Detection of Intracranial Atherosclerotic Steno-Occlusive Disease with 3D Time-of-Flight Magnetic Resonance Angiography with Sensitivity Encoding at 3T
C.G. Choia,
D.H. Leea,
J.H. Leea,
H.W. Pyuna,
D.W. Kangb,
S.U. Kwonb,
J.K. Kimc,
S.J. Kima and
D.C. Suha
a Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
b Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
c Department of Radiology, Veterans Hospital, Seoul, Republic of Korea
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Fig 1. A 61-year-old male patient with dysarthria.
A, 3D TOF-MRA shows a segmental high-grade stenosis (white arrow) at the cavernous segment of the distal ICA.
B, DSA lateral view reveals almost identical features of stenosis (black arrow) at the corresponding location.
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Fig 2. A 70-year-old female patient with involuntary movement of the left side.
A, 3D TOF-MRA shows a flow void (white arrow) in the proximal portion of the right middle cerebral artery with visible distal branches.
B, DSA anteroposterior view reveals a focal high-degree stenosis (black arrow) at the corresponding location.
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Fig 3. A 69-year-old male patient with dizziness.
A, 3D TOF-MRA shows a focal high-grade stenosis (white arrow) at the proximal portion of the basilar trunk.
B, DSA oblique view also shows a focal high-grade stenosis (black arrow) at the corresponding location.
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Fig 4. A 60-year-old female patient with left side weakness (enrollment number 43 in Table 4).
A, 3D TOF-MRA shows a flow void (white arrow) in the proximal portion of left MCA with visible distal branches.
B, DSA oblique view reveals a focal low-degree stenosis at the corresponding location (black arrow, measured as 40%).
C, Retrospective review of the axial source images also shows a high-grade stenosis at the corresponding location. This type of overestimation may be caused by the turbulent flow and intravoxel phase dispersion within the proximal MCA stenosis close to the distal ICA bifurcation. This patient had a near occlusion of the right MCA that was responsible for her symptoms (not presented).
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Fig 5. A 61-year-old female patient with left side weakness (enrollment number 10 in Table 4).
A, 3D TOF-MRA shows a faint flow signal intensity along the course of the right ICA (white arrows). Both readers suspected high-grade stenosis in the petrocavernous segment of the ICA.
B, Lateral view, an early phase of DSA, reveals a severe stenosis of the proximal ICA bulb portion (black arrow) with early filling of the external carotid artery.
C, Late-phase DSA shows slow filling and decreased diameter of the petrocavernous segment, compatible with near occlusion of the ICA. Supraclinoidal segment of the distal ICA is filling from the ipsilateral posterior communicating artery (not presented).
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