Contrast-enhanced intracranial 3D MR angiography (CE-MRA) in assessing arterial stenoses and aneurysms

Purpose: The aim of this study was to evaluate the diagnostic potential of CE-MR angiography in intracranial arterial stenoses and aneurysms. Material and Methods: Thirteen patients with intracranial arterial stenoses and ten patients with aneurysms, including 6 cases with GDC coil-occluded aneurysms, were examined by both 3 D TOF-MR angiography and CE-MR angiography. In cases of stenoocclusive diseases colour-coded duplex sonography and in cases of aneurysms arterial digital subtraction angiography served as reference method. Results: Both TOF-MRA and CE-MRA could well depict filiform stenosis. In contrast to TOF-MRA, CE-MRA did not show any false positive stenosis or occlusion in regions of turbulent or slow blood flow. Stenoses of the medial cerebral artery could not be graded sufficiently by CE-MRA. In aneurysms the parent vessel was better shown by TOF-MRA. CE-MRA, however, more sensitively detected reperfusion in GDC coil-occluded aneurysms. Conclusion: Stenoses of small vessels were graded less exactly by CE-MRA than by TOF-MRA due to lower spatial resolution. CE-MRA, however, seems to be superior in regions of turbulent or slow blood flow. CE-MRA also offers advantages in follow-up examinations of coil-occluded aneurysms.