MR angiography with three-dimensional time-of-flight and targeted maximum-intensity-projection reconstructions in the follow-up of intracranial aneurysms embolized with Guglielmi detachable coils
Vj. Kahara et al., MR angiography with three-dimensional time-of-flight and targeted maximum-intensity-projection reconstructions in the follow-up of intracranial aneurysms embolized with Guglielmi detachable coils, AM J NEUROR, 20(8), 1999, pp. 1470-1475
Citations number
12
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Neurosciences & Behavoir
BACKGROUND AND PURPOSE: Intra-arterial contrast angiographies are generally
used to confirm treatment results of endovascular neurointerventions such
as aneurysm obliteration. We compared MR angiography with distal subtractio
n angiography (DSA) as a follow-up technique for the detection of aneurysma
l remnant cavities and arterial patency in patients treated for intracrania
l aneurysms with Guglielmi detachable coils (GDCs).
METHODS: In 20 consecutive patients, follow-up MR angiography and routine i
ntra-arterial cerebral angiography were performed on the same day 1 to 7 mo
nths (mean, 4.5 months) after embolization with GDCs, MR angiographic data
were postprocessed for subvolume maximum intensity projections centered on
the region of the treated aneurysm. Hard copies of both imaging studies wer
e interpreted independently in a blinded fashion to record and compare remn
ant cavities, location of residual flow, and adjacent arterial narrowing, u
sing DSA as the standard of reference. The interpreters also established an
occlusion grade for the treated aneurysms as evidenced on DSA images and e
valuated MR angiograms for artifactual effects.
RESULTS: Overall sensitivity and positive predictive value of MR angiograph
y in revealing aneurysmal remnant cavities were both 90%. Specificity in ru
ling out a remnant cavity with MR angiography was 91%. One remnant cavity w
as missed by MR angiography, and in five patients, false adjacent arterial
encroachments were reported.
CONCLUSION: MR angiography may be useful in the long-term follow-up of succ
essfully treated small and medium-sized aneurysms after concurrent primary
verification of their occlusion with DSA.