Purpose: To compare the reliability of magnetic resonance (MR) angiography performed with magnetization transfer suppression and variable flip angle excitation with that of intraarterial digital subtraction angiography (DSA) in imaging of the cerebral arteries.
Material and methods: Fifty nonconsecutive patients referred for intraarterial DSA gave informed consent to also undergo MR angiography of the intracranial arteries.
Results: MR angiography had a sensitivity of 100% and a specificity of 95% for detection of vessel occlusion (10 abnormalities). For detection of substantial vessel stenosis (seven abnormalities), sensitivity and specificity were both 86%; for detection of aneurysm (six abnormalities), sensitivity was 83% and specificity was 98%. Sensitivity and specificity were 100% for detection of arteriovenous malformation (three abnormalities), vessel displacement (three abnormalities), and extracranial-intracranial bypass (two abnormalities). MR angiography did not reliably demonstrate small feeding vessels of a tumor or faint residual perfusion of a thrombosed aneurysm.
Conclusion: MR angiographic diagnosis of disease of the intracranial vasculature has high sensitivity and specificity but still is limited in comparison with intraarterial DSA.