Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1995 Sep;59(3):225–237. doi: 10.1136/jnnp.59.3.225

Imaging blood vessels of the head and neck.

R J Sellar 1
PMCID: PMC486018  PMID: 7673947

Abstract

ATHEROSCLEROTIC DISEASE: Patients with transient ischaemic attacks or a non-disabling stroke who are surgical candidates should be screened with Doppler ultrasound, or MRA/CT, or both. The choice will depend on local expertise and availability. If DUS is used it is recommended that the equipment is regularly calibrated and a prospective audit of results, particularly of those patients that go on to angiography, is maintained locally. Those patients found to have the DUS equivalent of a 50% stenosis should have angiography only if surgical or balloon angioplasty treatment is contemplated. Angiography should be performed with meticulous technique to minimise risks. ANEURYSM AND ARTERIOVENOUS MALFORMATIONS: Angiography remains the investigation of choice for patients with subarachnoid haemorrhage. Magnetic resonance angiography and CT can demonstrate the larger aneurysm but because even small aneurysms can rupture with devastating effects, these techniques are not the examination of first choice. Angiography is also the only technique that adequately defines the neck of an aneurysm. This information is becoming increasingly important in management decisions-for instance, whether to clip or use a coil. Likewise angiography is the only technique to fully define the vascular anatomy of arteriovenous malformations although the size of the nidus can be monitored by MRA and this is a useful method of follow up after stereotactic radiosurgery, embolisation, or surgery. There are specific uses for MRA such as in patients presenting with a painful 3rd nerve palsy and as a screening test for those patients with a strong family history of aneurysms. VASCULITIS, FIBROMUSCULAR HYPERPLASIA, AND DISSECTION: These rare arterial diseases are best detected by angiography, although there are increasing reports of successful diagnosis by MRA. There are traps for the many unwary and MRA does not give an anatomical depiction of the arteries but a flow map. Slow flow may lead to signal loss and a false positive diagnosis of vasculitis.

Full text

PDF
225

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ackerman R. H., Candia M. R. Identifying clinically relevant carotid disease. Stroke. 1994 Jan;25(1):1–3. doi: 10.1161/01.str.25.1.1. [DOI] [PubMed] [Google Scholar]
  2. Anderson C. M., Saloner D., Lee R. E., Griswold V. J., Shapeero L. G., Rapp J. H., Nagarkar S., Pan X., Gooding G. A. Assessment of carotid artery stenosis by MR angiography: comparison with x-ray angiography and color-coded Doppler ultrasound. AJNR Am J Neuroradiol. 1992 May-Jun;13(3):989–1008. [PMC free article] [PubMed] [Google Scholar]
  3. Anderson C. M., Saloner D., Tsuruda J. S., Shapeero L. G., Lee R. E. Artifacts in maximum-intensity-projection display of MR angiograms. AJR Am J Roentgenol. 1990 Mar;154(3):623–629. doi: 10.2214/ajr.154.3.2106232. [DOI] [PubMed] [Google Scholar]
  4. Anson J., Crowell R. M. Cervicocranial arterial dissection. Neurosurgery. 1991 Jul;29(1):89–96. doi: 10.1097/00006123-199107000-00015. [DOI] [PubMed] [Google Scholar]
  5. Baker L. L., Kucharczyk J., Sevick R. J., Mintorovitch J., Moseley M. E. Recent advances in MR imaging/spectroscopy of cerebral ischemia. AJR Am J Roentgenol. 1991 Jun;156(6):1133–1143. doi: 10.2214/ajr.156.6.2028855. [DOI] [PubMed] [Google Scholar]
