Matas test combined with MR flow measurement

Prior to the temporary or permanent therapeutic occlusion of the carotid artery, evaluation of the cerebral collateral circulation via the circle of Willis is necessary in order to prevent complications. The purpose of our study was to evaluate the flow velocity of the contralateral common carotid artery using Renal Time Acquisition and Velocity Evaluation (RACE) before and during a Matas test and to estimate brain collateral circulation. Five normal subjects were studied with a 1.5 T superconducting imager (Siemens, Erlangen) using a neck coil. RACE is a one-dimensional projective flow measurement technique using fast low angle shot (FLASH) without phase encoding gradient (FLASH sequence: TR=20 ms, TE=6 ms, FA=90 degrees, FOV=220 mm, slice thickness=8 mm). The total acquisition time is about 10 seconds without need for electrocardiographic synchronization. Flow velocity of the common carotid artery was evaluated using the RACE technique before and during a Matas test. The relative flow ratio of the contralateral carotid artery (flow velocity during the Matas test divided by that before the Matas test) was calculated. Additionally, using a head coil, 3 dimensional time-flight MR angiograms of the brain were obtained for each subject order to evaluate the anterior communicating artery. Six out of the 10 common carotid arteries were sufficiently compressed to stop blood flow. The relative mean ratio was 1.74 with a standard deviation of 0.36. The anterior communicating artery was visualized in all subjects. Increased blood volume is thus thought to maintain the blood supply of a cerebral hemisphere affected by compression of the common carotid artery via the anterior communicating artery. MR flow measurement using RACE before and during the Matas test seems to be a noninvasive method for evaluating cerebral collateral circulation via the circle of Willis. (author)