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
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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.
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.
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).
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.
• 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.
KeywordsIntracranial aneurysms Coiling MRA DSA 3T MRI
Anterior cerebral artery
Anterior communicating artery
Contrast-enhanced magnetic resonance angiography
Digital subtraction angiography
Internal carotid artery
Middle cerebral artery
Maximum intensity projection
Magnetic resonance angiography
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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