  6. Baum S., Stein G. N., Kuroda K. K. Complications of "no arteriography". Radiology. 1966 May;86(5):835–838. doi: 10.1148/86.5.835. [DOI] [PubMed] [Google Scholar]
  7. Bendick P. J., Jackson V. P., Becker G. J. Comparison of ultrasound scanning/Doppler with digital subtraction angiography in evaluating carotid arterial disease. Med Instrum. 1983 May-Jun;17(3):220–222. [PubMed] [Google Scholar]
  8. Bland J. M., Altman D. G. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307–310. [PubMed] [Google Scholar]
  9. Blatter D. D., Parker D. L., Ahn S. S., Bahr A. L., Robison R. O., Schwartz R. B., Jolesz F. A., Boyer R. S. Cerebral MR angiography with multiple overlapping thin slab acquisition. Part II. Early clinical experience. Radiology. 1992 May;183(2):379–389. doi: 10.1148/radiology.183.2.1561338. [DOI] [PubMed] [Google Scholar]
  10. Brant-Zawadzki M., Anderson M., DeArmond S. J., Conley F. K., Jahnke R. W. Radiation-induced large intracranial vessel occlusive vasculopathy. AJR Am J Roentgenol. 1980 Jan;134(1):51–55. doi: 10.2214/ajr.134.1.51. [DOI] [PubMed] [Google Scholar]
  11. Carroll B. A. Carotid sonography. Radiology. 1991 Feb;178(2):303–313. doi: 10.1148/radiology.178.2.1987583. [DOI] [PubMed] [Google Scholar]
  12. Cebul R. D., Paulus R. A. The failure of intravenous digital subtraction angiography in replacing carotid arteriography. Ann Intern Med. 1986 Apr;104(4):572–574. doi: 10.7326/0003-4819-104-4-572. [DOI] [PubMed] [Google Scholar]
  13. Chikos P. M., Fisher L. D., Hirsch J. H., Harley J. D., Thiele B. L., Strandness D. E., Jr Observer variability in evaluating extracranial carotid artery stenosis. Stroke. 1983 Nov-Dec;14(6):885–892. doi: 10.1161/01.str.14.6.885. [DOI] [PubMed] [Google Scholar]
  14. Clark W. M., Hatten H. P., Jr Noninvasive screening of extracranial carotid disease: duplex sonography with angiographic correlation. AJNR Am J Neuroradiol. 1981 Sep-Oct;2(5):443–447. [PMC free article] [PubMed] [Google Scholar]
  15. Creasy J. L., Price R. R., Presbrey T., Goins D., Partain C. L., Kessler R. M. Gadolinium-enhanced MR angiography. Radiology. 1990 Apr;175(1):280–283. doi: 10.1148/radiology.175.1.2315497. [DOI] [PubMed] [Google Scholar]
  16. Davies K. N., Humphrey P. R. Complications of cerebral angiography in patients with symptomatic carotid territory ischaemia screened by carotid ultrasound. J Neurol Neurosurg Psychiatry. 1993 Sep;56(9):967–972. doi: 10.1136/jnnp.56.9.967. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Ducos de Lahitte M., Marc-Vergnes J. P., Rascol A., Guiraud B., Manelfe C. Intravenous angiography of the extracranial cerebral arteries. Radiology. 1980 Dec;137(3):705–711. doi: 10.1148/radiology.137.3.7003649. [DOI] [PubMed] [Google Scholar]
  18. Dumoulin C. L., Souza S. P., Walker M. F., Wagle W. Three-dimensional phase contrast angiography. Magn Reson Med. 1989 Jan;9(1):139–149. doi: 10.1002/mrm.1910090117. [DOI] [PubMed] [Google Scholar]
  19. EASTCOTT H. H., PICKERING G. W., ROB C. G. Reconstruction of internal carotid artery in a patient with intermittent attacks of hemiplegia. Lancet. 1954 Nov 13;267(6846):994–996. doi: 10.1016/s0140-6736(54)90544-9. [DOI] [PubMed] [Google Scholar]
