Document Detail

Time-of-flight MR angiography of carotid artery stenosis: does a flow void represent severe stenosis?
MedLine Citation:
PMID:  12427639     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Time-of-flight (TOF) magnetic resonance angiography (MRA) is commonly used to visualize the carotid arteries; however, flow void artifacts can appear. Our purpose was to determine the frequency and diagnostic meaning of flow voids by using real patient data, as part of a larger study of MRA compared with the criterion standard, digital subtraction angiography (DSA). METHODS: In 1997-2000, 390 consecutive patients with sonographic findings suggestive of carotid artery stenosis were included in this study. All patients subsequently underwent three-dimensional (3D) TOF MRA and conventional DSA. The frequency of flow void artifacts on 3D TOF MRA images were compared with stenosis measurements on DSA images. RESULTS: We recorded 107 flow voids (16%) during 3D TOF MRA of 662 carotid arteries. DSA images were available for comparison in 102 cases. The median percentage of stenosis in this subgroup of flow voids on MRA images was 80%, compared with measurements on DSA images according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria. Stenoses ranged from 36% to 100% (occlusion). Three flow voids (2.9%) were in the 0-49% range; 11 (10.8%), in the 50-69% range; and 86 (84.3%), in the 70-99% range. Two flow voids (2.0%) represented occlusions. The positive predictive value of a flow void artifact for the presence of severe (70-99%) stenosis was 84.3% (95% CI: 77.3%, 91.4%). CONCLUSION: Flow void artifacts represented severe stenosis in most of the arteries. According to our data, the assumption that flow voids on 3D TOF MRA images represent severe stenosis is justified.
Paul J Nederkoorn; Yolanda van der Graaf; Bert C Eikelboom; Aad van der Lugt; Lambertus W Bartels; Willem P T M Mali
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  23     ISSN:  0195-6108     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:    2002 Nov-Dec
Date Detail:
Created Date:  2002-11-12     Completed Date:  2003-03-12     Revised Date:  2008-02-14    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1779-84     Citation Subset:  IM    
Julius Center for Patient Oriented Research, University Medical Center Utrecht, the Netherlands.
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MeSH Terms
Aged, 80 and over
Angiography, Digital Subtraction
Blood Flow Velocity / physiology
Carotid Artery, Common / physiopathology,  radiography,  ultrasonography
Carotid Stenosis / diagnosis*,  physiopathology
Magnetic Resonance Angiography*
Middle Aged
Observer Variation
Predictive Value of Tests
Prospective Studies
Severity of Illness Index
Systole / physiology
Ultrasonography, Doppler, Duplex
Comment In:
AJNR Am J Neuroradiol. 2003 Nov-Dec;24(10):2120   [PMID:  14625247 ]
AJNR Am J Neuroradiol. 2003 Sep;24(8):1727; author reply 1727   [PMID:  13679300 ]

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