With respect to the qualitative evaluation of 4D-ASL MRA images, interobserver agreement was excellent for all items (κ=1). On DSA, collateral flow via the anterior communicating artery (AcomA) was observed in six patients, via the posterior communicating artery (PcomA) in four patients, and via both the AcomA and PcomA in three patients. κ statistics were used to assess interobserver and intermodality agreement. The collateral flow via the circle of Willis was read on 4D-ASL MRA and DSA images by two sets of two independent readers each. At 300-ms intervals seven dynamic scans were obtained with a spatial resolution of 0.5×0.5×0.6 mm(3). The flow-sensitive alternating inversion recovery (FAIR) preparation scheme with look-locker sampling was used for spin labeling. All underwent 4D-ASL MRA at 3 T and digital subtraction angiography (DSA). The inclusion criteria were fulfilled by 13 patients with carotid artery steno-occlusive disease. Institutional review board approval and prior written informed consent from all patients were obtained. To evaluate whether 3-T four-dimensional (4D) arterial spin-labelling (ASL) -based magnetic resonance angiography (MRA) is useful for assessing the collateral circulation via the circle of Willis in patients with carotid artery steno-occlusive disease.
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