  20. Edelman R. R., Ahn S. S., Chien D., Li W., Goldmann A., Mantello M., Kramer J., Kleefield J. Improved time-of-flight MR angiography of the brain with magnetization transfer contrast. Radiology. 1992 Aug;184(2):395–399. doi: 10.1148/radiology.184.2.1620835. [DOI] [PubMed] [Google Scholar]
  21. Edelman R. R. MR angiography: present and future. AJR Am J Roentgenol. 1993 Jul;161(1):1–11. doi: 10.2214/ajr.161.1.8517285. [DOI] [PubMed] [Google Scholar]
  22. Edelman R. R., Mattle H. P., Kleefield J., Silver M. S. Quantification of blood flow with dynamic MR imaging and presaturation bolus tracking. Radiology. 1989 May;171(2):551–556. doi: 10.1148/radiology.171.2.2704823. [DOI] [PubMed] [Google Scholar]
  23. Edelman R. R., Mattle H. P., O'Reilly G. V., Wentz K. U., Liu C., Zhao B. Magnetic resonance imaging of flow dynamics in the circle of Willis. Stroke. 1990 Jan;21(1):56–65. doi: 10.1161/01.str.21.1.56. [DOI] [PubMed] [Google Scholar]
  24. Edelman R. R., Mattle H. P., Wallner B., Bajakian R., Kleefield J., Kent C., Skillman J. J., Mendel J. B., Atkinson D. J. Extracranial carotid arteries: evaluation with "black blood" MR angiography. Radiology. 1990 Oct;177(1):45–50. doi: 10.1148/radiology.177.1.2399337. [DOI] [PubMed] [Google Scholar]
  25. Eliasziw M., Streifler J. Y., Fox A. J., Hachinski V. C., Ferguson G. G., Barnett H. J. Significance of plaque ulceration in symptomatic patients with high-grade carotid stenosis. North American Symptomatic Carotid Endarterectomy Trial. Stroke. 1994 Feb;25(2):304–308. doi: 10.1161/01.str.25.2.304. [DOI] [PubMed] [Google Scholar]
  26. Forster D. M., Steiner L., Hakanson S., Bergvall U. The value of repeat pan-angiography in cases of unexplained subarachnoid hemorrhage. J Neurosurg. 1978 May;48(5):712–716. doi: 10.3171/jns.1978.48.5.0712. [DOI] [PubMed] [Google Scholar]
  27. Goldberg H. I., Grossman R. I., Gomori J. M., Asbury A. K., Bilaniuk L. T., Zimmerman R. A. Cervical internal carotid artery dissecting hemorrhage: diagnosis using MR. Radiology. 1986 Jan;158(1):157–161. doi: 10.1148/radiology.158.1.3940374. [DOI] [PubMed] [Google Scholar]
  28. Goldstein S. J., Fried A. M., Young B., Tibbs P. A. Limited usefulness of aortic arch angiography in the evaluation of carotid occlusive disease. AJR Am J Roentgenol. 1982 Jan;138(1):103–108. doi: 10.2214/ajr.138.1.103. [DOI] [PubMed] [Google Scholar]
  29. Goodson S. F., Flanigan D. P., Bishara R. A., Schuler J. J., Kikta M. J., Meyer J. P. Can carotid duplex scanning supplant arteriography in patients with focal carotid territory symptoms? J Vasc Surg. 1987 Apr;5(4):551–557. [PubMed] [Google Scholar]
  30. Greenan T. J., Grossman R. I., Goldberg H. I. Cerebral vasculitis: MR imaging and angiographic correlation. Radiology. 1992 Jan;182(1):65–72. doi: 10.1148/radiology.182.1.1727311. [DOI] [PubMed] [Google Scholar]
  31. Grosset D. G., Georgiadis D., Abdullah I., Bone I., Lees K. R. Doppler emboli signals vary according to stroke subtype. Stroke. 1994 Feb;25(2):382–384. doi: 10.1161/01.str.25.2.382. [DOI] [PubMed] [Google Scholar]
  32. Grzyska U., Freitag J., Zeumer H. Selective cerebral intraarterial DSA. Complication rate and control of risk factors. Neuroradiology. 1990;32(4):296–299. doi: 10.1007/BF00593048. [DOI] [PubMed] [Google Scholar]
