• 대한방사선기술학회지:방사선기술과학
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• 제42권5호
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• pp.351-356
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• 2019

This study aimed to determine whether there was a difference in measurements between North American Symptomatic Carotid Endarterectomy Trial(NASCET) and Warfarin-Aspirin Symptomatic Intracranial Disease(WASID) methods that measure the middle cerebral artery stenosis in Digital Subtraction Angiography (DSA) and Magnetic Resonance Angiography (MRA). It involved 24 patients who had completed both DSA and MRA among patients with Middle Cerebral Artery (MCA) stenosis. The Middle Cerebral Artery (MCA) stenosis was measured using the NASCET and WASID methods through a retrospective analysis. For the NASCET and WASID methods, they performed measurements on normal blood vessels located far from and close to the stenosis, respectively. The mean value and standard deviation of the Digital Subtraction Angiography (DSA) measured by the NASCET method were 59.23% and 13.27%. On the other hand, those of the Digital Subtraction Angiography (DSA) measured by the WASID method were 66.64% and 12.47%. And, the mean value and standard deviation of the Magnetic Resonance Angiography (MRA) measured by the NASCET method were 49.82% and 12.06%. By contrast, those of the Magnetic Resonance Angiography (MRA) measured by the WASID method were 56.63% and 10.67%. All the p-values obtained by the Pearson and Spearman correlation tests in the Digital Subtraction Angiography (DSA) and the Magnetic Resonance Angiography (MRA) were <0.01. In conclusion, this study suggests that both the NASCET and WASID methods to measure the middle cerebral artery stenosis in the Digital Subtraction Angiography (DSA) and the Magnetic Resonance Angiography (MRA) can be used if they are not used interchangeably.

• Investigative Magnetic Resonance Imaging
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• 제25권4호
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• pp.209-217
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• 2021

Magnetic resonance angiography (MRA) plays an important role in accurate diagnosis and appropriate treatment planning for patients with arterial disease. Contrast-enhanced (CE) MRA is fast and robust, offering hemodynamic information of arterial flow, but involves the risk of a side effect called nephrogenic systemic fibrosis. Various non-contrast-enhanced (NCE) MRA techniques have been developed by utilizing the fact that arterial blood is moving fast compared to background tissues. NCE MRA is completely free of any safety issues, but has different drawbacks for various approaches. This review article describes basic principles of CE and NCE MRA techniques with a focus on how to generate angiographic image contrast from a pulse sequence perspective. Advantages, pitfalls, and key applications are also discussed for each MRA method.

• Anatomy and Cell Biology
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• 제56권4호
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• pp.469-473
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• 2023

Anomalies of anterior cerebral artery (ACA) include aplasia, hypoplasia and variations in number. Magnetic resonance angiography (MRA) is a non-invasive diagnostic technique for assessment of anomalies of cerebral arteries. The aim of the study was to determine the role of MRA in detection of variants of ACA in adults. This study is an observational retrospective study. This study included forty-nine adult cases (28 males and 21 females), mean age 48±12.9 SD with anomalies of ACA in MRA. Magnetic resonance imaging of the brain and MRA were done to all patients. Cerebral MRA and magnetic resonance images were evaluated for frequency and distribution of variants of anterior cerebral arteries, associated aneurysms and infarctions. Odds ratios (ORs) and relative risk were calculated to determine risk of occurrence of cerebral infarctions in patients with anomalies of ACA. Hypoplasia of ACA was the commonest anomaly of ACA (51% of cases). Risk of occurrence of cerebral infarctions was higher in cases with azygos variant (OR, 3.3; P=0.35) than in those with hypoplastic ACA (OR, 2; P=0.58). MRA was highly reliable in identification of different variants of ACA and concomitant vascular changes.

