High-resolution Contrast-enhanced MR Angiography Research Articles

Equilibrium-Phase High Spatial Resolution Contrast-Enhanced MR Angiography at 1.5T in Preoperative Imaging for Perforator Flap Breast Reconstruction

ObjectivesThe aim was (i) to evaluate the accuracy of equilibrium-phase high spatial resolution (EP) contrast-enhanced magnetic resonance angiography (CE-MRA) at 1.5T using a blood pool contrast agent for the preoperative evaluation of deep inferior epigastric artery perforator branches (DIEP), and (ii) to compare image quality with conventional first-pass CE-MRA.MethodsTwenty-three consecutive patients were included. All patients underwent preoperative CE-MRA to determine quality and location of DIEP. First-pass imaging after a single bolus injection of 10 mL gadofosveset trisodium was followed by EP imaging. MRA data were compared to intra-operative findings, which served as the reference standard.ResultsThere was 100% agreement between EP CE-MRA and surgical findings in identifying the single best perforator branch. All EP acquisitions were of diagnostic quality, whereas in 10 patients the quality of the first-pass acquisition was qualified as non-diagnostic. Both signal- and contrast-to-noise ratios were significantly higher for EP imaging in comparison with first-pass acquisitions (p<0.01).ConclusionsEP CE-MRA of DIEP in the preoperative evaluation of patients undergoing a breast reconstruction procedure is highly accurate in identifying the single best perforator branch at 1.5Tesla (T). Besides accuracy, image quality of EP imaging proved superior to conventional first-pass CE-MRA.

MR angiography of carotid artery aneurysms in a porcine model at 3 tesla: Comparison of two different macrocyclic gadolinium chelates and of dynamic and conventional techniques

To evaluate the differences in image quality of two macrocyclic gadolinium-based contrast agents, gadobutrol and gadoterate meglumine, using time-resolved, contrast-enhanced MR angiography (CE-MRA) in a porcine carotid artery aneurysm model and to compare image quality between dynamic and conventional, single acquisition CE-MRA. Bilateral carotid aneurysms were created surgically in this Institutional Animal Care and Use Committee approved study. Dynamic CE-MRA studies optimized for high temporal resolution were performed at 3 Tesla. Scans using equivalently dosed (on a per mmol basis) gadobutrol and gadoterate meglumine were compared qualitatively and quantitatively in terms of contrast-to-noise ratio (CNR). Higher spatial resolution dynamic and conventional CE-MRA were also compared. N = 16 aneurysms were assessed. Qualitative evaluation of dynamic CE-MRA scans demonstrated a preference for gadobutrol over gadoterate meglumine. Significantly higher aneurysm CNR was found with gadobutrol (133 ± 44) versus gadoterate meglumine, the latter at both equivalent and double injection rates (94 ± 35 and 102 ± 38). In a blinded assessment, conventional CE-MRA was preferred qualitatively when compared with dynamic CE-MRA. However, dynamic CE-MRA was generally capable of providing diagnostic image quality. Gadobutrol is preferred to gadoterate meglumine for high temporal resolution dynamic CE-MRA, a fact with important clinical implications for low dose CE-MRA protocols in patients at risk for nephrogenic systemic fibrosis. Conventional high resolution CE-MRA provides superior image quality when compared with dynamic CE-MRA.

High-Resolution 3T MR Angiography of the Carotid Arteries: Comparison of Manual and Semiautomated Quantification of Stenosis

High-resolution contrast-enhanced MR angiography (CE-MRA) acquired at 3T exquisitely depict carotid artery (CA) stenosis. In this study, we examined the agreement of different vessel-analysis tools with manual quantitative measurement by 2 readers using CE-MRA data. Three vessel tools determining the trajectory of the vessel of interest and, subsequently, the vessel dimensions were tested against manual measurements. Diameter and area stenoses were calculated. CE-MRA data of 32 patients with CA stenosis were evaluated. The agreement between different measurements was assessed with kappa statistics after categorizing stenosis (<25%, 25%-49%, 50%-69%, 70%-99%, and 100%). The mean grades of stenosis based on diameter measurements were 59% (readers) and 60%/56%/59% based on the analysis with tools A/B/C (P = 0.2-0.7). kappa values for agreement between readers and the vessel tools were 0.73/0.77/0.77 (tools A/B/C for all CAs) and 0.66/0.74/0.75 (for the symptomatic side). The mean grades of stenoses based on area measurements for tools A/B/C were 68%/63%/69% versus 58% for readers. Values from readers differed significantly from those for tools A and C (P < 0.01). kappa values for agreement between readers and the vessel tools were 0.66/0.55/0.64 (for all CAs) and 0.53/0.44/0.57 (for the symptomatic side). The automated approach allows accurate assessment of vessel dimensions in MRA images at least for diameter measurements according to the North American Symptomatic Carotid Endarterectomy Trial criteria.

