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Kim, Lee, Choi, Jung, Ahn, and Kim: Pseudostenosis at the Origin of the Vertebral Artery on Contrast-enhanced MRA: Correlation with Aortic Motion on Dynamic 3D Time-Resolved Contrast-Enhanced MRA
Original Article
Journal of the Korean Society of Magnetic Resonance in Medicine

Journal of the Korean Society of Magnetic Resonance in Medicine 2012; 16(3): 236-242.

Published online: 31 December 2012

DOI: https://doi.org/10.0000/jksmrm.2012.16.3.236

Pseudostenosis at the Origin of the Vertebral Artery on Contrast-enhanced MRA: Correlation with Aortic Motion on Dynamic 3D Time-Resolved Contrast-Enhanced MRA

Seonmun Kim, Sungwon Lee, Hyun Seok Choi, So-Lyung Jung, Kook-Jin Ahn, Bum-soo Kim

Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Korea.

Corresponding author: Hyun Seok Choi, M.D. Department of Radiology, Seoul St. Mary's Hospital, 222, Banpo-daero, Seocho-gu, Seoul 137-701, Korea. Tel. 82-10-2517-0806, Fax. 82-2-599-6771, hschoi@catholic.ac.kr

Received 13 August 2012       Revised 28 September 2012       Accepted 29 September 2012

Copyright © 2012 Korean Society of Magnetic Resonance in Medicine

Abstract

Purpose

The origin of the vertebral artery (VA) is a frequent site of pseudostenosis on contrast-enhanced MRA (CE-MRA). The purpose of this study is to evaluate the relationship between the motion of the aortic arch and pseudostenosis at the origin of the VA.

Materials and Methods

Our study had approval of our institutional review board. 47 patients underwent CT angiography (CTA), CE-MRA, and 3D time-resolved contrast-enhanced MRA (TR-CEMRA) within 6.87±9.89 days (mean±SD). Percent stenosis using the NASCET criteria was measured on CTA and CE-MRA. CTA was used as a reference standard to classify the CE-MRA into pseudostenosis and control group. Pseudostenosis was determined as 50%-99% stenosis observed on CE-MRA but normal to less than 50% stenosis on CTA. Aortic motion (distance between the highest position and lowest position of aortic arch) was measured on TR-CEMRA. Age, route of intravenous contrast media, motion of aortic arch, and normal distal diameter of VA were compared between the two groups.

Results

There were 17 patients and 23 vertebral arteries of pseudostenosis. Patients with pseudostenosis showed more aortic motion (3.61±1.88 vs. 2.05±1.97 mm) and older age (71.29±8.88 vs. 62.32±13.19 year-old). Route of intravenous contrast media and normal distal diameter of VA were not associated with pseudostenosis.

Conclusion

VA origin is a frequent site of pseudostenosis. Older age and more motion of aortic arch are associated with pseudostenosis on CE-MRA.

Keywords: Pseudostenosis, Neck MR angiography, Vertebral artery, Time-resolved contrast enhanced MRA, Aortic motion

Figures and Tables

Fig. 1
a-f. serial images of dynamic 3D time-resolved contrast-enhanced MRA.
c. Lowest position of upper border of aortic arch are marked by red horizontal line.
d. Highest position of upper border of aortic arch. Distance between these two horizontal lines was considered as motion of aortic arch
jksmrm-16-236-g001
Fig. 2
a. CTA shows no stenosis of the origin of the left vertebral artery.
b. MRA of same patient after 5 days shows pseudostenosis of the origin of the left vertebral artery (arrow).
jksmrm-16-236-g002
Table 1
Comparison of Results between Contrast-enhanced MR Angiography (MRA) and CT Angiography (CTA)
jksmrm-16-236-i001
Table 2
Comparison of Results between Pseudostenosis Group and Control Group and True Stenosis Group
jksmrm-16-236-i002

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