Comparison Between 3D TOF Magnetic Resonance Angiography and Intraarterial Digital Subtraction Angiography in Imaging the Circle of Willis

This study was done compare the accuracy of non-contrast enhanced 3D time of flight magnetic resonance angiography (3D TOF MRA) with intraarterial digital subtraction angiography (IADSA) in depicting the arterial segments of the circle of Willis. 398 arterial segments were analysed from 38 patients who underwent both non-contrast enhanced 3D TOF MRA and IADSA examinations in Hospital Universiti Sains Malaysia from November 1998 to December 2000. Two observers performed blinded retrospective analysis of the IADSA images and Maximum Intensity Projection display of the 3D TOF MRA of the circle of Willis on separate sessions. Non-contrast enhanced 3D TOF MRA was sensitive and specific in depicting the A1, A2, M1, P1 and Anterior Communicating segments of the circle of Willis with a sensitivity ranging from 94.5% to 100% and specificity ranging from 90.5% to 100%. However it was poor in depicting the Posterior Communicating segments with a sensitivity of 21.4%. MIP display of the non-contrast enhanced 3D TOF MRA is sensitive in depicting the anatomy of the circle of Willis except for the PCOM segment. It is thus a reliable method for screening of this arterial circle.