CEREBROVASCULAR DISEASE EVALUATION WITH MAGNETIC RESONANCE IMAGING AND MAGNETIC RESONANCE ANGIOGRAPHY

Magnetic resonance imaging (MRI) is an important imaging technique for evaluation of cerebral ischemic changes.Using magnetic resonance angiography (MRA), both large and medium sized intracranial arteries and veins can be visualized by selecting appropriate imaging parameters.The aim of this retrospective study was to evaluate our own results in the diagnosis of cerebrovascular diseases with MRI and MRA, and to compare them with literature data.Data on 278 patients with cerebrovascular symptomatology (158 female and 120 male, mean age 45.54 years), examined between April 2001 and November 2002, were analyzed.MRA was performed in all 278, and both MRA and MRI in 231 patients.On MRA, 90 pathologic alterations of intracranial arteries (69 aneurysms and 21 vascular malformations), 13 intracranial arterial occlusions, 19 intracranial arterial stenoses, and 14 cases of intracranial arteriosclerotic changes were identified.On MRI, 114 strokes (73 brain infarctions, 22 cerebral hemorrhages and 19 subarachnoid hemorrhages), 14 vascular malformations and 14 cases of small vessel disease were detected.MRI was found to be a powerful tool to detect ischemic lesions immediately upon stroke onset.MRA is highly sensitive for the detection of occlusive disease in large intracranial arteries.For cerebral venous and sinus thrombosis, MRI and MRA are first line studies.MRA of extracranial and intracranial vessels alone or in combination with transcranial color-coded duplex sonography (TCCD) as well as computed tomography angiography (CTA) may eliminate the need of intra-arterial digital subtraction angiography (DSA) in most patients studied for occlusive cerebrovascular disease.DSA may be reserved for those patients in whom there is a disagreement among the results obtained by use of noninvasive techniques, and for the diagnosis of arteriovenous malformations, whereas MRA can prove useful on follow-up examinations.