Supraaortic Arteries: Contrast-enhanced MR Angiography at 3.0 T—Highly Accelerated Parallel Acquisition for Improved Spatial Resolution over an Extended Field of View

Purpose: To prospectively use 3.0-T breath-hold high-spatial-resolution contrast material–enhanced magnetic resonance (MR) angiography with highly accelerated parallel acquisition to image the supraaortic arteries of patients suspected of having arterial occlusive disease.

Materials and Methods: Institutional review board approval and written informed consent were obtained for this HIPAA-compliant study. Eighty patients (44 men, 36 women; age range, 44–90 years) underwent contrast-enhanced MR angiography of the head and neck at 3.0 T with an eight-channel neurovascular array coil. By applying a generalized autocalibrating partially parallel acquisition algorithm with an acceleration factor of four, high-spatial-resolution (0.7 × 0.7 × 0.9 mm = 0.44-mm3 voxels) three-dimensional contrast-enhanced MR angiography was performed during a 20-second breath hold. Two neuroradiologists evaluated vascular image quality and arterial stenoses. Interobserver variability was tested with the κ coefficient. Quantitation of stenosis at MR angiography was compared with that at digital subtraction angiography (DSA) (n = 13) and computed tomographic (CT) angiography (n = 12) with Spearman rank correlation coefficient (Rs).

Results: Arterial stenoses were detected with contrast-enhanced MR angiography in 208 (reader 1) and 218 (reader 2) segments, with excellent interobserver agreement (κ = 0.80). There was a significant correlation between contrast-enhanced MR angiography and CT angiography (Rs = 0.95, reader 1; Rs = 0.87, reader 2) and between contrast-enhanced MR angiography and DSA (Rs = 0.94, reader 1; Rs = 0.92, reader 2) for the degree of stenosis. Sensitivity and specificity of contrast-enhanced MR angiography for detection of arterial stenoses greater than 50% were 94% and 98% for reader 1 and 100% and 98% for reader 2, with DSA as the standard of reference. Vascular image quality was sufficient for diagnosis or excellent for 97% of arterial segments evaluated.

Conclusion: By using highly accelerated parallel acquisition, the described 3.0-T contrast-enhanced MR angiographic protocol enabled visualization and characterization of the majority of supraaortic arteries, with diagnostic or excellent image quality (97% of arterial segments) and diagnostic values comparable with those obtained by using CT angiography and DSA for detection of arterial stenoses.

