Intracranial artery velocity measurement using 4D PC MRI at 3 T: comparison with transcranial ultrasound techniques and 2D PC MRI

• Published in: Neuroradiology 2013-03, Vol.55 (4), p.389-398
• Main Authors: Meckel, Stephan, Leitner, Lorenz, Bonati, Leo H., Santini, Francesco, Schubert, Tilman, Stalder, Aurelien F., Lyrer, Philippe, Markl, Michael, Wetzel, Stephan G.
• Format: Article
• Language: English
• Subjects: Adult; Algorithms; Blood Flow Velocity - physiology; Carotid artery; Cerebral Arteries - anatomy & histology; Cerebral Arteries - physiology; Cerebrovascular Circulation - physiology; Diagnostic Neuroradiology; Echoencephalography - methods; Female; Humans; Image Enhancement - methods; Image Interpretation, Computer-Assisted - methods; Imaging; Imaging, Three-Dimensional - methods; Magnetic Resonance Angiography - methods; Male; Medicine; Medicine & Public Health; Neurology; Neuroradiology; Neurosciences; Neurosurgery; Radiology; Reproducibility of Results; Sensitivity and Specificity; Young Adult
• ISSN: 0028-3940; 1432-1920
• DOI: 10.1007/s00234-012-1103-z

Introduction 4D phase contrast MR imaging (4D PC MRI) has been introduced for spatiotemporal evaluation of intracranial hemodynamics in various cerebrovascular diseases. However, it still lacks validation with standards of reference. Our goal was to compare blood flow quantification derived from 4D PC MRI with transcranial ultrasound and 2D PC MRI. Methods Velocity measurements within large intracranial arteries [internal carotid artery (ICA), basilar artery (BA), and middle cerebral artery (MCA)] were obtained in 20 young healthy volunteers with 4D and 2D PC MRI, transcranial Doppler sonography (TCD), and transcranial color-coded duplex sonography (TCCD). Maximum velocities at peak systole (PSV) and end diastole (EDV) were compared using regression analysis and Bland–Altman plots. Results Correlation of 4D PC MRI measured velocities was higher in comparison with TCD ( r  = 0.49–0.66) than with TCCD (0.35–0.44) and 2D PC MRI (0.52–0.60). In mid-BA and ICA C7 segment, a significant correlation was found with TCD (0.68–0.81 and 0.65–0.71, respectively). No significant correlation was found in carotid siphon. On average over all volunteers, PSVs and EDVs in MCA were minimally underestimated compared with TCD/TCCD. Minimal overestimation of velocities was found compared to TCD in mid-BA and ICA C7 segment. Conclusion 4D PC MRI appears as valid alternative for intracranial velocity measurement consistent with previous reference standards, foremost with TCD. Spatiotemporal averaging effects might contribute to vessel size-dependent mild underestimation of velocities in smaller (MCA), and overestimation in larger-sized (BA and ICA) arteries, respectively. Complete spatiotemporal flow analysis may be advantageous in anatomically complex regions (e.g. carotid siphon) relative to restrictions of ultrasound techniques.