Comparison of TOF-MRA and silent scan-MRA in depicting cerebral arteries in patients with Moyamoya disease

Abstract

Background Silent scan magnetic resonance angiography (silent-MRA) as an arterial spin labeling technique offering sound reduction is insensitive to saturation effect. Time-of-flight (TOF)-MRA has limitations in terms of fine or slow-flow blood vessels due to sensitive saturation effects. Purpose Silent-MRA was compared with TOF-MRA for visualizing cerebral arteries in patients with Moyamoya disease (MMD). Material and Methods Forty-one patients with MMD were scanned with both silent-MRA and TOF-MRA. Silent-MRA was compared with TOF-MRA both quantitatively and qualitatively. Quantitatively, both signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured. Qualitatively, steno-occlusive severity of the main cerebral arteries and grading of Moyamoya vessels (MMVs) were evaluated. The grading for MMVs was classified into one of five categories (1 = absolutely negative; 5 = absolutely positive). Results Both SNR and CNR were significantly higher in TOF-MRA (SNR = 155.2 ± 90.8; CNR = 116.6 ± 72.0) than in silent-MRA (SNR = 45.8 ± 10.1; CNR = 38.6 ± 10.1) (P < 0.001). No significant difference in steno-occlusive severity of the main cerebral arteries in either right or left cerebral hemispheres was observed between silent-MRA and TOF-MRA. In grading MMVs, the silent-MRA score (mean ± SD = 4.6 ± 0.5) was significantly higher than that of TOF-MRA (3.2 ± 1.6) (P < 0.001). Conclusion Silent-MRA appears to better visualize MMVs than TOF-MRA and it can equally depict steno-occlusive lesions of the cerebral arteries.

Can Hybrid Arterial Spin Labeling‐Tagged Zero‐Echo‐Time Magnetic Resonance Angiography Be an Effective Candidate in the Evaluation of Intracranial Artery Diseases? A Clinical Feasibility Study

“…The signal‐to‐noise ratio (SNR) and contrast‐to‐noise ratio (CNR) were calculated with the following equations 11,17 : where V represents the average flow signal intensity in the regions of interest (ROIs), B represents the average signal in the background ROIs, and σ is the standard deviation of the signals in the background ROIs. For the signal intensity measurement, ROIs were placed inside a normal artery or defined background (nonvascular background tissue on the midpoint of line between bilateral C1 segment terminals) on the axial images.…”

“…Among the various ASL‐MRA approaches, zero‐echo‐time (ZTE) MRA can diminish the saturation effect, minimize magnetic susceptibility, and reduce acoustic noise by integrating a continuous ASL (cASL) strategy, ZTE acquisition, and three‐dimensional (3D) radial sampling trajectories 14 . Previous studies have demonstrated the promising superiority of cASL‐ZTE‐MRA over TOF‐MRA in the follow‐up assessment of coiled aneurysms and the diagnosis of intracranial artery diseases 15–20 . However, Holdsworth et al implied that marginal blurring along the vessel walls occurs in cASL‐ZTE‐MRA and might be mistaken for vascular lesions 21 .…”

The feasibility of non-contrast-enhanced zero echo time magnetic resonance angiography for characterization of intracranial atherosclerotic disease

“…Katsuki et al (19) use this technique to describe the arteries near the cerebral aneurysm with clip and the peripheral cerebral arteries. In addition, other scholars also employed zTE-MRA for evaluating cerebrovascular disorder in clinic, including cerebral arteriovenous malformation and moyamoya disease (20)(21)(22). In essence, zTE-MRA uses a continuous ASL strategy and a zTE radial acquisition readout scheme (23).…”

Three tesla magnetic resonance angiography with ultrashort echo time describes the arteries near the cerebral aneurysm with clip and the peripheral cerebral arteries

“…Time-of-flight magnetic resonance angiography (TOF-MRA) is a fast and non-invasive method and used for evaluation of postoperative cerebral vasospasm, but clip-induced artifact limits assessment of the artery in the vicinity of the clip, especially of aneurysm neck remnants. [ 1 ] MRA with ultrashort echo time (UTE-MRA) reduces metal artifact,[ 3 , 7 - 9 ] and its usefulness is reported for the assessment of the internal flow in the intracranial stent,[ 4 , 10 ] moyamoya disease,[ 12 ] and arteriovenous malformation. [ 13 ] Besides, 1.5T UTE-MRA revealed the artery in the vicinity of a clip,[ 5 ] but the obtained image is too rough to evaluate the aneurysm remnant, and its description range is too narrow to assess the cerebral vasospasm especially of the peripheral portion.…”