3D Time-Resolved MR Angiography (MRA) of the Carotid Arteries with Time-Resolved Imaging with Stochastic Trajectories: Comparison with 3D Contrast-Enhanced Bolus-Chase MRA and 3D Time-Of-Flight MRA

Time-resolved MR angiography (MRA) offers the combined advantage of large anatomic coverage and hemodynamic flow information. We applied parallel imaging and time-resolved imaging with stochastic trajectories (TWIST), which uses a spiral trajectory to undersample k-space, to perform time-resolved MRA of the extracranial internal carotid arteries and compare it to time-of-flight (TOF) and high-resolution contrast-enhanced (HR) MRA. A retrospective review of 31 patients who underwent carotid MRA at 1.5T using TOF, time-resolved and HR MRA was performed. Images were evaluated for the presence and degree of ICA stenosis, reader confidence, and number of pure arterial frames attained with the TWIST technique. With a consensus interpretation of all sequences as the reference standard, accuracy for identifying stenosis was 90.3% for TWIST MRA, compared with 96.0% and 88.7% for HR MRA and TOF MRA, respectively. HR MRA was significantly more accurate than the other techniques (P < .05). TWIST MRA yielded datasets with high in-plane spatial resolution and distinct arterial and venous phases. It provided dynamic information not otherwise available. Mean diagnostic confidence was satisfactory or greater for TWIST in all patients. The TWIST technique consistently obtained pure arterial phase images while providing dynamic information. It is rapid, uses a low dose of contrast, and may be useful in specific circumstances, such as in the acute stroke setting. However, it does not yet have spatial resolution comparable with standard contrast-enhanced MRA.

Orthogonal measurement of thoracic aorta luminal diameter using ECG‐gated high‐resolution contrast‐enhanced MR angiography

To compare orthogonal measurements of the thoracic aortic luminal diameter to standard axial measurements within the same patient population using ECG-gated high-resolution contrast-enhanced MR angiography (CE-MRA). In all, 45 consecutive patients who had undergone CE-MRA for suspected disease of the thoracic aorta were evaluated retrospectively. Two diameter measurement techniques were performed for each patient's thoracic aorta: standard axial and orthogonal to the aorta. Seven anatomic locations along the thoracic aorta were used for measurement. The data obtained were compared using a paired, two-tailed t-test. We found that the aorta diameter measurements acquired from axial MRA images were significantly greater (P < 0.05) than those acquired from images orthogonal to the course of the aorta at six of seven anatomic sites. Overall, standard axial measurements were found to overestimate luminal diameter of the thoracic aorta by 0.24 cm (95% confidence interval [CI]: 0.14, 0.33) compared to orthogonal measurements. 13.3% of the patients were placed into a greater aorta size classification based on the axial versus the orthogonal measurements. Standard axial measurements can overestimate vessel size of the thoracic aorta. ECG-gated high-resolution CE-MRA can be used to measure orthogonal diameters of the thoracic aorta.

Initial experience of demonstrating hepatic artery in orthotopic liver transplanation candidates using high resolution contrast-enhanced MR angiography accelearated by generalized autocalibrating partial parallel acquisition

目的 探讨利用全局自动校准部分并行采集(GRAPPA)技术行肝动脉高分辨对比增强MR血管成像(CE-MRA)的可行性,评价其对肝动脉显示的价值.方法 对67例原位肝移植受体行GRAPPA三维CE-MRA检查,2名放射科医师独立评价肠系膜上动脉、肝总动脉、肝右动脉、肝左动脉、胃左动脉、胃十二肠动脉、第Ⅳ段肝动脉、右前肝动脉和右后肝动脉的显影质量并行Weighted Kappa分析,并采用4级评分共同评价肝动脉各级分支的显示情况,以手术结果为对照评估肝动脉系统解剖和变异.结果 2名医师对各段动脉显影评分有很好的一致性(Kappa值均＞0.75);39例达到肝左、右动脉远端分支4级水平,23例为肝左、右动脉3级水平,4例为肝固有动脉2级水平,1例为肝总动脉1级水平,平均显示级别为3.49.67例中53例正常肝动脉解剖和14例变异在高分辨率MRA图像中得到准确显示.结论 利用GRAPPA技术可获取高分辨CE-MRA肝动脉图像,并且可准确评估肝动脉解剖。