  33. Hankey G. J., Warlow C. P. Cost-effective investigation of patients with suspected transient ischaemic attacks. J Neurol Neurosurg Psychiatry. 1992 Mar;55(3):171–176. doi: 10.1136/jnnp.55.3.171. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Hankey G. J., Warlow C. P., Sellar R. J. Cerebral angiographic risk in mild cerebrovascular disease. Stroke. 1990 Feb;21(2):209–222. doi: 10.1161/01.str.21.2.209. [DOI] [PubMed] [Google Scholar]
  35. Heinz E. R. Aneurysms and MR angiography. AJNR Am J Neuroradiol. 1993 Jul-Aug;14(4):974–977. [PMC free article] [PubMed] [Google Scholar]
  36. Heiserman J. E., Dean B. L., Hodak J. A., Flom R. A., Bird C. R., Drayer B. P., Fram E. K. Neurologic complications of cerebral angiography. AJNR Am J Neuroradiol. 1994 Sep;15(8):1401–1411. [PMC free article] [PubMed] [Google Scholar]
  37. Heiserman J. E., Drayer B. P., Fram E. K., Keller P. J., Bird C. R., Hodak J. A., Flom R. A. Carotid artery stenosis: clinical efficacy of two-dimensional time-of-flight MR angiography. Radiology. 1992 Mar;182(3):761–768. doi: 10.1148/radiology.182.3.1535891. [DOI] [PubMed] [Google Scholar]
  38. Heiserman J. E., Drayer B. P., Fram E. K., Keller P. J. MR angiography of cervical fibromuscular dysplasia. AJNR Am J Neuroradiol. 1992 Sep-Oct;13(5):1454–1457. [PMC free article] [PubMed] [Google Scholar]
  39. Huston J., 3rd, Lewis B. D., Wiebers D. O., Meyer F. B., Riederer S. J., Weaver A. L. Carotid artery: prospective blinded comparison of two-dimensional time-of-flight MR angiography with conventional angiography and duplex US. Radiology. 1993 Feb;186(2):339–344. doi: 10.1148/radiology.186.2.8421731. [DOI] [PubMed] [Google Scholar]
  40. Huston J., 3rd, Rufenacht D. A., Ehman R. L., Wiebers D. O. Intracranial aneurysms and vascular malformations: comparison of time-of-flight and phase-contrast MR angiography. Radiology. 1991 Dec;181(3):721–730. doi: 10.1148/radiology.181.3.1947088. [DOI] [PubMed] [Google Scholar]
  41. Imparato A. M., Riles T. S., Mintzer R., Baumann F. G. The importance of hemorrhage in the relationship between gross morphologic characteristics and cerebral symptoms in 376 carotid artery plaques. Ann Surg. 1983 Feb;197(2):195–203. doi: 10.1097/00000658-198302000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Isensee C., Reul J., Thron A. Magnetic resonance imaging of thrombosed dural sinuses. Stroke. 1994 Jan;25(1):29–34. doi: 10.1161/01.str.25.1.29. [DOI] [PubMed] [Google Scholar]
  43. Jeans W. D., Mackenzie S., Baird R. N. Angiography in transient cerebral ischaemia using three views of the carotid bifurcation. Br J Radiol. 1986 Feb;59(698):135–142. doi: 10.1259/0007-1285-59-698-135. [DOI] [PubMed] [Google Scholar]
  44. Kalender W. A., Polacin A. Physical performance characteristics of spiral CT scanning. Med Phys. 1991 Sep-Oct;18(5):910–915. doi: 10.1118/1.596607. [DOI] [PubMed] [Google Scholar]
  45. Keller P. J., Drayer B. P., Fram E. K., Williams K. D., Dumoulin C. L., Souza S. P. MR angiography with two-dimensional acquisition and three-dimensional display. Work in progress. Radiology. 1989 Nov;173(2):527–532. doi: 10.1148/radiology.173.2.2798885. [DOI] [PubMed] [Google Scholar]
  46. Laster R. E., Jr, Acker J. D., Halford H. H., 3rd, Nauert T. C. Assessment of MR angiography versus arteriography for evaluation of cervical carotid bifurcation disease. AJNR Am J Neuroradiol. 1993 May-Jun;14(3):681–688. [PMC free article] [PubMed] [Google Scholar]
  47. Laub G. Displays for MR angiography. Magn Reson Med. 1990 May;14(2):222–229. doi: 10.1002/mrm.1910140208. [DOI] [PubMed] [Google Scholar]
