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. 2014 Dec;20(6):686-92.
doi: 10.15274/INR-2014-10064. Epub 2014 Dec 5.

Contrast-Enhanced and Time-of-Flight MR Angiographic Assessment of Endovascular Coiled Intracranial Aneurysms at 1.5 T

Akin Levent  1 , Ihsan Yuce  2 , Suat Eren  3 , Omer Ozyigit  3 , Mecit Kantarci  3
Affiliations

Contrast-Enhanced and Time-of-Flight MR Angiographic Assessment of Endovascular Coiled Intracranial Aneurysms at 1.5 T

Akin Levent et al. Interv Neuroradiol. 2014 Dec.

Abstract

This study evaluated contrast-enhanced magnetic resonance angiography (CE-MRA) and three-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) through comparisons with digital subtraction angiography (DSA) for the follow-up of intracranial aneurysms treated with detachable coils. Sixty-seven patients with 79 aneurysms underwent 3D-TOF-MRA, CE-MRA, and catheter angiography one year after coiling. Two independent observers classified recanalization status on images as neck or body remnant or no recanalization. For 3D-TOF-MRA and CE-MRA, the intermodality agreement, interobserver agreement, and correlation with angiography were assessed. Sixty-seven patients with 79 coiled aneurysms agreed to participate in the study. Three aneurysms could not be detected on 3D-TOF-MRA, so they were excluded from this study. Interobserver agreement was very good for 3D-TOF-MRA and CE-MRA (kappa (κ): 0.87, 0.94, respectively). Correlation of TOF-MRA with angiography was good (κ: 0.76). Correlation of CE-MRA with angiography was excellent (κ: 0.91). The sensitivity and specificity of TOF-MRA were 92% and 98%, respectively. The sensitivity and specificity of CE-MRA were 96% and 98%, respectively. After selective embolization of intracranial aneurysms, CE-MRA is useful and comparable to DSA in the assessment of aneurysmal recanalization. Agreement with the gold standard is stronger with CE-MRA than with 3D-TOF-MRA.

Keywords: CE angiography; TOF angiography; coiled aneurysm follow-up.

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Figures

Figure 1
Figure 1
DSA image shows an ACoA aneurysm (A) and coiled aneurysm (B) after endovascular treatment (arrowheads). Follow-up 3D-TOF-MRA (C), CE-MRA (D) and DSA (E) images at 12 months show a body remnant (dashed arrows).
Figure 2
Figure 2
Disagreement between 3D-TOF-MRA and DSA on the occlusion of an ACoA aneurysm. Follow-up TOF-MRA (A) and CE-MRA (B) images at 12 months show a small neck remnant (false positive neck remnant). Follow-up DSA image (C) at 12 months shows complete occlusion (arrows).
See this image and copyright information in PMC

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