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European Radiology

, Volume 22, Issue 10, pp 2255–2263 | Cite as

Follow-up of coiled intracranial aneurysms: comparison of 3D time-of-flight and contrast-enhanced magnetic resonance angiography at 3T in a large, prospective series

  • Laurent PierotEmail author
  • Christophe Portefaix
  • Anne Boulin
  • Jean-Yves Gauvrit
Neuro

Abstract

Objectives

To compare 3D-TOF magnetic resonance angiography (MRA) and contrast-enhanced MRA (CE-MRA) sequences at 3T in the follow-up of coiled aneurysms with digital subtracted angiography (DSA) as the gold standard.

Methods

DSA, 3D-TOF and CE-MRA were performed in a prospective series of 126 aneurysms in 96 patients (57 female, 39 male; age: 25–75 years, mean: 51.3 ± 11.3 years). The quality of aneurysm occlusion was assessed independently and anonymously by a core laboratory.

Results

Using DSA (gold standard technique), total occlusion was depicted in 57 aneurysms (45.2%), neck remnant in 34 aneurysms (27.0%) and aneurysm remnant in 35 aneurysms (27.8%). Sensitivity, specificity, positive predictive value and negative predictive value were very similar with 3D-TOF and CE-MRA. Visibility of coils was much better with 3D-TOF (95.2%) than with CE-MRA (23.0%) (P < 0.001). Also, substantial artefacts were less frequent with 3D-TOF (4.0%) than with CE-MRA (11.9%; P = 0.012).

Conclusions

In this large prospective series of patients with coiled aneurysms, at 3T 3D-TOF MRA was equivalent to CE-MRA for the evaluation of aneurysm occlusion, but coil visibility was superior at 3D-TOF. Thus the use of 3D-TOF at 3T is recommended for the follow-up of coiled intracranial aneurysms.

Key Points

• Different Magnetic Resonance (MR) imaging techniques are used to evaluate intracranial aneurysms.

At 3T MR, 3D-TOF and CE-MRA appear equivalent for evaluating coiled aneurysms..

Coils are better visualised on 3D-TOF than on CE-MRA.

Combined analysis of 3D-TOF and CE-MRA does not seem helpful.

At 3T, 3D-TOF techniques are recommended for monitoring patients with coiled aneurysms.

Keywords

Intracranial aneurysms Coiling MRA DSA 3T MRI 

Abbreviations

ACA

Anterior cerebral artery

Acom

Anterior communicating artery

CE-MRA

Contrast-enhanced magnetic resonance angiography

DSA

Digital subtraction angiography

ICA

Internal carotid artery

MCA

Middle cerebral artery

MIP

Maximum intensity projection

MRA

Magnetic resonance angiography

TOF

Time-of-flight

Notes

Conflict of interest

The authors declare that they have no conflict of interest in relation to the topic of the manuscript.

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Copyright information

© European Society of Radiology 2012

Authors and Affiliations

  • Laurent Pierot
    • 1
    • 5
    Email author
  • Christophe Portefaix
    • 1
    • 2
  • Anne Boulin
    • 3
  • Jean-Yves Gauvrit
    • 4
  1. 1.Department of Radiology, Maison Blanche HospitalUniversity of ReimsReimsFrance
  2. 2.CReSTIC SIC EA3804University of ReimsReimsFrance
  3. 3.Department of NeuroradiologyFoch HospitalSuresnesFrance
  4. 4.Department of Radiology, CHU RennesUniversity of RennesRennesFrance
  5. 5.Service de radiologieHopital de la Maison Blanche - CHUReimsFrance

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