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. 2014 May 12:10:16.
doi: 10.1186/1746-160X-10-16.

Whole body magnetic resonance angiography and computed tomography angiography in the vascular mapping of head and neck: an intraindividual comparison

Manuel Kramer, Siegfried A Schwab  1 , Emeka Nkenke, Achim Eller, Ferdinand Kammerer, Matthias May, João F Baigger, Michael Uder, Michael Lell
Affiliations

Whole body magnetic resonance angiography and computed tomography angiography in the vascular mapping of head and neck: an intraindividual comparison

Manuel Kramer et al. Head Face Med. .

Abstract

Introduction: The aim of the study was to compare the detectability of neck vessels with contrast enhanced magnetic resonance angiography (MRA) in the setting of a whole-body MRA and multislice computed tomography angiography (CTA) for preoperative vascular mapping of head and neck.

Methods: In 20 patients MRA was performed prior to microvascular reconstruction of the mandible with osteomyocutaneous flaps. CTA of the neck served as the method of reference.1.5 T contrast enhanced magnetic resonance angiograms were acquired to visualize the vascular structures of the neck in the setting of a whole-body MRA examination. 64-slice spiral computed tomography was performed with a dual-phase protocol, using the arterial phase images for 3D CTA reconstruction. Maximum intensity projection was employed to visualize MRA and CTA data. To retrieve differences in the detectability of vessel branches between MRA and CTA, a McNemar test was performed.

Results: All angiograms were of diagnostic quality. There were no statistically significant differences between MRA and CTA for the detection of branches of the external carotid artery that are relevant host vessels for microsurgery (p = 0.118). CTA was superior to MRA if all the external carotid artery branches were included (p < 0.001).

Conclusions: MRA is a reliable alternative to CTA in vascular mapping of the cervical vasculature for planning of microvascular reconstruction of the mandible. In the setting of whole-body MRA it could serve as a radiation free one-stop-shop tool for preoperative assessment of the arterial system, potentially covering both, the donor and host site in one single examination.

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Figures

Figure 1
Figure 1
Sagittal maximum intensity projection (MIP) reconstructions of computed tomography angiography (left) and subtracted magnetic resonance angiography (right) images of the cervical vasculature of a patient scheduled for microvascular reconstruction. 1: external carotid artery; 2: facial artery; 3: maxillary artery.
Figure 2
Figure 2
Sagittal maximum intensity projection (MIP) reconstructions of computed tomography angiography (left) and subtracted magnetic resonance angiography (right) images of a patient who suffers from tumor recurrence and who had previously received a microvascular graft with vessel anastomosis. The external carotid artery has been resected. Asterisk: graft vessel.
Figure 3
Figure 3
Coronal (MIP) of a subtracted whole-body MRA (two step contrast injection protocol, four overlapping field of views (FOVs)).
See this image and copyright information in PMC

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