© RSNA, 2007


  • 1 Hankey GJ, Warlow CP, Sellar RJ. Cerebral angiographic risk in mild cerebrovascular disease. Stroke 1990; 21: 209–222. Crossref, MedlineGoogle Scholar
  • 2 Heiserman JE, Dean BL, Hodak JA, et al. Neurologic complications of cerebral angiography. AJNR Am J Neuroradiol 1994;15:1401–1407. MedlineGoogle Scholar
  • 3 American College of Radiology. The ACR practice guideline for the performance of diagnostic cervicocerebral angiography in adults. Reston, Va: American College of Radiology, 2005; 57–70. Google Scholar
  • 4 Marcus CD, Ladam-Marcus VJ, Bigot JL, Clement C, Baehrel B, Menanteau BP. Carotid arterial stenosis: evaluation at CT angiography with the volume-rendering technique. Radiology 1999;211:775–780. LinkGoogle Scholar
  • 5 Berg M, Zhang Z, Ikonen A, et al. Multi-detector row CT angiography in the assessment of carotid artery disease in symptomatic patients: comparison with rotational angiography and digital subtraction angiography. AJNR Am J Neuroradiol 2005;26:1022–1034. MedlineGoogle Scholar
  • 6 Randoux B, Marro B, Koskas F, et al. Carotid artery stenosis: prospective comparison of CT, three-dimensional gadolinium-enhanced MR, and conventional angiography. Radiology 2001;220:179–185. LinkGoogle Scholar
  • 7 Josephson SA, Bryant SO, Mak HK, Johnston SC, Dillon WP, Smith WS. Evaluation of carotid stenosis using CT angiography in the initial evaluation of stroke and TIA. Neurology 2004;63:457–460. Crossref, MedlineGoogle Scholar
  • 8 Remonda L, Senn P, Barth A, Arnold M, Lovblad KO, Schroth G. Contrast-enhanced 3D MR angiography of the carotid artery: comparison with conventional digital subtraction angiography. AJNR Am J Neuroradiol 2002;23:213–219. MedlineGoogle Scholar
  • 9 Leclerc X, Gauvrit JY, Nicol L, Pruvo JP. Contrast-enhanced MR angiography of the craniocervical vessels: a review. Neuroradiology 1999;41:867–874. Crossref, MedlineGoogle Scholar
  • 10 Carr JC, Ma J, Desphande V, Pereles S, Laub G, Finn JP. High-resolution breath-hold contrast-enhanced MR angiography of the entire carotid circulation. AJR Am J Roentgenol 2002;178:543–549. Crossref, MedlineGoogle Scholar
  • 11 Randoux B, Marro B, Koskas F, Chiras J, Dormont D, Marsault C. Proximal great vessels of aortic arch: comparison of three-dimensional gadolinium-enhanced MR angiography and digital subtraction angiography. Radiology 2003;229:697–702. LinkGoogle Scholar
  • 12 Sodickson DK, McKenzie CA, Li W, Wolff S, Manning WJ, Edelman RR. Contrast-enhanced 3D MR angiography with simultaneous acquisition of spatial harmonics: a pilot study. Radiology 2000;217:284–289. LinkGoogle Scholar
  • 13 Pruessmann KP, Weiger M, Scheidegger MB, Boesiger P. SENSE: sensitivity encoding for fast MRI. Magn Reson Med 1999;42:952–962. Crossref, MedlineGoogle Scholar
  • 14 Griswold MA, Jakob PM, Heidemann RM, et al. Generalized autocalibrating partially parallel acquisitions (GRAPPA). Magn Reson Med 2002;47:1202–1210. Crossref, MedlineGoogle Scholar
  • 15 Pruessmann KP. Parallel imaging at high field strength: synergies and joint potential. Top Magn Reson Imaging 2004;15:237–244. Crossref, MedlineGoogle Scholar
  • 16 Landis JR, Koch GG. An application of hierarchical kappa-type statistics in the assessment of majority agreement among multiple observers. Biometrics 1977;33:363–374. Crossref, MedlineGoogle Scholar
  • 17 Leclerc X, Nicol L, Gauvrit JY, Le Thuc V, Leys D, Pruvo JP. Contrast-enhanced MR angiography of supraaortic vessels: the effect of voxel size on image quality. AJNR Am J Neuroradiol 2000;21:1021–1027. MedlineGoogle Scholar
  • 18 Willinek WA, von Falkenhausen M, Born M, et al. Noninvasive detection of steno-occlusive disease of the supra-aortic arteries with three-dimensional contrast-enhanced magnetic resonance angiography: a prospective, intra-individual comparative analysis with digital subtraction angiography. Stroke 2005;36:38–43. Crossref, MedlineGoogle Scholar
