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AJNR - American Journal of Neuroradiology

Published ahead of print on October 8, 2008
doi: 10.3174/ajnr.A1302

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American Journal of Neuroradiology 30:46-52, January 2009
© 2009 American Society of Neuroradiology

HEAD & NECK

High-Resolution 3T MR Angiography of the Carotid Arteries: Comparison of Manual and Semiautomated Quantification of Stenosis

R. Habibi^a, M.M. Lell^a, R. Steiner^c, S.G. Ruehm^a, J.W. Sayre^a,b, K. Nael^a and J.P. Finn^a

^a Department of Radiological Sciences, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, Calif
^b Department of Biostatistics, UCLA School of Public Health, Los Angeles, Calif
^c Department of Radiology, University Erlangen, Erlangen, Germany

Please address correspondence to: Reza Habibi, MD, Department of Radiology, David Geffen School of Medicine at UCLA, Peter V. Ueberroth Bldg, Ste 3371, 10945 Le Conte Ave, Los Angeles, CA 90095; e-mail: Rhabibi{at}mednet.ucla.edu

BACKGROUND AND PURPOSE: High-resolution contrast-enhanced MR angiography (CE-MRA) acquired at 3T exquisitely depict carotid artery (CA) stenosis. In this study, we examined the agreement of different vessel-analysis tools with manual quantitative measurement by 2 readers using CE-MRA data.

MATERIALS AND METHODS: Three vessel tools determining the trajectory of the vessel of interest and, subsequently, the vessel dimensions were tested against manual measurements. Diameter and area stenoses were calculated. CE-MRA data of 32 patients with CA stenosis were evaluated. The agreement between different measurements was assessed with statistics after categorizing stenosis (<25%, 25%–49%, 50%–69%, 70%–99%, and 100%).

RESULTS: The mean grades of stenosis based on diameter measurements were 59% (readers) and 60%/56%/59% based on the analysis with tools A/B/C (P = 0.2–0.7). values for agreement between readers and the vessel tools were 0.73/0.77/0.77 (tools A/B/C for all CAs) and 0.66/0.74/0.75 (for the symptomatic side). The mean grades of stenoses based on area measurements for tools A/B/C were 68%/63%/69% versus 58% for readers. Values from readers differed significantly from those for tools A and C (P < 0.01). values for agreement between readers and the vessel tools were 0.66/0.55/0.64 (for all CAs) and 0.53/0.44/0.57 (for the symptomatic side).

CONCLUSIONS: The automated approach allows accurate assessment of vessel dimensions in MRA images at least for diameter measurements according to the North American Symptomatic Carotid Endarterectomy Trial criteria.