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Severe stenosis of the internal carotid artery, case 2

Hemodynamically significant stenosis of the right internal carotid artery, 1.5 T.

Fig.1 The DSA image (left) after selective injection of the right common carotid artery shows severe stenosis at the origin of the internal carotid artery (arrow). Sagittal MIP reconstructions from transverse 3D (middle) and 2D (right) TOF MRA acquisitions are also shown. The flow gap phenomenon is demonstrated, related to fast intravoxel spin dephasing in conjunction with accelerated and/or turbulent flow. An area of intravascular signal loss is seen within the stenotic and poststenotic segments of the internal carotid artery with recovery of the signal distal to the stenosis, where laminar flow is reestablished. The flow gap is less prominent on the 3D (red arrow) than on the 2D (yellow arrow) TOF MR angiograms. Conversely, the poststenotic slow flow is better visualized with the 2D TOF technique.

Fig. 2 3D TOF targeted MIP images of the right carotid artery in different projections. Same observations as on Fig.1.

Fig. 3 2D TOF targeted MIP images of the right carotid artery in different projections. Same observations as on Fig.1.

 

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Fig. 1

Severe stenosis of the internal carotid artery, case 2, Fig. 1
Severe stenosis of the internal carotid artery, case 2, Fig. 2
Severe stenosis of the internal carotid artery, case 2, Fig. 3