• Investigative Magnetic Resonance Imaging
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• 제22권4호
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• pp.266-271
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• 2018

A 66-year-old woman was referred for treatment of incidental detection of two intracranial aneurysms. Time-of-flight MR angiography (TOF MRA) revealed two aneurysms at the M1 segment of the right middle cerebral artery, and clinoid segment of left internal carotid artery, respectively. On digital subtraction angiography, there was a saccular aneurysm on the left internal carotid artery, but the other aneurysm was not detected on the right middle cerebral artery. Based on comprehensive review of imaging findings, organized thrombosed aneurysm was judged as the most likely diagnosis. In the presented report, magnetization transfer (MT) pulse to TOF MRA was used, to differentiate aneurysm-mimicking lesion on TOF MRA. We report that MT technique could be effective in differentiating true aneurysm, from possible T1 high signal artifact on TOF MRA.

• Journal of Korean Neurosurgical Society
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• 제37권4호
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• pp.263-267
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• 2005

Objective: Middle cerebral artery(MCA) anomalies are found incidentally on conventional cerebral angiography and magnetic resonance angiography(MRA). Our goal is to examine the incidence and types of MCA anomalies. Methods: Cerebral angiography was performed in 448 patients and MRA in 743; the patients had or were suspected to have cerebrovascular disease. The images were retrospectively evaluated for arterial anatomic anomalies. We use Teal's classification for definition of accessory and duplicated MCAs. Results: On cerebral angiography, the following anomalies of the MCA were found in seven patients: fenestration (n = 2, incidence = 0.45%); duplication (n = 2, incidence = 0.45%); accessory MCA (n = 2, incidence = 0.45%); aplasia (n = 1, incidence = 0.22%). On MRA, eight patients had anomalous MCAs : fenestration (n = 1, incidence = 0.14%); duplication (n= 6, incidence = 0.81%); accessory (n = 1, incidence = 0.14%). Conclusion: Although the clinical significance is not great, we find a relatively high incidence of anomalous MCAs. Knowledge and recognition of these MCA anomalies are useful and important in the interpretation of cerebral images and during neurosurgical procedures.

• Investigative Magnetic Resonance Imaging
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• 제22권1호
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• pp.71-77
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• 2018

Purpose: To develop a two-dimensional (2D) image-based respiratory motion correction technique for free-breathing coronary magnetic resonance angiography (MRA). Materials and Methods: The proposed respiratory navigator obtained aliased a 2D sagittal image from under-sampled k-space data and utilized motion correlation between the aliased images. The proposed navigator was incorporated into the conventional coronary MRA sequence including the diaphragm navigator and tested in three healthy subjects. Results: The delineation of major coronary arteries was significantly improved using the proposed 2D motion correction (S/I and A/P) compared to one-dimensional (S/I) correction using the conventional diaphragm navigator. Conclusion: The 2D image-based respiratory navigator was proposed for free-breathing coronary angiography and showed the potential for improving respiratory motion correction compared to the conventional 1D correction.

• Korean Journal of Radiology
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• 제25권6호
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• pp.575-588
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• 2024

Objective: Differentiating intracranial aneurysms from normal variants using CT angiography (CTA) or MR angiography (MRA) poses significant challenges. This study aimed to evaluate the efficacy of proton-density MRA (PD-MRA) compared to high-resolution time-of-flight MRA (HR-MRA) in diagnosing aneurysms among patients with indeterminate findings on conventional CTA or MRA. Materials and Methods: In this retrospective analysis, we included patients who underwent both PD-MRA and HR-MRA from August 2020 to July 2022 to assess lesions deemed indeterminate on prior conventional CTA or MRA examinations. Three experienced neuroradiologists independently reviewed the lesions using HR-MRA and PD-MRA with reconstructed voxel sizes of 0.25³ mm³ or 0.2³ mm³, respectively. A neurointerventionist established the gold standard with digital subtraction angiography. We compared the performance of HR-MRA, PD-MRA (0.25³-mm³ voxel), and PD-MRA (0.2³-mm³ voxel) in diagnosing aneurysms, both per lesion and per patient. The Fleiss kappa statistic was used to calculate inter-reader agreement. Results: The study involved 109 patients (average age 57.4 ± 11.0 years; male:female ratio, 11:98) with 141 indeterminate lesions. Of these, 78 lesions (55.3%) in 69 patients were confirmed as aneurysms by the reference standard. PD-MRA (0.25³-mm³ voxel) exhibited significantly higher per-lesion diagnostic performance compared to HR-MRA across all three readers: sensitivity ranged from 87.2%-91.0% versus 66.7%-70.5%; specificity from 93.7%-96.8% versus 58.7%-68.3%; and accuracy from 90.8%-92.9% versus 63.8%-69.5% (P ≤ 0.003). Furthermore, PD-MRA (0.25³-mm³ voxel) demonstrated significantly superior per-patient specificity and accuracy compared to HR-MRA across all evaluators (P ≤ 0.013). The diagnostic accuracy of PD-MRA (0.2³-mm³ voxel) surpassed that of HR-MRA and was comparable to PD-MRA (0.25³-mm³ voxel). The kappa values for inter-reader agreements were significantly higher in PD-MRA (0.820-0.938) than in HR-MRA (0.447-0.510). Conclusion: PD-MRA outperformed HR-MRA in diagnostic accuracy and demonstrated almost perfect inter-reader consistency in identifying intracranial aneurysms among patients with lesions initially indeterminate on CTA or MRA.

