Comparative informative value of radiation diagnostic techniques in the detection of great arterial stenotic lesions of the head

To define the comparative informative value of different radiation diagnostic techniques, such as transcranial Doppler study (TCDS), duplex (DS) of the great arteries of the head, magnetic resonance angiography (MRA) of vessels of the vessels of Willis and great arteries of the head, digital substraction angiography (DSA), the authors analyze the results of examination of 15 patients with stenotic lesions of common carotid bifurcations or upper segments of inferior carotids and combined lesions. A full agreement of DSA and MRA findings was revealed in 6 patients; of them 5 and 1 patients had inferior carotid occlusion and subocclusion, respectively. There was mainly a discordance of data on lesion re-evaluation in < 90-99% (MRA revealed a complete lack of blood flow) and < 70% stenosis (changes were estimated as physiological turbulence in the bulb of the inferior carotid while analyzing MR images). It is shown that the combination of MRA and DS of the great arteries of head for diagnosis the presence and extent of stenosis and TCDS for evaluation of the activation of collateral circulatory pathways and a cerebrovascular reserve may virtually replace DSA which must probably be used only when the data obtained by different methods are in deviation