American Journal of Neuroradiology 2009;30:46.
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American Journal of Neuroradiology
DOI 10.3174/ajnr.A1302
HEAD & NECK
High-Resolution 3T MR Angiography of the Carotid Arteries: Comparison of Manual and Semiautomated Quantification of Stenosis
From the Department of Radiological Sciences (R.H., M.M.L., S.G.R., J.W.S., K.N., J.P.F.), David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, Calif; Department of Biostatistics (J.W.S.), UCLA School of Public Health, Los Angeles, Calif; and Department of Radiology (R.S.), 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 = .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 < .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.