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Re-circulation artefact at the carotid bulb can be differentiated from true stenosis

Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea

View larger version (106K): [in a new window]   Figure 1. Re-circulation artefact. (a) An ill-defined filling defect is noted at the bulb of the internal carotid artery, appearing as an ambiguous shadow (arrows) with preservation of posterior wall contour on two-dimensional Fourier transformation time-of-flight MR angiography (2D-FT TOF MRA). The common carotid artery is not involved. (b) No filling defect is noted on film–screen X-ray contrast angiography.

View larger version (97K): [in a new window]   Figure 2. Re-circulation artefact. (a) At the bulb of the internal carotid artery, a filling defect with ill-defined margin is noted (black arrow), showing ambiguous darkness and preservation of posterior wall contour (white arrows) on two-dimensional Fourier transformation time-of-flight MR angiography (2D-FT TOF MRA). (b) No defect is noted on film–screen X-ray contrast angiography.

View larger version (108K): [in a new window]   Figure 3. True stenotic defect. (a) A focal, dark filling defect is noted at the posterior bulb of the internal carotid artery (arrow) on two-dimensional Fourier transformation time-of-flight MR angiography (2D-FT TOF MRA). The defect appears as dark as the background darkness. The posterior wall contour is not preserved, and the margin of the defect is sharp. (b) The filling defect is well documented on digital subtraction angiography (arrow).