Spiral 3D time-of-flight MR angiography for rapid non-contrast carotid artery imaging: Clinical feasibility and protocol optimization

Editorial for “Accelerated Two‐Point Dixon MR Angiography Improves Diagnostic Performance for Cervical Artery Diseases”

“…As acknowledged by the authors, diagnostic interpretation of TOF MRA in the clinical setting is typically done using tailored maximum intensity projected images that have been generated after cropping of nonvascular background signals including fat, as well as with the use of source images. The 7.2‐cm‐thick imaging slabs used with three‐dimensional TOF were substantially thicker than used in other reports 3,7,9 and 2‐fold thicker than used with FLEXA, and as suggested by study numerical simulations, likely reduced inflow enhancement and arterial conspicuity for three‐dimensional TOF. Nonetheless, this parameter was apparently derived from the manufacturer default protocol for three‐dimensional TOF.…”

“…TOF techniques, however, have well‐known limitations in terms of image quality, imaging efficiency, and anatomic coverage for evaluating the cervical arteries 4 . Consequently, technical advances that improve the image quality, imaging efficiency, and anatomic coverage of nonenhanced neck MRA are needed and are of high research interest 5–9 …”

“…4 Consequently, technical advances that improve the image quality, imaging efficiency, and anatomic coverage of nonenhanced neck MRA are needed and are of high research interest. [5][6][7][8][9] In this issue of JMRI, Amemiya et al 10 report the use of an accelerated three-dimensional two-echo Dixon MRI pulse sequence (FLEXA) at 3 Tesla for whole-neck nonenhanced MRA in 32 patients with cervical arterial diseases in a very short acquisition time of 88 seconds. Comparison of the rapid FLEXA technique was made with respect to a 4.6-fold lengthier three-dimensional TOF MRA protocol.…”