Modern cross-sectional imaging in the diagnosis and follow-up of intracranial aneurysms

Abstract

Digital subtraction angiography (DSA) is still considered the gold standard for most applications in neurovascular imaging. However, with the ongoing development of cross-sectional imaging modalities DSA is increasingly being replaced by less invasive methods. This contribution describes the diagnostic value and the increasing potential of computed tomography angiography (CTA) and magnetic resonance angiography (MRA) in the diagnosis and follow-up of intracranial aneurysms. The main role of CTA is in the diagnosis and therapy planning of ruptured aneurysms; in contrast, MRA plays an increasingly important role in the screening for asymptomatic aneurysms (especially in cases of familial subarachnoid hemorrhage) and in the follow-up after endovascular therapy with coils and/or intracranial stents. Technical issues concerning examination technique are covered here as well as an approach to advanced postprocessing of the image data. Furthermore, a brief outlook on the impact of new developments (MRA with parallel imaging and at 3.0 T) is given.