Clinical MRA of the Carotid Arteries

  • Michele Anzidei
  • Beatrice Cavallo Marincola
  • Fabrizio Boni
  • Carlo Catalano


Magnetic resonance angiography (MRA) is one of the most practical diagnostic imaging modality for the evaluation of extracranial carotid arteries. This chapter review various MRA techniques for the evaluation of carotid disease, including unenhanced approaches as time-of-flight and phase-contrast imaging as well as contrast-enhanced MRA and plaque imaging sequences, providing various clinical samples of common and uncommon pathologic conditions.


Compute Tomography Angiography Magnetic Resonance Angiography Digital Subtraction Angiography Carotid Stenosis Gadobenate Dimeglumine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Reddy KS, Yusuf S (1998) Emerging epidemic of cardiovascular disease in developing countries. Circulation 97:597–601CrossRefGoogle Scholar
  2. 2.
    McNeill AM, Rosamond WD, Girman CJ, Golden SH, Schmidt MI, East HE, Ballantyne CM, Heiss G (2005) The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study. Diabetes Care 28(2):385–390PubMedCrossRefGoogle Scholar
  3. 3.
    Willig DS, Turski PA, Frayne R, Graves VB, Korosec FR, Swan JS, Mistretta CA, Grist TM (1998) Contrast-enhanced 3D MR DSA of the carotid artery bifurcation: preliminary study of comparison with unenhanced 2D and 3D time-of-flight MR angiography. Radiology 208(2):447–451PubMedGoogle Scholar
  4. 4.
    De Marco JK, Nesbit GM, Wesbey GE, Richardson D (1994) Prospective evaluation of extracranial carotid stenosis: MR angiography with maximum-intensity projections and multiplanar reformation compared with conventional angiography. AJR Am J Roentgenol 163(5):1205–1212PubMedCrossRefGoogle Scholar
  5. 5.
    Mitra D, Connolly D, Jenkins S, English P, Birchall D, Mandel C, Shrikanth K, Gregson B, Gholkar A (2006) Comparison of image quality, diagnostic confidence and interobserver variability in contrast enhanced MR angiography and 2D time of flight angiography in evaluation of carotid stenosis. Br J Radiol 79(939):201–207PubMedCrossRefGoogle Scholar
  6. 6.
    Thurnher S (2005) MRA of the carotid arteries. Eur Radiol 15(Suppl 5):E11–E16PubMedGoogle Scholar
  7. 7.
    Huston J 3rd, Fain SB, Riederer SJ, Wilman AH, Bernstein MA, Busse RF (1999) Carotid arteries: maximizing arterial to venous contrast in fluoroscopically triggered contrast-enhanced MR angiography with elliptic centric view ordering. Radiology 211(1):265–273PubMedGoogle Scholar
  8. 8.
    Huston J 3rd, Fain SB, Wald JT, Luetmer PH, Rydberg CH, Covarrubias DJ, Riederer SJ, Bernstein MA, Brown RD, Meyer FB, Bower TC, Schleck CD (2001) Carotid artery: elliptic centric contrast-enhanced MR angiography compared with conventional angiography. Radiology 218(1):138–143PubMedGoogle Scholar
  9. 9.
    Essig M, Nikolaou K, Meaney JF (2007) Magnetic resonance angiography of the head and neck vessels. Eur Radiol 17(Suppl 2):B30–B37, ReviewPubMedGoogle Scholar
  10. 10.
    Nikolaou K, Kramer H, Grosse C, Clevert D, Dietrich O, Hartmann M, Chamberlin P, Assmann S, Reiser MF, Schoenberg SO (2006) High-spatial-resolution multistation MR angiography with parallel imaging and blood pool contrast agent: initial experience. Radiology 241(3):861–872, Epub 2006 Oct 10PubMedCrossRefGoogle Scholar
  11. 11.
    Anzidei M, Napoli A, Marincola BC, Kirchin MA, Neira C, Geiger D, Zaccagna F, Catalano C, Passariello R (2009) High-resolution steady state magnetic resonance angiography of the carotid arteries: are intravascular agents necessary?: feasibility and preliminary experience with gadobenate dimeglumine. Invest Radiol 44(12):784–792PubMedCrossRefGoogle Scholar
  12. 12.
    Vanninen RL, Manninen HI, Partanen PL, Vainio PA, Soimakallio S (1995) Carotid artery stenosis: clinical efficacy of MR phase-contrast flow quantification as an adjunct to MR angiography. Radiology 194(2):459–467PubMedGoogle Scholar
  13. 13.
    Mathiesen EB, Bonaa KH, Joakimsen O (2001) Echolucent plaques are associated with high risk of ischemic cerebrovascular events in carotid stenosis: the Tromso study. Circulation 103:2171–2175PubMedCrossRefGoogle Scholar