  • 19 Phan T, Huston J 3rd, Bernstein MA, Riederer SJ, Brown RD Jr. Contrast-enhanced magnetic resonance angiography of the cervical vessels: experience with 422 patients. Stroke 2001;32:2282–2286. Crossref, MedlineGoogle Scholar
  • 20 Cloft HJ, Murphy KJ, Prince MR, Brunberg JA. 3D gadolinium-enhanced MR angiography of the carotid arteries. Magn Reson Imaging 1996;14:593–600. Crossref, MedlineGoogle Scholar
  • 21 Rouleau PA, Huston J 3rd, Gilbertson J, Brown RD Jr, Meyer FB, Bower TC. Carotid artery tandem lesions: frequency of angiographic detection and consequences for endarterectomy. AJNR Am J Neuroradiol 1999;20:621–625. MedlineGoogle Scholar
  • 22 Eliasziw M, Streifler JY, Fox AJ, Hachinski VC, Ferguson GG, Barnett HJ. Significance of plaque ulceration in symptomatic patients with high-grade carotid stenosis. North American Symptomatic Carotid Endarterectomy Trial. Stroke 1994;25:304–308. Google Scholar
  • 23 Yang CW, Carr JC, Futterer SF, et al. Contrast-enhanced MR angiography of the carotid and vertebrobasilar circulations. AJNR Am J Neuroradiol 2005;26:2095–2101. MedlineGoogle Scholar
  • 24 Fain SB, Riederer SJ, Bernstein MA, Huston J 3rd. Theoretical limits of spatial resolution in elliptical-centric contrast-enhanced 3D-MRA. Magn Reson Med 1999;42:1106–1116. Crossref, MedlineGoogle Scholar
  • 25 Huston J 3rd, Fain SB, Wald JT, et al. Carotid artery: elliptic centric contrast-enhanced MR angiography compared with conventional angiography. Radiology 2001;218:138–143. LinkGoogle Scholar
  • 26 Nederkoorn PJ, Elgersma OE, van der Graaf Y, Eikelboom BC, Kappelle LJ, Mali WP. Carotid artery stenosis: accuracy of contrast-enhanced MR angiography for diagnosis. Radiology 2003;228:677–682. LinkGoogle Scholar
  • 27 Willinek WA, Gieseke J, Conrad R, et al. Randomly segmented central k-space ordering in high-spatial-resolution contrast-enhanced MR angiography of the supraaortic arteries: initial experience. Radiology 2002;225:583–588. LinkGoogle Scholar
  • 28 Sodickson DK, Manning WJ. Simultaneous acquisition of spatial harmonics (SMASH): fast imaging with radiofrequency coil arrays. Magn Reson Med 1997;38:591–603. Crossref, MedlineGoogle Scholar
  • 29 Wiesinger F, Boesiger P, Pruessmann KP. Electrodynamics and ultimate SNR in parallel MR imaging. Magn Reson Med 2004;52:376–390. Crossref, MedlineGoogle Scholar
  • 30 Ohliger MA, Grant AK, Sodickson DK. Ultimate intrinsic signal-to-noise ratio for parallel MRI: electromagnetic field considerations. Magn Reson Med 2003;50:1018–1030. Crossref, MedlineGoogle Scholar
  • 31 Campeau NG, Huston J 3rd, Bernstein MA, Lin C, Gibbs GF. Magnetic resonance angiography at 3.0 Tesla: initial clinical experience. Top Magn Reson Imaging 2001;12:183–204. Crossref, MedlineGoogle Scholar
  • 32 Willinek WA, Born M, Simon B, et al. Time-of-flight MR angiography: comparison of 3.0-T imaging and 1.5-T imaging—initial experience. Radiology 2003;229:913–920. LinkGoogle Scholar
  • 33 Nael K, Michaely HJ, Villablanca P, Salamon N, Laub G, Finn JP. Time-resolved contrast enhanced magnetic resonance angiography of the head and neck at 3.0 Tesla: initial results. Invest Radiol 2006;41:116–124. Crossref, MedlineGoogle Scholar
  • 34 Weiger M, Pruessmann KP, Leussler C, Roschmann P, Boesiger P. Specific coil design for SENSE: a six-element cardiac array. Magn Reson Med 2001;45:495–504. Crossref, MedlineGoogle Scholar
  • 35 de Zwart JA, Ledden PJ, van Gelderen P, Bodurka J, Chu R, Duyn JH. Signal-to-noise ratio and parallel imaging performance of a 16-channel receive-only brain coil array at 3.0 Tesla. Magn Reson Med 2004;51:22–26. Crossref, MedlineGoogle Scholar
  • 36 Neimatallah MA, Chenevert TL, Carlos RC, et al. Subclavian MR arteriography: reduction of susceptibility artifact with short echo time and dilute gadopentetate dimeglumine. Radiology 2000;217:581–586. LinkGoogle Scholar

Article History

Published in print: 2007