  48. Lewin J. S., Laub G. Intracranial MR angiography: a direct comparison of three time-of-flight techniques. AJNR Am J Neuroradiol. 1991 Nov-Dec;12(6):1133–1139. [PMC free article] [PubMed] [Google Scholar]
  49. Little J. R., Sawhny B., Weinstein M. Pseudo-tandem stenosis of the internal carotid artery. Neurosurgery. 1980 Dec;7(6):574–577. doi: 10.1227/00006123-198012000-00006. [DOI] [PubMed] [Google Scholar]
  50. Marchal G., Bosmans H., Van Fraeyenhoven L., Wilms G., Van Hecke P., Plets C., Baert A. L. Intracranial vascular lesions: optimization and clinical evaluation of three-dimensional time-of-flight MR angiography. Radiology. 1990 May;175(2):443–448. doi: 10.1148/radiology.175.2.2326471. [DOI] [PubMed] [Google Scholar]
  51. Marks M. P., Napel S., Jordan J. E., Enzmann D. R. Diagnosis of carotid artery disease: preliminary experience with maximum-intensity-projection spiral CT angiography. AJR Am J Roentgenol. 1993 Jun;160(6):1267–1271. doi: 10.2214/ajr.160.6.8498231. [DOI] [PubMed] [Google Scholar]
  52. Markus H. Transcranial Doppler detection of circulating cerebral emboli. A review. Stroke. 1993 Aug;24(8):1246–1250. doi: 10.1161/01.str.24.8.1246. [DOI] [PubMed] [Google Scholar]
  53. Masaryk A. M., Ross J. S., DiCello M. C., Modic M. T., Paranandi L., Masaryk T. J. 3DFT MR angiography of the carotid bifurcation: potential and limitations as a screening examination. Radiology. 1991 Jun;179(3):797–804. doi: 10.1148/radiology.179.3.2027995. [DOI] [PubMed] [Google Scholar]
  54. Masaryk T. J., Obuchowski N. A. Noninvasive carotid imaging: caveat emptor. Radiology. 1993 Feb;186(2):325–328. doi: 10.1148/radiology.186.2.8421728. [DOI] [PubMed] [Google Scholar]
  55. Mattle H. P., Kent K. C., Edelman R. R., Atkinson D. J., Skillman J. J. Evaluation of the extracranial carotid arteries: correlation of magnetic resonance angiography, duplex ultrasonography, and conventional angiography. J Vasc Surg. 1991 Jun;13(6):838–845. [PubMed] [Google Scholar]
  56. Mattle H. P., Wentz K. U., Edelman R. R., Wallner B., Finn J. P., Barnes P., Atkinson D. J., Kleefield J., Hoogewoud H. M. Cerebral venography with MR. Radiology. 1991 Feb;178(2):453–458. doi: 10.1148/radiology.178.2.1987608. [DOI] [PubMed] [Google Scholar]
  57. Mittl R. L., Jr, Broderick M., Carpenter J. P., Goldberg H. I., Listerud J., Mishkin M. M., Berkowitz H. D., Atlas S. W. Blinded-reader comparison of magnetic resonance angiography and duplex ultrasonography for carotid artery bifurcation stenosis. Stroke. 1994 Jan;25(1):4–10. doi: 10.1161/01.str.25.1.4. [DOI] [PubMed] [Google Scholar]
  58. Norris J. W. Does transcranial Doppler have any clinical value? Neurology. 1990 Feb;40(2):329–331. doi: 10.1212/wnl.40.2.329. [DOI] [PubMed] [Google Scholar]
  59. O'Leary D. H., Polak J. F. High-resolution carotid sonography: past, present, and future. AJR Am J Roentgenol. 1989 Oct;153(4):699–704. doi: 10.2214/ajr.153.4.699. [DOI] [PubMed] [Google Scholar]
  60. Padayachee T. S., Bingham J. B., Graves M. J., Colchester A. C., Cox T. C. Dural sinus thrombosis. Diagnosis and follow-up by magnetic resonance angiography and imaging. Neuroradiology. 1991;33(2):165–167. doi: 10.1007/BF00588259. [DOI] [PubMed] [Google Scholar]
  61. Perlmutter J. S. New techniques in neuroimaging: when are pretty pictures clinically useful? Curr Opin Neurol. 1993 Dec;6(6):889–890. doi: 10.1097/00019052-199312000-00010. [DOI] [PubMed] [Google Scholar]