Utilizing generalized autocalibrating partial parallel acquisition (GRAPPA) to achieve high-resolution contrast-enhanced MR angiography of hepatic artery: initial experience in orthotopic liver transplantation candidates

Utilizing generalized autocalibrating partial parallel acquisition (GRAPPA) to achieve high-resolution contrast-enhanced MR angiography of hepatic artery: initial experience in orthotopic liver transplantation candidates

Quantitative Analysis of ECG-Gated High-Resolution Contrast-Enhanced MR Angiography of the Thoracic Aorta

The purpose of this study was to evaluate the effect of cardiac gating on the quality of images of the thoracic aorta at various levels during contrast-enhanced MR angiography compared with MR angiography without cardiac gating. Fifty patients underwent high-resolution contrast-enhanced MR angiography on a 1.5-T whole-body system. The 50 patients were composed of two groups of 25 consecutive patients; one group underwent MR angiography with ECG gating and the other group underwent MR angiography without ECG gating. A sagittal (3D) gradient-echo fast low-angle shot (FLASH) sequence (TR/TE, 2.8/1.4; flip angle, 25 degrees; readout, 512; voxel size, 1.4 x 0.8 x 1.3 mm) with an asymmetric k-space scanning scheme in all three gradient axes was used, and 0.2 mmol/kg of gadopentetate dimeglumine was injected at 2 mL/s. Sharpness of the thoracic aorta was evaluated at three levels by generating a signal intensity profile across the aortic vessel wall and calculating the distance between two points along a line representing the slope of the signal intensity profile. Both sides of the intensity profile were analyzed and averaged and then used to calculate sharpness. An additional group of six patients was included who had undergone both a gated and an ungated sequence; results of this group were analyzed independently. Quantitative analysis of the sharpness of the ascending thoracic aorta showed a significant increase in sharpness in both the 50-patient and six-patient groups (p < 0.005) with the addition of cardiac gating. Cardiac gating significantly improves the sharpness of the ascending aorta, a portion of the aorta that is subject to a great deal of blurring caused by cardiac motion. High-resolution contrast-enhanced MR angiography with cardiac gating can produce high quality images of the thoracic vasculature, thus enabling accurate diagnosis of vessel disease.

Utilizing generalized autocalibrating partial parallel acquisition (GRAPPA) to achieve high-resolution contrast-enhanced MR angiography of hepatic artery: Initial experience in orthotopic liver transplantation candidates

Objective To evaluate feasibility of using GRAPPA to acquire high-resolution 3D contrast-enhanced MR angiography (CE-MRA) of hepatic artery and value of GRAPPA for displaying vessels anatomy. Materials and methods High-resolution CE-MRA using GRAPPA was performed in 67 orthotopic liver transplantation recipient candidates. Signal intensity (SI) and relative SI, i.e., Cv-ro (vessel-to-liver contrast) of the aorta and the hepatic common artery (HCA), were measured. The SI and the relative SI were compared and analyzed using T-test. For purpose of qualitative evaluation, the vessel visualization quality and the order of depicted hepatic artery branches were evaluated by two radiologists independently and assessed by weighted kappa analysis. The depiction of hepatic arterial anatomy and variations was evaluated, and results were correlated with the findings in surgery. Results The mean SI values were 283.29 ± 65.07 (mean ± S.D.) for aorta and 283.16 ± 64.07 for HCA, respectively. The mean relative SI values were 0.698 ± 0.09 for aorta and 0.696 ± 0.09 for HCA, respectively. Homogeneous enhancement between aorta and HCA was confirmed by statistically insignificant differences ( p-values were 0.89 for mean SI values and 0.12 for mean relative SI values, respectively). The average score for vessel visualization ranged from good to excellent for different artery segments. Overall interobserver agreement in the visualization of different artery segments was excellent (kappa value > 0.80). The distal intrahepatic segmental arteries were well delineated for majority of patients with excellent interobserver agreement. Normal hepatic arterial anatomy was correctly demonstrated in 53 patients, and arterial anomalies were accurately detected on high-resolution MRA image of all 14 patients. Conclusion High-resolution hepatic artery MRA acquired using GRAPPA in a reproducible manner excellently depicts and delineates small vessels and can be routinely used for evaluating OLT candidates.

