Prospective Evaluation of Carotid Artery Stenosis: Elliptic Centric Contrast-Enhanced MR Angiography and Spiral CT Angiography Compared with Digital Subtraction Angiography
Juan Alvarez-Lineraa,
Julián Benito-Leónb,
José Escribanoa,
Jorge Campolloc and
Ricardo Gestod
a Department of Neuroradiology, Rúber International Hospital, Madrid, Spain
b Service of Neurology, Móstoles General Hospital, Móstoles, Spain
c Department of Neuroradiology, University Hospital "Doce de Octubre," Madrid, Spain
d Service of Vascular Surgery, University Hospital "Doce de Octubre," Madrid, Spain
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FIG 1. Grade 1 stenosis of the left internal carotid artery.
A, Oblique DSA image shows minimal stenosis of the left internal carotid artery.
B, Elliptic centric contrast-enhanced MR angiogram, in the same projection as that of the DSA image, depicts a good correlation with DSA.
C, Spiral CT angiogram shows that the calcium distribution (type 1) does not preclude a good evaluation of the vessel.
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FIG 2. Grade 2 stenosis overestimated with elliptic centric contrast-enhanced MR angiography.
A, Oblique DSA image demonstrates a grade 2 stenosis in the left internal carotid artery.
B, Elliptic centric contrast-enhanced MR angiogram shows mild overestimation of the stenosis (grade 3).
C, Spiral CT angiogram shows good correlation with DSA.
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FIG 3. Grade 4 stenosis with good correlation in all techniques.
A, Oblique DSA image shows critical stenosis in the right internal carotid artery.
B, Elliptic centric contrast-enhanced MR angiogram depicts the same information.
C, Spiral CT angiogram shows a good correlation with the other imaging techniques. Notice a type 3 calcification in the wall of artery; however, it is sufficiently separated in the reconstruction image.
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FIG 4. Grade 2 stenosis overestimated with spiral CT angiography.
A, Oblique DSA image shows grade 2 stenosis in the left internal carotid artery.
B, Elliptic centric contrast-enhanced MR angiogram shows the same findings.
C and D, Spiral CT angiograms show type 4 calcification. In this case, the stenosis was overestimated (grade 3) because of the difficulty in separating calcium from the contrast material.
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