  62. Podolak M. J., Hedlund L. W., Evans A. J., Herfkens R. J. Evaluation of flow through simulated vascular stenoses with gradient echo magnetic resonance imaging. Invest Radiol. 1989 Mar;24(3):184–189. doi: 10.1097/00004424-198903000-00002. [DOI] [PubMed] [Google Scholar]
  63. Polak J. F., Bajakian R. L., O'Leary D. H., Anderson M. R., Donaldson M. C., Jolesz F. A. Detection of internal carotid artery stenosis: comparison of MR angiography, color Doppler sonography, and arteriography. Radiology. 1992 Jan;182(1):35–40. doi: 10.1148/radiology.182.1.1727306. [DOI] [PubMed] [Google Scholar]
  64. Polak J. F., Kalina P., Donaldson M. C., O'Leary D. H., Whittemore A. D., Mannick J. A. Carotid endarterectomy: preoperative evaluation of candidates with combined Doppler sonography and MR angiography. Work in progress. Radiology. 1993 Feb;186(2):333–338. doi: 10.1148/radiology.186.2.8421730. [DOI] [PubMed] [Google Scholar]
  65. Polak J. F. Noninvasive carotid evaluation: carpe diem. Radiology. 1993 Feb;186(2):329–331. doi: 10.1148/radiology.186.2.8421729. [DOI] [PubMed] [Google Scholar]
  66. Quint D. J., Spickler E. M. Magnetic resonance demonstration of vertebral artery dissection. Report of two cases. J Neurosurg. 1990 Jun;72(6):964–967. doi: 10.3171/jns.1990.72.6.0964. [DOI] [PubMed] [Google Scholar]
  67. Rippe D. J., Boyko O. B., Spritzer C. E., Meisler W. J., Dumoulin C. L., Souza S. P., Heinz E. R. Demonstration of dural sinus occlusion by the use of MR angiography. AJNR Am J Neuroradiol. 1990 Jan-Feb;11(1):199–201. [PMC free article] [PubMed] [Google Scholar]
  68. Robinson M. L., Sacks D., Perlmutter G. S., Marinelli D. L. Diagnostic criteria for carotid duplex sonography. AJR Am J Roentgenol. 1988 Nov;151(5):1045–1049. doi: 10.2214/ajr.151.5.1045. [DOI] [PubMed] [Google Scholar]
  69. Ross J. S., Masaryk T. J., Modic M. T., Ruggieri P. M., Haacke E. M., Selman W. R. Intracranial aneurysms: evaluation by MR angiography. AJR Am J Roentgenol. 1990 Jul;155(1):159–165. doi: 10.2214/ajr.155.1.2112839. [DOI] [PubMed] [Google Scholar]
  70. Rothwell P. M., Gibson R. J., Slattery J., Sellar R. J., Warlow C. P. Equivalence of measurements of carotid stenosis. A comparison of three methods on 1001 angiograms. European Carotid Surgery Trialists' Collaborative Group. Stroke. 1994 Dec;25(12):2435–2439. doi: 10.1161/01.str.25.12.2435. [DOI] [PubMed] [Google Scholar]
  71. SELDINGER S. I. Catheter replacement of the needle in percutaneous arteriography; a new technique. Acta radiol. 1953 May;39(5):368–376. doi: 10.3109/00016925309136722. [DOI] [PubMed] [Google Scholar]
  72. Saloner D., Selby K., Anderson C. M. MRA studies of arterial stenosis: improvements by diastolic acquisition. Magn Reson Med. 1994 Feb;31(2):196–203. doi: 10.1002/mrm.1910310213. [DOI] [PubMed] [Google Scholar]
  73. Schuler J. J., Flanigan D. P., Lim L. T., Keifer T., Williams L. R., Behrend A. J. The effect of carotid siphon stenosis on stroke rate, death, and relief of symptoms following elective carotid endarterectomy. Surgery. 1982 Dec;92(6):1058–1067. [PubMed] [Google Scholar]
  74. Schwartz R. B., Jones K. M., Chernoff D. M., Mukherji S. K., Khorasani R., Tice H. M., Kikinis R., Hooton S. M., Stieg P. E., Polak J. F. Common carotid artery bifurcation: evaluation with spiral CT. Work in progress. Radiology. 1992 Nov;185(2):513–519. doi: 10.1148/radiology.185.2.1410365. [DOI] [PubMed] [Google Scholar]