High resolution contrast-enhanced MR angiography using zero-filling interpolation technique

目的 在解剖学仿真动脉模型上对2种零点充填(zero-filling interpolation,ZIP)技术进行比较研究.方法 8个解剖学仿真动脉模型,腔内径为2～10 mm,在1.5 T MR扫描仪上用头线圈进行钆喷替酸葡甲胺增强MR血管成像.快速扰相位梯度回波(FSPGR)序列的参数设置如下:反转角45°,TR6 ms,TE 1.4 ms,带宽31.2 kHz,层厚1.4 mm.研究过程中上述参数保持不变,而ZIP则选择1024×1024或512×512.重组最大信号强度投影(MIP)图像后,原始单层图像和MIP图像均用于图像质量的评估.在ZIP 1024×1024和ZIP 512×512图像上均测量了信噪比(SNR).利用宽度中点(FWHM)法确定血管边缘后计算腔内直径.结果 8个解剖学仿真动脉模型在2种ZIP技术中均得到了很好的显示.在所有仿真模型图像中,ZIP 1024×1024技术获得的图像血管边缘均较ZIP512×512技术的更清晰;而在FWHM结果中,8个仿真模型腔内直径的计算结果准确性均相同.虽然ZIP 1024×1024技术的平均SNR(26.7±3.8)比ZIP 512×512的平均SNR(31.6±4.1)低(t=4.018,P＜0.01),但ZIP 1024×1024图像的总体质量均比ZIP 512×512的更好.结论 ZIP 1024×1024技术的图像总体质量优于ZIP 512×512技术.研究方向可着重于扫描序列的修改及参数的调整,以期同时获得较高的分辨率和SNR。

High spatial resolution contrast-enhanced MR angiography of the supraaortic arteries using the quadrature body coil at 3.0T: A feasibility study

To examine whether the the increased signal-to-noise (S/N) available at 3.0T would permit the use of the quadrature body coil for high spatial resolution contrast-enhanced (CE) MR angiography (MRA), and whether the large FOV that was used in our routine 1.5T protocol would also be feasible at 3.0T. In a prospective study, 43 patients and five volunteers were examined on a clinical whole-body 3.0T MR unit (Intera, Philips Medical Systems, Best, The Netherlands) after institutional review board approval and informed consent. Three-dimensional CE MRA (T1 gradient echo-sequence with TR/TE = 5.7/1.93 msec.; acquisition time, 1:54 min.) using randomly segmented central k-space ordering (CENTRA) was acquired with the quadrature body coil, using over a FOV of 350 mm. A high-image matrix of 432x432 yielded a non-zero filled voxel size of 0.81 mm x 0.81 mm x 1.0 mm (0.66 mm(3)). For quantitative analysis, contrast ratios (CR) between vessels (S) and signal in surrounding tissue (ST) were calculated [(S-ST)/(S+ST)]. For qualitative analysis, image quality and presence of artifacts were rated by two radiologists in consensus on a five-point scale (1=excellent to 5=nondiagnostic). Digital subtraction angiography (DSA) served as the standard of reference in patients with vascular disease. In the five volunteers, 1.5T CE MRA using a phased array neurovascular coil was available for intraindividual comparison. 3.0T CE MRA was successfully performed in 48/48 subjects (100%). Mean CR+/- SD were 0.76 (139.30/182.42) and 0.87 (235.18/270.14) at 3.0T and 1.5T respectively . Mean image quality was 3.82+/-0.86. Intraindividual comparison between 1.5T and 3.0T CE MRA in the volunteers revealed no significant difference in image quality (4.2+/-0.74 vs 4.6+/-0.80; p>0.05). Vascular disease was correctly identified in 13/13 patients with DSA correlation. CE MRA of the supraaortic arteries is feasible at 3.0T using a large FOV of 350 mm. The signal gain at 3.0T enables high spatial resolution contrast-enhanced MR angiography by using the built-in quadrature body coil only.

