Diagnosing Carotid Near-Occlusion with Phase-Contrast MRI

Overview

Journal AJNR Am J Neuroradiol

Specialty Neurology

Date 2021 Mar 12

PMID 33707277

Citations 6

Authors

E Johansson

L Zarrinkoob

A Wahlin

A Eklund

J Malm

Affiliations

Soon will be listed here.

Abstract

Carotid near-occlusion is a frequently overlooked diagnosis when CTA examinations are assessed in routine practice. To evaluate the potential value of phase-contrast MR imaging in identifying near-occlusion, we examined 9 carotid near-occlusions and 20 cases of conventional ≥50% carotid stenosis (mean stenosis degree, 65%) with phase-contrast MR imaging. Mean ICA flow was lower in near-occlusions (52 mL/min) than in conventional ≥50% stenosis (198 mL/min, < .001). ICA flow of ≤110 mL/min was 100% sensitive and specific for near-occlusion. Phase-contrast MR imaging is a promising tool for diagnosing carotid near-occlusion.

Citing Articles

The pitfalls and challenges in the diagnosis and treatment of patients with carotid near-occlusion: a narrative review.

Xia F, Zhao J, Bao L, Lyu X Quant Imaging Med Surg. 2024; 14(12):9600-9619.

PMID: 39698665 PMC: 11651966. DOI: 10.21037/qims-24-1037.

Assessments of arterial and venous phase radiodensity does not improve carotid near-occlusion diagnostics.

Brunnander K, Henze A, Fox A, Johansson E Sci Rep. 2024; 14(1):18616.

PMID: 39127795 PMC: 11316748. DOI: 10.1038/s41598-024-68732-w.

Phase-contrast magnetic resonance imaging of intracranial and extracranial blood flow in carotid near-occlusion.

Holmgren M, Henze A, Wahlin A, Eklund A, Fox A, Johansson E Neuroradiology. 2024; 66(4):589-599.

PMID: 38400954 PMC: 10937755. DOI: 10.1007/s00234-024-03309-y.

Diagnostic separation of conventional ⩾50% carotid stenosis and near-occlusion with phase-contrast MRI.

Holmgren M, Henze A, Wahlin A, Eklund A, Fox A, Johansson E Eur Stroke J. 2023; 9(1):135-143.

PMID: 38032058 PMC: 10916822. DOI: 10.1177/23969873231215634.

Symptomatic and asymptomatic carotid near-occlusions have very similar angiographic appearance on CT-angiography.

Kellomaki E, Gu T, Fox A, Johansson E Neuroradiology. 2022; 64(11):2203-2206.

PMID: 36129513 PMC: 9576665. DOI: 10.1007/s00234-022-03054-0.

References

Spencer M, Reid J . Quantitation of carotid stenosis with continuous-wave (C-W) Doppler ultrasound. Stroke. 1979; 10(3):326-30. DOI: 10.1161/01.str.10.3.326. View

Naylor A, Ricco J, de Borst G, Debus S, De Haro J, Halliday A . Editor's Choice - Management of Atherosclerotic Carotid and Vertebral Artery Disease: 2017 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2017; 55(1):3-81. DOI: 10.1016/j.ejvs.2017.06.021. View

Fox A, Eliasziw M, Rothwell P, Schmidt M, Warlow C, Barnett H . Identification, prognosis, and management of patients with carotid artery near occlusion. AJNR Am J Neuroradiol. 2005; 26(8):2086-94. PMC: 8148868. View

Johansson E, Aviv R, Fox A . Atherosclerotic ICA stenosis coinciding with ICA asymmetry associated with Circle of Willis variations can mimic near-occlusion. Neuroradiology. 2019; 62(1):101-104. PMC: 6940316. DOI: 10.1007/s00234-019-02309-7. View

Gu T, Aviv R, Fox A, Johansson E . Symptomatic carotid near-occlusion causes a high risk of recurrent ipsilateral ischemic stroke. J Neurol. 2019; 267(2):522-530. PMC: 6989616. DOI: 10.1007/s00415-019-09605-5. View

Johansson E, Fox A . Carotid Near-Occlusion: A Comprehensive Review, Part 1--Definition, Terminology, and Diagnosis. AJNR Am J Neuroradiol. 2015; 37(1):2-10. PMC: 7960223. DOI: 10.3174/ajnr.A4432. View

Zarrinkoob L, Wahlin A, Ambarki K, Birgander R, Eklund A, Malm J . Blood Flow Lateralization and Collateral Compensatory Mechanisms in Patients With Carotid Artery Stenosis. Stroke. 2019; 50(5):1081-1088. PMC: 6485302. DOI: 10.1161/STROKEAHA.119.024757. View

Brott T, Halperin J, Abbara S, Bacharach J, Barr J, Bush R . 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease. A report of the American College of Cardiology Foundation/American Heart Association.... Circulation. 2011; 124(4):e54-130. DOI: 10.1161/CIR.0b013e31820d8c98. View

Zarrinkoob L, Ambarki K, Wahlin A, Birgander R, Eklund A, Malm J . Blood flow distribution in cerebral arteries. J Cereb Blood Flow Metab. 2015; 35(4):648-54. PMC: 4420884. DOI: 10.1038/jcbfm.2014.241. View

10.

Johansson E, Benhabib H, Herod W, Hopyan J, Machnowska M, Maggisano R . Carotid near-occlusion can be identified with ultrasound by low flow velocity distal to the stenosis. Acta Radiol. 2018; 60(3):396-404. DOI: 10.1177/0284185118780900. View

11.

Bartlett E, Walters T, Symons S, Fox A . Diagnosing carotid stenosis near-occlusion by using CT angiography. AJNR Am J Neuroradiol. 2006; 27(3):632-7. PMC: 7976976. View

12.

Johansson E, Ohman K, Wester P . Symptomatic carotid near-occlusion with full collapse might cause a very high risk of stroke. J Intern Med. 2014; 277(5):615-23. DOI: 10.1111/joim.12318. View

13.

Khangure S, Benhabib H, Machnowska M, Fox A, Gronlund C, Herod W . Carotid near-occlusion frequently has high peak systolic velocity on Doppler ultrasound. Neuroradiology. 2017; 60(1):17-25. DOI: 10.1007/s00234-017-1938-4. View

14.

Johansson E, Fox A . Carotid Near-Occlusion: A Comprehensive Review, Part 2--Prognosis and Treatment, Pathophysiology, Confusions, and Areas for Improvement. AJNR Am J Neuroradiol. 2015; 37(2):200-4. PMC: 7959965. DOI: 10.3174/ajnr.A4429. View

15.

Johansson E, Gu T, Aviv R, Fox A . Carotid near-occlusion is often overlooked when CT angiography is assessed in routine practice. Eur Radiol. 2020; 30(5):2543-2551. PMC: 7160198. DOI: 10.1007/s00330-019-06636-4. View