  75. Sitzer M., Fürst G., Fischer H., Siebler M., Fehlings T., Kleinschmidt A., Kahn T., Steinmetz H. Between-method correlation in quantifying internal carotid stenosis. Stroke. 1993 Oct;24(10):1513–1518. doi: 10.1161/01.str.24.10.1513. [DOI] [PubMed] [Google Scholar]
  76. Spencer M. P., Reid J. M. Quantitation of carotid stenosis with continuous-wave (C-W) Doppler ultrasound. Stroke. 1979 May-Jun;10(3):326–330. doi: 10.1161/01.str.10.3.326. [DOI] [PubMed] [Google Scholar]
  77. Spetzler R. F., Martin N. A. A proposed grading system for arteriovenous malformations. J Neurosurg. 1986 Oct;65(4):476–483. doi: 10.3171/jns.1986.65.4.0476. [DOI] [PubMed] [Google Scholar]
  78. Teasdale E., Statham P., Straiton J., Macpherson P. Non-invasive radiological investigation for oculomotor palsy. J Neurol Neurosurg Psychiatry. 1990 Jul;53(7):549–553. doi: 10.1136/jnnp.53.7.549. [DOI] [PMC free article] [PubMed] [Google Scholar]
  79. Todd N. V., Howie J. E., Miller J. D. Norman Dott's contribution to aneurysm surgery. J Neurol Neurosurg Psychiatry. 1990 Jun;53(6):455–458. doi: 10.1136/jnnp.53.6.455. [DOI] [PMC free article] [PubMed] [Google Scholar]
  80. Turner W. H., Murie J. A. Intravenous digital subtraction angiography for extracranial carotid artery disease. Br J Surg. 1989 Dec;76(12):1247–1250. doi: 10.1002/bjs.1800761207. [DOI] [PubMed] [Google Scholar]
  81. Waugh J. R., Sacharias N. Arteriographic complications in the DSA era. Radiology. 1992 Jan;182(1):243–246. doi: 10.1148/radiology.182.1.1727290. [DOI] [PubMed] [Google Scholar]
  82. Wedeen V. J., Meuli R. A., Edelman R. R., Geller S. C., Frank L. R., Brady T. J., Rosen B. R. Projective imaging of pulsatile flow with magnetic resonance. Science. 1985 Nov 22;230(4728):946–948. doi: 10.1126/science.4059917. [DOI] [PubMed] [Google Scholar]
  83. Wiebers D. O., Whisnant J. P., Sundt T. M., Jr, O'Fallon W. M. The significance of unruptured intracranial saccular aneurysms. J Neurosurg. 1987 Jan;66(1):23–29. doi: 10.3171/jns.1987.66.1.0023. [DOI] [PubMed] [Google Scholar]
  84. Wolff S. D., Balaban R. S. Magnetization transfer contrast (MTC) and tissue water proton relaxation in vivo. Magn Reson Med. 1989 Apr;10(1):135–144. doi: 10.1002/mrm.1910100113. [DOI] [PubMed] [Google Scholar]
  85. Wolpert S. M., Caplan L. R. Current role of cerebral angiography in the diagnosis of cerebrovascular diseases. AJR Am J Roentgenol. 1992 Jul;159(1):191–197. doi: 10.2214/ajr.159.1.1609697. [DOI] [PubMed] [Google Scholar]
  86. Wood G. W., Lukin R. R., Tomsick T. A., Chambers A. A. Digital subtraction angiography with intravenous injection: assessment of 1,000 carotid bifurcations. AJR Am J Roentgenol. 1983 May;140(5):855–859. doi: 10.2214/ajr.140.5.855. [DOI] [PubMed] [Google Scholar]
  87. Zwiebel W. J., Austin C. W., Sackett J. F., Strother C. M. Correlation of high-resolution, B-mode and continuous-wave Doppler sonography with arteriography in the diagnosis of carotid stenosis. Radiology. 1983 Nov;149(2):523–532. doi: 10.1148/radiology.149.2.6622699. [DOI] [PubMed] [Google Scholar]
  88. Zwiebel W. J. Duplex sonography of the cerebral arteries: efficacy, limitations, and indications. AJR Am J Roentgenol. 1992 Jan;158(1):29–36. doi: 10.2214/ajr.158.1.1727355. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES