Abstract
To test the feasibility of a quiescent interval low-angle shot (QLASH) sequence for nonenhanced MR angiography (MRA) of the extracranial carotid arteries at 3 T. The extracranial carotid arteries were imaged using QLASH MRA in healthy volunteers and patients with carotid arterial disease. The impact of three gating strategies (electrocardiographic-gated, pulse-gated, ungated) was evaluated. Image quality comparisons were made with respect to two-dimensional (2D) time of flight (TOF) MRA in volunteers and patients and contrast-enhanced MRA (CEMRA) in patients. Stenoses in patients were graded. QLASH MRA displayed the entire extent of the extracranial carotid arteries from their origins to the skull base. Electrocardiographic-gated QLASH MRA provided better image quality than pulse-gated and ungated implementations (P < 0.05) as well as 2D TOF MRA (P < 0.05). For grading of disease, QLASH MRA showed almost perfect agreement with CEMRA (Cohen's kappa = 0.86, P < 0.001) in a small cohort of patients with carotid arterial stenosis. QLASH MRA allows for evaluation of the entire extent of the extracranial carotid arteries with an average scan time of less than 6 min and better image quality than 2D TOF. Initial clinical results in this pilot study suggest that QLASH has potential utility as a nonenhanced alternative to CEMRA.
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