Measurement of internal carotid artery stenosis from source MR angiograms

Abstract

Purpose: To determine whether interpretation of internal carotid artery (ICA) stenosis from source partitions is more accurate than interpretation from maximum-intensity projections (MIPs) from three-dimensional (3D) time-of-flight (TOF) magnetic resonance (MR) angiography.

Materials and methods: The percentage of diameter ICA stenosis was measured on source images and MIPs from sagittal (n = 150) and transverse (n = 140) 3D TOF MR angiography. Measurements were compared with those from conventional angiography.

Results: Sensitivity and specificity for distinguishing 70%-99% stenosis were 96% and 78%, respectively, for sagittal MIPs, 88% and 90% for sagittal source images, 92% and 86% for transverse MIPs, and 92% and 95% for transverse source images. Areas under the receiver operating characteristic curves statistically significantly increased (P < .05) with interpretation from source images. Complete loss of intravascular signal was not encountered on source partitions except within a greater than 85% stenosis.

Conclusion: Interpretation of source partitions rather than MIPs reduces the tendency for overestimation of stenosis with MR angiography and improves the specificity for discriminating 70%-99% stenosis.