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. 2012 Jul;18(7):MT60-5.
doi: 10.12659/msm.883199.

Time-resolved imaging of contrast kinetics does not improve performance of follow-up MRA of embolized intracranial aneurysms

Zbigniew Serafin  1 , Piotr Strześniewski, Władysław Lasek, Wojciech Beuth
Affiliations

Time-resolved imaging of contrast kinetics does not improve performance of follow-up MRA of embolized intracranial aneurysms

Zbigniew Serafin et al. Med Sci Monit. 2012 Jul.

Abstract

Background: The use of contrast media and the time-resolved imaging of contrast kinetics (TRICKS) technique have some theoretical advantages over time-of-flight magnetic resonance angiography (TOF-MRA) in the follow-up of intracranial aneurysms after endovascular treatment. We prospectively compared the diagnostic performance of TRICKS and TOF-MRA with digital subtracted angiography (DSA) in the assessment of occlusion of embolized aneurysms.

Material/methods: Seventy-two consecutive patients with 72 aneurysms were examined 3 months after embolization. Test characteristics of TOF-MRA and TRICKS were calculated for the detection of residual flow. The results of quantification of flow were compared with weighted kappa. Intraobserver and interobserver reproducibility was determined.

Results: The sensitivity of TOF-MRA was 85% (95% CI, 65-96%) and of TRICKS, 89% (95% CI, 70-97%). The specificity of both methods was 91% (95% CI, 79-98%). The accuracy of the flow quantification ranged from 0.76 (TOF-MRA) to 0.83 (TRICKS). There was no significant difference between the methods in the area under the ROC curve regarding both the detection and the quantification of flow. Intraobserver reproducibility was very good with both techniques (kappa, 0.86-0.89). The interobserver reproducibility was moderate for TOF-MRA and very good for TRICKS (kappa, 0.74-0.80).

Conclusions: In this study, TOF-MRA and TRICKS presented similar diagnostic performance; therefore, the use of time-resolved contrast-enhanced MRA is not justified in the follow-up of embolized aneurysms.

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Figures

Figure 1
Figure 1
Consecutive phases of cerebral TRICKS angiography.
Figure 2
Figure 2
Follow-up MRA after embolization of the left internal carotid artery aneurysm. The residual aneurysm neck (arrows) has similar morphology in TOF-MRA (A) and TRICKS (B).
Figure 3
Figure 3
Follow-up angiography with 3D-DSA (A), TOF-MRA (B), and TRICKS (C). The residual flow area (arrows) in the anterior communicating artery aneurysm was not detected by TOF-MRA.
See this image and copyright information in PMC

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