  14. 14.
    Yuan C, Mitsumori LM, Beach KW, Maravilla KR (2001) Carotid atherosclerotic plaque: noninvasive MR characterization and identification of vulnerable lesions. Radiology 221(2):285–299, ReviewPubMedCrossRefGoogle Scholar
  15. 15.
    Lell M, Fellner C, Baum U, Hothorn T, Steiner R, Lang W, Bautz W, Fellner FA (2007) Evaluation of carotid artery stenosis with multisection CT and MR imaging: influence of imaging modality and postprocessing. AJNR Am J Neuroradiol 28(1):104–110PubMedGoogle Scholar
  16. 16.
    Layton KF, Huston J 3rd, Cloft HJ, Kaufmann TJ, Krecke KN, Kallmes DF (2007) Specificity of MR angiography as a confirmatory test for carotid artery stenosis: is it valid? AJR Am J Roentgenol 188(4):1114–1116PubMedCrossRefGoogle Scholar
  17. 17.
    North American Symptomatic Carotid Endarterectomy Trial (NASCET) Collaborators (1991) Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med 325(7):445–453CrossRefGoogle Scholar
  18. 18.
    Alvarez-Linera J, Benito-León J, Escribano J, Campollo J, Gesto R (2003) Prospective evaluation of carotid artery stenosis: elliptic centric contrast-enhanced MR angiography and spiral CT angiography compared with digital subtraction angiography. AJNR Am J Neuroradiol 24(5):1012–1019PubMedGoogle Scholar
  19. 19.
    Borisch I, Horn M, Butz B et al (2003) Preoperative evaluation of carotid artery stenosis: comparison of contrast-enhanced MR angiography and duplex sonography with digital subtraction angiography. AJNR Am J Neuroradiol 24(6):1117–1122PubMedGoogle Scholar
  20. 20.
    Nederkoorn PJ, van der Graaf Y, Hunink MG (2003) Duplex ultrasound and magnetic resonance angiography compared with digital subtraction angiography in carotid artery stenosis: a systematic review. Stroke 34(5):1324–1332PubMedCrossRefGoogle Scholar
  21. 21.
    Lenhart M, Framme N, Volk M et al (2002) Time-resolved contrast enhanced magnetic resonance angiography of the carotid arteries: diagnostic accuracy and inter-observer variability compared with selective catheter angiography. Invest Radiol 37(10):535–541PubMedCrossRefGoogle Scholar
  22. 22.
    U-King-Im JM, Trivedi RA, Graves MJ et al (2004) Contrast-enhanced MR angiography for carotid disease: diagnostic and potential clinical impact. Neurology 62(8):1282–1290PubMedCrossRefGoogle Scholar
  23. 23.
    Anzalone N, Scomazzoni F, Castellano R, Strada L, Righi C, Politi LS, Kirchin MA, Chiesa R, Scotti G (2005) Carotid artery stenosis: intraindividual correlations of 3D time-of-flight MR angiography, contrast-enhanced MR angiography, conventional DSA, and rotational angiography for detection and grading. Radiology 236(1):204–213, Epub 2005 Jun 13PubMedCrossRefGoogle Scholar
  24. 24.
    Lombardi M, Bartolozzi C (2005) Magnetic resonance imaging of the heart and vessels. Springer, Berlin, pp 136–141, cap. 6Google Scholar
  25. 25.
    Cantú C, Pineda C, Barinagarrementeria F, Salgado P, Gurza A, de Pablo P, Espinosa R, Martínez-Lavín M (2000) Noninvasive cerebrovascular assessment of Takayasu arteritis. Stroke 31(9):2197–2202PubMedCrossRefGoogle Scholar
  26. 26.
    Yang CW, Carr JC, Futterer SF, Morasch MD, Yang BP, Shors SM, Finn JP (2005) Contrast-enhanced MR angiography of the carotid and vertebrobasilar circulations. AJNR Am J Neuroradiol 26(8):2095–2101PubMedGoogle Scholar
  27. 27.
    van den Berg R, Schepers A, de Bruïne FT, Liauw L, Mertens BJ, van der Mey AG, van Buchem MA (2004) The value of MR angiography techniques in the detection of head and neck paragangliomas. Eur J Radiol 52(3):240–245PubMedCrossRefGoogle Scholar
  28. 28.
    Vattoth S, Cherian J, Pandey T (2007) Magnetic resonance angiographic demonstration of carotid-cavernous fistula using elliptical centric time resolved imaging of contrast kinetics (EC-TRICKS). Magn Reson Imaging 25(8):1227–1231, Epub 2007 Apr 18PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2014

Authors and Affiliations

  • Michele Anzidei
    • 1
  • Beatrice Cavallo Marincola
    • 1
  • Fabrizio Boni
    • 1
  • Carlo Catalano
    • 1
  1. 1.Department of Radiological SciencesUniversity of RomeRomeItaly

Personalised recommendations