Gadolinium-enhanced 3D MRA of the aortic arch vessels the detection of atherosclerotic cerebrovascular occlusive disease

Glenn Krinsky, Menahem Maya, Neil Rofsky, Jonathan Lebowitz, Peter Kim Nelson, Michael Ambrosino, Evan Kaminer, Jay Earls, Lynette Masters, Gary Giangola, Andrew Litt, Jeffrey Weinreb

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Purpose: Our goal was to evaluate non-breath-hold Gd-enhanced 3D MR angiography (MRA) for the detection of atherosclerotic occlusive disease of the aortic arch vessels and to compare image quality with two breath-hold techniques. Method: One hundred sixty consecutive patients with known or clinically suspected atherosclerotic cerebrovascular occlusive disease underwent Gd-enhanced 3D MRA of the aortic arch and great vessels. One hundred twenty-six examinations were performed with the body coil after infusion of 40 ml of Gd-DTPA; 89 of these were performed without breath- holding and 37 were acquired during suspended respiration. Thirty-four examinations were performed in a body phased-array coil with breath-holding, a timing examination, and 20 ml of contrast agent by manual (n = 17) or power (n = 17) injection. Images were evaluated for the presence of blurring and ghosting artifacts and venous enhancement. Of the 27 patients who underwent non-breath-hold MRI and digital subtraction angiography (DSA), two readers blinded to the DSA results retrospectively evaluated the MRA examinations for the presence of occlusive disease of the innominate, carotid, subclavian, and vertebral arteries. DSA correlation was not evaluated for the 71 breath-hold studies. Results: Sensitivity and specificity for arch vessel occlusive disease with non-breath-hold MRA were 38 and 94% for Reader A and 38 and 95% for Reader B. Breath-holding significantly reduced blurting and ghosting artifacts (p < 0.001) when compared with non-breath-hold imaging, and use of 20 ml of contrast medium, with a timing examination, resulted in significantly less venous enhancement than seen with 40 ml (p < 0.001). Conclusion: Non-breath-hold Gd-enhanced 3D MRA is insensitive for detecting arch vessel occlusive disease. Breath-hold imaging, in conjunction with a timing examination and a lower dose of contrast agent, improves image quality, but further studies are needed to assess diagnostic accuracy.

Original languageEnglish (US)
Pages (from-to)167-178
Number of pages12
JournalJournal of Computer Assisted Tomography
Volume22
Issue number2
DOIs
StatePublished - 1998

Fingerprint

Cerebrovascular Disorders
Gadolinium
Thoracic Aorta
Angiography
Breath Holding
Digital Subtraction Angiography
Contrast Media
Artifacts
Brachiocephalic Trunk
Gadolinium DTPA
Subclavian Artery
Vertebral Artery
Carotid Arteries
Respiration
Sensitivity and Specificity
Injections

Keywords

  • Atherosclerosis
  • Blood vessels, cerebral
  • Blood vessels, occlusion
  • Brain, blood flow
  • Breath-holding
  • Magnetic resonance angiography (MRA)
  • Magnetic resonance imaging, three-dimensional (3D MRI)

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Gadolinium-enhanced 3D MRA of the aortic arch vessels the detection of atherosclerotic cerebrovascular occlusive disease. / Krinsky, Glenn; Maya, Menahem; Rofsky, Neil; Lebowitz, Jonathan; Nelson, Peter Kim; Ambrosino, Michael; Kaminer, Evan; Earls, Jay; Masters, Lynette; Giangola, Gary; Litt, Andrew; Weinreb, Jeffrey.

In: Journal of Computer Assisted Tomography, Vol. 22, No. 2, 1998, p. 167-178.

Research output: Contribution to journalArticle

Krinsky, G, Maya, M, Rofsky, N, Lebowitz, J, Nelson, PK, Ambrosino, M, Kaminer, E, Earls, J, Masters, L, Giangola, G, Litt, A & Weinreb, J 1998, 'Gadolinium-enhanced 3D MRA of the aortic arch vessels the detection of atherosclerotic cerebrovascular occlusive disease', Journal of Computer Assisted Tomography, vol. 22, no. 2, pp. 167-178. https://doi.org/10.1097/00004728-199803000-00003
Krinsky, Glenn ; Maya, Menahem ; Rofsky, Neil ; Lebowitz, Jonathan ; Nelson, Peter Kim ; Ambrosino, Michael ; Kaminer, Evan ; Earls, Jay ; Masters, Lynette ; Giangola, Gary ; Litt, Andrew ; Weinreb, Jeffrey. / Gadolinium-enhanced 3D MRA of the aortic arch vessels the detection of atherosclerotic cerebrovascular occlusive disease. In: Journal of Computer Assisted Tomography. 1998 ; Vol. 22, No. 2. pp. 167-178.
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AU - Maya, Menahem

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AU - Nelson, Peter Kim

AU - Ambrosino, Michael

AU - Kaminer, Evan

AU - Earls, Jay

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