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AJNR - American Journal of Neuroradiology

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Feathering: Vertebral Artery Pseudostenosis with Elliptical Centric Contrast-Enhanced MR Angiography

J. Huston, III^a, M.A. Bernstein^a and S.J. Riederer^a

^a Department of Radiology, Mayo Clinic, Rochester, Minn

View larger version (146K): [in a new window]   Fig 1. A 46-year-old man with neck pain following trauma referred for MR angiography to exclude a dissection. 2D TOF demonstrates a widely patent left vertebral artery (A). MIP subvolume of the posterior circulation (B) shows an irregular possibly stenotic midleft vertebral artery that was initially felt to represent a dissection. Review of axial reformatted source images shows multiple small ring-shaped areas of signal intensity corresponding to small cervical vessels (arrow, C). The interference pattern created by these target patterns distorts the left vertebral artery resulting in ill-defined borders when compared with the right vertebral artery.

View larger version (173K): [in a new window]   Fig 2. A 52-year-old women with persistent neck pain. CE elliptical centric MR angiogram shows irregularity of both midvertebral arteries, right greater than left (A). Follow-up MR angiogram 1 year later with an earlier trigger time reduces the feathering artifact (B). Review of source images shows that the multiple interference patterns on the first examination (arrow, C) are less evident with the earlier triggering on the second examination (arrow, D). As a result the vertebral arteries are more clearly delineated on the second examination.