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AJNR - American Journal of Neuroradiology

Published ahead of print on July 17, 2008
doi: 10.3174/ajnr.A1179

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MR Imaging: Influence of Imaging Technique and Postprocessing on Measurement of Internal Carotid Artery Stenosis

F. Runck^a,c, R.P. Steiner^b, W.A. Bautz^c and M.M. Lell^c

^a Department of Radiology and Neuroradiology, Klinikum Augsburg, Augsburg, Germany
^b Department of Sports and Rehabilitation Medicine, University of Ulm, Ulm, Germany
^c Institute of Radiology, University Erlangen-Nuremberg, Erlangen, Germany

View larger version (16K): [in this window] [in a new window]   Fig 1. Comparison of differences in stenosis values between the observers. All lines indicating the 95% CI cross the zero line. This shows that observers do not differ significantly in the measurement of ICA stenosis. obs indicates observer; VR, volume-rendering.

View larger version (17K): [in this window] [in a new window]   Fig 2. Comparison between TOF-MPR and TOF-MIP shows the smallest deviation, and comparison between CE-MPR and CE volume-rendering (VR) shows the highest deviation between ICA stenosis values. Differences are displayed by means of scatterplots (left row) and Bland-Altman plots (right row). CIs of the difference in stenosis values are given as gray bands.

View larger version (23K): [in this window] [in a new window]   Fig 3. Comparison of techniques by differences between stenosis values. Pairs of techniques that cross the zero line are not considered significantly different. ICA stenosis values differ significantly between CE-MPR and CE volume-rendering (VR).

View larger version (113K): [in this window] [in a new window]   Fig 4. Stenosis of the right ICA. A, An overview with the CE-MIP method. Enlarged pictures with CE-MIP (B) and CE volume-rendering (C) show local signal-intensity loss with distal enhancement, but residual signal intensity is detectable with TOF-MRA (D, TOF-MIP; E, TOF volume-rendering) and CE-MPR (F, G) at the site of minimal lumen (arrow). With TOF-MRA (D, E), signal intensity is fading at the edge of the scan volume, resulting in artificial lumen reduction.