• Journal of Magnetics
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• 제20권1호
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• pp.40-46
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• 2015

This study investigated the accuracy of magnetic resonance angiography (MRA) and computed tomography angiography (CTA) in terms of reflecting the actual vascular length. Three-dimensional time of flight (3D TOF) MRA, 3D contrast-enhanced (CE) MRA, volume-rendering after CTA and maximum intensity projection were investigated using a flow model phantom with a diameter of 2.11 mm and area of $0.26cm^2$. 1.5 and 3.0 Tesla devices were used for 3D TOF MRA and 3D CE MRA. CTA was investigated using 16 and 64 channel CT scanners, and the images were transmitted and reconstructed by volume-rendering and maximum intensity projection, followed by conduit length measurement as described above. The smallest 3D TOF MRA measure was $2.51{\pm}0.12mm$ with a flow velocity of 40 cm/s using the 3.0 Tesla apparatus, and $2.57{\pm}0.07mm$ with a velocity of 71.5 cm/s using the 1.5 Tesla apparatus; both images were magnified from the actual measurement of 2.11 mm. The measurement with the 16 channel CT scanner was smaller ($3.83{\pm}0.37mm$) than the reconstructed image on maximum intensity projection. The images from CTA from examination apparatus and reconstruction technique were all larger than the actual measurement.

• Journal of Korean Neurosurgical Society
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• 제29권8호
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• pp.1063-1068
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• 2000

Objectives : To determine the contribution of cranial magnetic resonance angiography(MRA) for the evaluation of patients with ischemic cerebrovascular accident. Methods : Magnetic resonance image(MRI) and MRA studies performed on 34 patients with ischemic stroke were retrospectively reviewed with the clinical records. Results : There were 9 transient ischemic attacks and 25 completed strokes in our series. Twenty-three of 34 MRA examinations(68%) were positive for stenosis or occlusion. The distribution of stenotic or occlusive vascular lesions were correlated with the location of infarction in 22 of the 23 positive cases(96%). MRA provided additional information not obtained from the MRI in 19 cases(56%). Conclusions : Vascular lesions demonstrated on intracranial MRA show a high correlation with infarct distribution. MRA provided information adjunctive to conventional MRI in a majority of cases. We conclude that MRA is an important noninvasive component of the complete evaluation of ischemic stroke.

• Journal of Magnetics
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• 제22권2호
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• pp.234-237
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• 2017

This study is aimed to optimize a location of region of interest (ROI) in test bolus carotid contrast enhanced magnetic resonance angiography (CE-MRA) at 3.0T. A total of consecutive 270 patients with no cardiovascular and vessel diseases were selected. Patients underwent elliptical centric 3D CE-MRA with the test bolus technique to identify the individual arterial arrival time. Quantitative measurements were performed by drawing ROIs of $25mm^2$ and signal intensities (SI) were measured in the center of common carotid artery (CCA), internal carotid artery (ICA) and aortic arch (AA). As a result, ROIs located within AA showed a significantly clarified arterial peak and over three times increased SI, while no significant arterial peak time differences were observed compared to ROIs located within CCA. In conclusion, it was demonstrated that the aortic arch is the optimal position to locate ROI in test bolus images of the carotid CE-MRA.