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This project was made possible thanks to IEEE Robotics and Automation Society (IEEE-RAS http://www.ieee-ras.org/) through a CEMRA grant (Creation of Educational Materials for Robotics and Automation).
The purpose of this study was to assess the agreement between TOF and CEMRA in carotid artery stenosis evaluation at 3T.
The extracranial carotid arteries were examined with both TOF MRA and CEMRA, with TOF MRA being performed first.
Both the 3D TOF and 3D CEMRA primary datasets and maximum intensity projection (MIP) images were reviewed.
TOF MRA and CEMRA were evaluated separately, with a four-weektime interval between evaluation sessions.
Stenosis grades determined by TOF and CEMRA were compared using the Spearman rank correlation coefficient and the Wilcoxon test.
CEMRA detected stenosis in 24 (52%) of 46 carotids evaluated (occlusion: n = 5; severe stenosis: n = 11; moderate stenosis: n = 5; mild stenosis: n = 3).
On both CEMRA and TOF, unilateral stenosis was found in 16 (69%) of 23 patients and bilateral stenosis in five (22%) of 23 patients, while no stenosis was detected in two (8.7%) of 23 patients.
TOF MRA yielded significantly higher results for stenosis grade in comparison to CEMRA (P = 0.014).
For CEMRA evaluation, the readers had identical results for stenosis grade in 40 (87%) of 46 cases and differing results in 6 (13%) of 46 cases.
Our study shows that the use of 3D TOF MRA results in significantly higher stenosis grades compared to CEMRA when evaluating carotid arteries at 3T.
While our study did not include a comparison with a standard of reference like DSA or rotational angiography, the higher stenosis grades yielded by TOF MRA in comparison to CEMRA at 3T represent a problem, as CEMRA of the carotid arteries is well validated.
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