Abstract
Assessment of the cerebral blood flow (CBF) is crucial in the evaluation of patients with steno-occlusive diseases of the arteries supplying the brain for prediction of stroke risk. Quantitative phase contrast magnetic resonance angiography (PC-MRA) can be utilised for noninvasive quantification of CBF. The aim of this study was to validate in-vivo PC-MRA data by comparing them with colour-coded duplex (CCD) sonography in patients with cerebrovascular disease. We examined 24 consecutive patients (mean age 63 years) with stenosis of arteries supplying the brain using PC-MRA and CCD. Velocities were measured in a total of 209 stenotic and healthy arterial segments (110 extra- and 99 intracranial). Moderate to good correlation of velocity measurements between both techniques was observed in all six extracranial and five out of seven intracranial segments (p <0.05). Velocities measured with CCD sonography were generally higher than those obtained by PC-MRA. Reversal of flow direction was detected consistently with both methods. PC-MRA represents a robust, standardised magnetic resonance imaging technique for blood flow measurements within a reasonable acquisition time, potentially evolving as valuable work-up tool for more precise patient stratification for revascularisation therapy. PC-MRA overcomes relevant weaknesses of CCD in being not operator-dependent and not relying on a bone window to assess the intracranial arteries.
Highlights
Assessment of the cerebral blood flow (CBF) is an established strategy in the evaluation of patients with stenosis of brain-supplying arteries for assessment of haemodynamic effects [1] that may impact patient selection for revascularisation therapy [2]
The velocity measurements, the differences between phase contrast magnetic resonance angiography (PC-MRA) and colour-coded duplex (CCD), and their statistical significance are given in table 2 and displayed in figure 2
Flow velocities assessed with CCD were higher compared with PC-MRA, 42% in intracranial and 32% extracranial arteries
Summary
Assessment of the cerebral blood flow (CBF) is an established strategy in the evaluation of patients with stenosis of brain-supplying arteries for assessment of haemodynamic effects [1] that may impact patient selection for revascularisation therapy [2]. CBF assessment is used to determine the pattern and volume of collateral circulation in a compromised area [3] and for follow-up after revascularisation therapy. CCD sonography is an accurate tool for grading stenoses and for measuring CBF in large cerebral arteries [9] in daily clinical practice because of its wide availability. It is highly operator dependent and the assessment of the intracranial arteries may be limited by insufficient insonation windows [10]. In vitro experiments of PC-MRA in large and small ves-
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