Summary
The introduction of fast gradient systems allows a reliable visualization of the extracranial carotid vessels by the magnetic
resonance angiography (MRA) which meanwhile is implemented into clinical routine. By the mainly applied time-of-flight (TOF)
technique, vessels can be imaged without contrast agent (CA). Due to the application of ultra-fast gradient-echo-sequences,
the first-pass evaluation of an intravenous bolus-injection of Gadolinium in the carotids from the aortic arch up to the skull
base can be performed in less than 30 s. In this study, advantages and disadvantages of both techniques are discussed. For
a qualitatively optimal contrast enhanced MRA (CE-MRA) timing parameters like injection delay, flow rate and the adjustment
of sequence parameters have to be considered in relation to the fast venous return from the sinus to the jugular veins. First,
the optimal time point of the data acquisition have been determined at a model and with a computer simulation in reference
to the presence of CA in the arteries. As a result, 90 % of the contrast contribution is defined by 16 % of the symmetrically
acquired central k-space lines. A measuring protocol for clinical use was obtained by a gradual variation of spacial resolution,
measuring time and CA-injection parameters and was proved in normal volunteers and patients. An exact determination of the
bolus-arrival-time by means of a test-bolus injection was acquired. The best qualitative results were achieved by a double-dose
injection at 2 ml/s injection rate. The temporal reserves of ultra-fast sequences should be invested in the improvement of
the spatial resolution. To date, further investigations related to the problem of optimal CA-application may improve the potentials
of CE-MRA procedures.
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