High-Resolution contrast-enhanced MR Angiography of the kidneys at 3 Tesla: Initial results

High-Resolution contrast-enhanced MR Angiography of the kidneys at 3 Tesla: Initial results

High-Resolution contrast-enhanced MR Angiography of the kidneys at 3 Tesla: Initial results

High-Resolution contrast-enhanced MR Angiography of the kidneys at 3 Tesla: Initial results

High Resolution Contrast-Enhanced MR Angiography in the Evaluation of Rabbit Carotid Artery

This study compared a high resolution contrast-enhanced MR angiography (MRA) sequence to conventional contrast-enhanced MRA sequence for imaging of rabbit carotid artery. Fifteen rabbits underwent an evaluation using both high resolution contrast-enhanced MRA sequence and conventional contrast-enhanced MRA sequence. Siemens 1.5 Tesla Magnetom Vision system was utilized. The parameters of high resolution sequence were: TR/TE= 6.2/2.0 msec, flip angle 25°, matrix 130×512, pixel size 0.96×0.49 mm, partition thickness 1.58 mm, acquisition time 24 sec. The parameters of conventional sequence were: TR/TE=3.8/1.4 msec, flip angle 35°, matrix 110×256, pixel size 1.48×1.02 mm, partition thickness 2mm, acquisition time 10 sec. Maximum intensity projection (MIP) images were created. Both original single slices and MIP images were used for image quality evaluation. Contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), distinctness of artery edge, and venous contamination were analyzed for both techniques. Higher average CNR and SNR were obtained with high resolution contrast-enhanced MRA, compared to average CNR and SNR with conventional contrast-enhanced MRA. The differences were statistically significant (P&lt;0.01). The artery edge with high resolution method was more distinct than conventional method. Jugular venous contamination was found in five of 15 cases with high resolution contrast-enhanced MRA and in four of 15 cases with conventional contrast-enhanced MRA. High resolution contrast-enhanced MRA has significant potential for high quality noninvasive vascular imaging. The image quality with high resolution contrast-enhanced MRA sequence is better than conventional contrast-enhanced MRA sequence.

High temporal and high spatial resolution contrast-enhanced MR angiography with CENTRA keyhole and SENSE at 3.0 T

High temporal and high spatial resolution contrast-enhanced MR angiography with CENTRA keyhole and SENSE at 3.0 T

Diagnosis of the hypothenar hammer syndrome by high-resolution contrast-enhanced MR angiography.

Our objective was to describe the imaging features of hypothenar hammer syndrome using minimally invasive contrast-enhanced MR angiography in comparison with oscillography study. In five patients with hypothenar hammer syndrome Gd-BOPTA-enhanced elliptically reordered 3D pulse sequence MR was compared with oscillography findings and clinical symptoms focusing on angiographic appearance of vessel injury, distribution pattern of hand vasculature and joining branches between the radial and ulnar artery supply. All patients showed segmental occlusion at the site of trauma impact with varying involvement of the superficial palmar arch, common volar digital arteries. Embolic disease was present in 50% of patients and could be clearly identified with MRA. Good correspondence was found between angiographic appearance including the presence of collaterals, clinical symptoms and oscillography. Bilateral comparison was helpful in distinguishing between vessel variants and pathology. Bilateral Gd-BOPTA-enhanced MR angiography is a minimally invasive method to depict clearly the localization and extent of vessel injury in hypothenar hammer syndrome providing valuable information about distribution pattern of hand vasculature and presence of collaterals; however, no flow data can be obtained.

High-resolution carotid artery MRA. Comparison with fast dynamic acquisition and duplex ultrasound scanning

Abstract Purpose: To determine whether the diagnostic accuracy of contrast-enhanced MR angiography (CE-MRA) of the carotid arteries is improved by using a slow-injection, high-resolution technique. Material and Methods: In 22 patients suspected to have internal carotid artery (ICA) stenosis at duplex ultrasound scanning (DUS), CE-MRA was performed both with a fast, dynamic (8 s/phase) and with a slower, high-resolution technique (scan time 2:20 min). Results: There was conformity between the CE-MRA techniques regarding the degree of stenosis in 34/40 extracranial ICAs. In 3/6 discrepant cases, short occlusions were seen with the fast dynamic technique, whereas both the high-resolution CE-MRA technique and DUS showed patent vessels. There was an overall tendency toward higher stenosis grading with the dynamic technique. Overlying veins could be removed on a workstation in all high-resolution examinations. Conclusion: The high-resolution carotid CE-MRA technique proposed herein seems to improve the diagnost...

