Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Ishimaru, H. Articles by Uetani, M. Search for Related Content PubMed PubMed Citation Articles by Ishimaru, H. Articles by Uetani, M.

American Journal of Neuroradiology 28:923-926, May 2007
© 2007 American Society of Neuroradiology

BRAIN

Accuracy of Pre- and Postcontrast 3D Time-of-Flight MR Angiography in Patients with Acute Ischemic Stroke: Correlation with Catheter Angiography

H. Ishimaru^a, M. Ochi^c, M. Morikawa^d, H. Takahata^b, Y. Matsuoka^a, T. Koshiishi^a, T. Fujimoto^a, A. Egawa^a, K. Mitarai^a, T. Murakami^d and M. Uetani^d

^a Department of Radiology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
^b Department of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Omura, Japan
^c Department of Radiology, Nagasaki-Kita Hospital, Nagasaki, Japan
^d Department of Radiology, Nagasaki University Hospital, Nagasaki, Japan

Please address correspondence to Hideki Ishimaru, MD, Department of Radiology, National Hospital Organization Nagasaki Medical Center, 2–1001-1 Kubara, Omura 856-8562, Japan; e-mail: ishimaruh{at}nmc.hosp.go.jp

BACKGROUND AND PURPOSE: 3D time-of-flight (TOF) MR angiography (MRA) is insensitive to slowflow; however, the use of MR imaging contrast agents helps to visualize slow-flow vessels and avoids overestimation of vascular occlusion. The purpose of this study was to correlate pre- and postcontrast 3D TOF MRA with the results of conventional angiography during endovascular reperfusion therapy and to determine the accuracy of postcontrast 3D TOF MRA.

MATERIALS AND METHODS: Thirteen patients who underwent endovascular reperfusion therapy for acute ischemic stroke were retrospectively analyzed. MR imaging techniques included single-slab 3D TOF MRA with and without contrast, as well as perfusion-weighted imaging. Angiography during reperfusion therapy was used as a standard of reference. Affected arteries were divided into segments either proximal or distal to the lesion, and pre- and postcontrast MRA signals were graded as absent, diminished or narrowed, or normal.

RESULTS: In 2 of 5 patients with arterial stenosis and 6 of 8 patients with complete occlusion, MRA signal intensity proximal to each lesion was absent, indicating a proximal pseudo-occlusion on precontrast MRA. Postcontrast MRA demonstrated an arterial signal intensity proximal to the stenotic or occlusive lesions in all 13 patients. Arterial signal intensity distal to the occlusion was identified on postcontrast MRA in 7 of 8 patients having complete occlusion, and the extent of occlusion on postcontrast MRA was similar to results of conventional angiography.

CONCLUSION: In this small series, postcontrast 3D TOF MRA more accurately delineated the extent of stenotic or occlusive arterial lesions than precontrast MRA.