Highly accelerated compressed sensing time-of-flight magnetic resonance angiography may be reliable for diagnosing head and neck arterial steno-occlusive disease: a comparative study with digital subtraction angiography

Introduction We aimed to investigate the utility of compressed sensing time-of-flight magnetic resonance angiography (CS TOF-MRA) for diagnosing intracranial and cervical arterial stenosis by using digital subtraction angiography (DSA) as the reference standard. Methods Thirty-seven patients with head and neck arterial stenoses who underwent CS TOF-MRA and DSA were retrospectively enrolled. The reconstructed resolution of CS TOF-MRA was 0.4 × 0.4 × 0.4 mm 3 . The scan time was 5 min and 2 s. The image quality of CS TOF-MRA was independently ranked by two neuroradiologists in 1031 arterial segments. The luminal stenosis grades on CS TOF-MRA and DSA were analyzed in 61 arterial segments and were compared using the Wilcoxon signed-rank test. The ability of CS TOF-MRA to predict moderate to severe stenosis or occlusion was analyzed. Results The image quality of most arterial segments (95.2%) on CS TOF-MRA was excellent. Arterial segments with low image quality were mainly the V3–4 segments of the vertebral artery. The majority of arterial stenoses (62.3%) were located in the cervical internal carotid artery. The luminal stenosis grades of CS TOF-MRA were concordant with that of DSA in 50 of 61 segments ( p = 0.366). CS TOF-MRA had a sensitivity of 84.4% and a specificity of 88.5% for predicting moderate to severe stenosis. For detecting occlusion lesions, it had a sensitivity of 100% and a specificity of 94.1%. Conclusion CS TOF-MRA provides adequate image quality within a reasonable acquisition time and is a reliable tool for diagnosing head and neck arterial steno-occlusive disease. Key Points • CS TOF-MRA provides a relatively large coverage (16 cm), high resolution (0.4 × 0.4 × 0.4 mm 3 ) and good image quality of head and neck arteries within 5 min and 2 s. • The diagnostic accuracy of CS TOF-MRA in the assessment of moderate to severe stenosis and occlusion was comparable with that of DSA. • Arterial segments with low image quality were mainly the V3 and V4 segments of the vertebral artery.