Non Contrast MRA of the Extracranial Carotid Arteries Utilizing a 3D ECG-Triggered Balanced Steady State Free Precession Technique with Spatial Saturation

Calvin Lo¹, Bidyut K. Pramanik¹, Daniel Kim¹, Xiaoming Bi², Peter Weale², Anna Nazarenko¹, Thomas P. Mulholland¹, Edmond A. Knopp¹, Vivian S. Lee¹, Ruth P. Lim¹

An ECG-gated 3D balanced steady state free precession (b-SSFP) MRA sequence, utilizing an inversion pulse to null out background tissue and a spatial saturation pulse to null out slowly flowing venous blood, has been described to visualize "fresh" arterial blood flowing into the image. We assessed the feasibility, diagnostic quality and accuracy of 3D b-SSFP MRA, compared with conventional TOF MRA for evaluation of the extracranial carotid arteries with reference to CE MRA. We found significantly superior SNR, CNR, image quality and diagnostic confidence for b-SSFP MRA compared with TOF MRA, and high concordance for stenosis with the reference standard.