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We included participants with suspected 50%\u2013100% carotid stenosis on at least one side, all were examined with CT angiography (CTA) and PC-MRI and both ICAs were analyzed. Degree of stenosis on CTA was the reference test. PC-MRI-based blood flow rates in extracranial ICA and intracranial cerebral arteries were assessed. ICA-cerebral blood flow (CBF) ratio was defined as ICA divided by sum of both ICAs and Basilar artery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We included 136 participants. The ICAs were 102\u2009&amp;lt;\u200950% stenosis, 88 conventional \u2a7e50% stenosis (31 with \u2a7e70%), 49 near-occlusion, 12 occlusions, 20 unclear cause of small distal ICA on CTA and one excluded. For separation of near-occlusion and conventional stenoses, ICA flow rate and ICA-CBF ratio had the highest area under the curve (AUC; 0.98\u20130.99) for near-occlusion. ICA-CBF ratio \u2a7d0.225 was 90% (45\/49) sensitive and 99% (188\/190) specific for near-occlusion. Inter-rater reliability for this threshold was excellent (kappa 0.98). Specificity was 94% (29\/31) for cases with \u2a7e70% stenosis. PC-MRI had modest performance for separating &amp;lt;50% and conventional \u2a7e50% stenosis (highest AUC 0.74), and eight (16%) of near-occlusions were not distinguishable from occlusion (no visible flow).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>ICA-CBF ratio \u2a7d0.225 on PC-MRI is an accurate and reliable method to separate conventional \u2a7e50% stenosis and near-occlusion that is feasible for routine use. PC-MRI should be considered further as a potential standard method for near-occlusion detection, to be used side-by-side with established modalities as PC-MRI cannot separate other degrees of stenosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23969873231215634","type":"journal-article","created":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T07:39:27Z","timestamp":1701329967000},"page":"135-143","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Diagnostic separation of conventional \u2a7e50% carotid stenosis and near-occlusion with phase-contrast MRI"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1315-7010","authenticated-orcid":false,"given":"Madelene","family":"Holmgren","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, Neurosciences, Ume\u00e5 University, Ume\u00e5, Sweden 1"},{"name":"Department of Radiation Sciences, Biomedical Engineering, Ume\u00e5 University, Ume\u00e5, Sweden 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Henze","sequence":"additional","affiliation":[{"name":"Department of Radiation Sciences, Biomedical Engineering, Ume\u00e5 University, Ume\u00e5, Sweden 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"W\u00e5hlin","sequence":"additional","affiliation":[{"name":"Department of Radiation Sciences, Biomedical Engineering, Ume\u00e5 University, Ume\u00e5, Sweden 2"},{"name":"Ume\u00e5 Center for Functional Brain Imaging, Ume\u00e5 University, Ume\u00e5, Sweden 3"},{"name":"Department of Applied Physics and Electronics, Ume\u00e5 University, Ume\u00e5, Sweden 4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Eklund","sequence":"additional","affiliation":[{"name":"Department of Radiation Sciences, Biomedical Engineering, Ume\u00e5 University, Ume\u00e5, Sweden 2"},{"name":"Ume\u00e5 Center for Functional Brain Imaging, Ume\u00e5 University, Ume\u00e5, Sweden 3"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan J","family":"Fox","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Science Center, University of Toronto, Toronto, ON, Canada 5"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5317-4563","authenticated-orcid":false,"given":"Elias","family":"Johansson","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Neurosciences, Ume\u00e5 University, Ume\u00e5, Sweden 1"},{"name":"Wallenberg Center for Molecular Medicine, Ume\u00e5 University, Ume\u00e5, Sweden 6"},{"name":"Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden 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