an acceleration factor of 4). CTA images were acquired on a 16-slice CT scanner (voxel dimension: 0.35 X 0.35 X 0.8 mm(3) in 17 seconds). The image quality and visualization of up to 26 intracranial arterial segments in each study was evaluated by 2 experienced radiologists. The arterial diameter for selective intracranial arteries was measured independently on each of the 3 studies, and statistical analysis and comparative correlation was performed. Results: A total of 312 arterial segments were examined by CE-MRA, TOF-MRA, and CTA. The majority of intracranial arteries (87%) were visualized with diagnostic image quality on CE-MRA with a significant correlation to TOF (R values = 0.84; 95% confidence interval 0.79-0.86, P < 0.0001), and to CTA (R values = 0.74; 95% confidence interavl 0.68-0.78, P < 0.001). The image quality for small intracranial arteries, including the anterior-inferior cerebellar artery, the posterior communicating artery, and the M3 branch of the middle cerebral artery, was significantly lower on CE-MRA compared with TOF and CTA (P < 0.03). There was a significant correlation for the dimensional measurements of arterial diameters at CE-MRA with TOF (r = 0.88, 95% confidence interval 0.81-0.93), and CTA (r = 0.83, 95% confidence interval 0.73-0.90). Conclusion: The described 3 T CE-MRA protocol, spanning from the cervical to the intracranial vessels, visualized and characterized the majority of intracranial arteries with image quality comparable with that obtained using TOF-MRA and CTA. Further clinical studies are required to establish the accuracy of the technique in a broader clinical setting.