MR-ANGIOGRAPHY OF SACCULAR ANEURYSMS AFTER TREATMENT WITH GUGLIELMI DETACHABLE COILS - PRELIMINARY EXPERIENCE

PURPOSE: To review our experience using MR angiography to assess the c erebral vasculature after aneurysmal treatment with Guglielmi detachab le coils (GDCs). METHODS: Forty three-dimensional time-of-night MR ang iographic studies were performed in 23 patients after endovascular ane urysmal therapy with GDCs. Digital subtraction angiographic (DSA) stud ies were evaluated retrospectively for the following findings: parent artery patency, branch vessel patency, residual flow within the aneury sm, and residual aneurysmal neck. The MR angiographic examinations wer e inspected for the same findings, as well as for the degree of signal loss surrounding the coil mass. Clinical histories were reviewed to d etermine the impact of MR angiographic findings on therapy. RESULTS: P atency status of the parent artery was correctly identified on 25 of 2 6 MR angiographic examinations with DSA confirmation. Thirty-four of 3 7 patent branch vessels were identified by MR angiography, Residual ne ck was correctly identified in seven studies of six aneurysms, with no false-negative or false-positive results. Intraaneurysmal flow was co rrectly identified in five of eight studies of six aneurysms with resi dual flow shown by DSA. Artifact and hemorrhage mimicked residual flow in two of 18 MR angiographic studies of aneurysms With no residual fl ow shown by DSA, In eight patients, MR angiography provided clinically useful information that affected therapy. CONCLUSIONS: MR angiography can identify flow within an aneurysm after treatment with GDCs as wel l as in the adjacent parent and branch vessels. This technique may be a useful adjunct to DSA in some clinical situations.