High-resolution breath-hold contrast-enhanced MR angiography of the entire carotid circulation.

The purpose of this study was to evaluate the effect of breathing on image quality of the aortic arch and carotid vessels during contrast-enhanced MR angiography and to show that high-resolution breath-hold contrast-enhanced MR angiography combined with a timing-bolus technique can produce high-quality images of the entire carotid circulation. Forty patients underwent high-resolution contrast-enhanced MR angiography on a 1.5-T Magnetom Symphony. A coronal three-dimensional (3D) gradient-echo sequence (TR/TE, 4.36/1.64; flip angle, 25 degrees) with asymmetric k-space acquisition was used. The 136 x 512 matrix yielded voxel sizes of 1.33 x 0.64 x 1.0 mm. A timing-bolus acquisition, orientated in the coronal plane to include the aortic arch, was obtained initially during free-breathing. Twenty milliliters of gadopenetate dimeglumine was injected at 2 mL/sec. Unenhanced and enhanced 3D volumes were recorded. A subtracted 3D set was calculated and subjected to a maximum-intensity-projection algorithm. Half of the patients held their breath during angiography and the other half did not. Aortic arch motion was measured on the timing-bolus acquisition as the distance moved by a single pixel in both the x and y directions. Maximum-intensity-projection MR images were assessed independently by two observers, and vessel sharpness was scored on a scale of 1-5. Sharpness was also assessed quantitatively by generating a signal intensity profile across the aortic arch vessel wall and calculating the average of the upslope and downslope at full-width half maximum. Visualization of carotid branch vessels was scored on a scale of 0-5, and venous contamination was scored on a scale of 0-3. Average in-plane aortic arch movement was 10.3 mm in the x direction and 8.7 mm in the y direction. Quantitative and qualitative sharpness of the aortic arch and great vessel origins was better (p < 0.05) during breath-holding than during non-breath-holding. No difference in the sharpness of the carotid vessels was noted between the two groups. Carotid branch vessels were well visualized from the aortic arch to the intracerebral circulation. The average venous contamination score was 0.56. Breath-holding greatly improves the sharpness of the aortic arch and great vessel origins but has no effect on visualization of the carotid vessels. High-resolution breath-hold contrast-enhanced MR angiography can produce high-quality, artifact-free images of the entire carotid circulation from the aortic arch to the intracerebral circulation.

Contrast-enhanced carotid MR angiography with commercially available triggering mechanisms and elliptic centric phase encoding.

The technical feasibility of contrast-enhanced MR angiography of the carotid arteries was evaluated with routinely available timing sequences and elliptic centric acquisition. The image quality of the contrast-enhanced MR angiography was compared with that of multiple overlapping thin-section acquisition MR angiography (MOTSA MR angiography). Sixty-three patients were enrolled. A 2-mL test bolus and commercially available software were used to time the gadolinium bolus. High-resolution contrast-enhanced MR angiography was performed with elliptic centric acquisition. The average time of bolus arrival was 17.3 sec (range, 12-25 sec). In 60 of the 63 patients, we had excellent or good visualization of the carotid bifurcation using contrast-enhanced MR angiography with little or no venous contamination. Two observers ranked delineation of stenosis and morphology of proximal internal carotid artery and overall diagnostic confidence statistically significantly higher for contrast-enhanced MR angiography compared with MOTSA: Ulceration, length of stenosis, and slow flow distal to a critical stenosis were better depicted with contrast-enhanced MR angiography than with MOTSA: Venetian blind artifact, saturation of slow or in-plane flow, and artifactual narrowing in carotid artery kinks plagued MOTSA but were not seen on contrast-enhanced MR angiography. MOTSA was graded superior to contrast-enhanced MR angiography in nine of 120 carotid bifurcations analyzed. High-resolution carotid contrast-enhanced MR angiography is technically feasible. We found a 95% success rate using commercially available hardware and software. The image quality with carotid contrast-enhanced MR angiography has improved so that it is equal or superior to the longer MOTSA in most patients.