Magnetic resonance angiography compared to intra-arterial digital subtraction angiography in patients with subarachnoid haemorrhage
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In order to evaluate the sensitivity and specificity of magnetic resonance angiography (MRA) in spontaneous subarachnoid haemorrhage, 14 patients with recent haemorrhage verified by CT or lumbar puncture were investigated with both selective intra-arterial digital subtraction angiography (IA-DSA) and MRA by two independent teams, each having the same preangiographic information. The results were compared with each other and whenever possible (all positive cases except one) with those of surgical intervention. Seven patients were identified by MRA and IA-DSA as having a single aneurysm on the circle of Willis, 1 an aneurysm of the posterior inferior cerebellar artery 1 an aneurysm of the internal carotid artery (siphon) and 2 patients with two aneurysms on the circle of Willis. MRA and IA-DSA both failed to demonstrate aneurysms in 2 cases. Three patients had negative results on both methods and no surgical intervention was attempted. The aneurysms ranged from 0.3 to 1.5 cm in size. In most cases there was agreement between MRA and DSA, leading us to believe that, if the proper protocols are followed, MRA is a powerful alternative to other established methods in the detection of intracranial aneurysms. At this stage it will not replace IA-DSA prior to surgery, but the ability to obtain various projections using 3D MRA may improve surgical planning.
Key wordsAneurysm, cerebral Cerebral angiography Magnetic resonance angiography
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- 1.Jenkins A, Hadley D, Teasdale G, Condon B, Macpherson P, Patterson J (1988) Magnetic resonance imaging of acute subarachnoid hemorrhage. J Neurosurg 68: 431–736Google Scholar
- 2.Jenkins A, Paterson J, Hadley DM, et al. (1989) Use of in vitro magnetic resonance tissue studies to optimise pulse sequences in the imaging of intracranial hemorrhage. Magn Reson Imaging 7: 394–403Google Scholar
- 3.Ross JS, Masaryk TJ, Modic MT, Ruggieri PM, Haacke EM, Selman WR (1990) Intracranial aneurysms: evaluation by MR angiography. AJNR 11: 449–456Google Scholar
- 4.Masaryk TJ, Modic MT, Ross JS, Ruggieri PM, Laub GA, Lenz GW, Haacke EM, Selman WR, Wiznitzer M, Harik SI (1989) Intracranial circulation: preliminary clinical results with 3D (volume) MR angiography. Radiology 171: 793–794Google Scholar
- 5.Gasparotti R, Orlandini A, Gualandi GF, Scipione V, Tansini A, Gnutti P, Bonetti M, Lavezzi P, Chiesa A, Galli G, Mearini M (1991) L'angiografia a risonanza magnetica nello studio del circolo cerebrale. I. Aneurismi cerebrali. Rev Neuroradiol 4: 153–166Google Scholar
- 6.Spitzer CE, Blinder RA (1989) Vascular applications of MRI. Magn Reson Q 5: 205–227Google Scholar
- 7.Weeden VJ, Rosen RR, Brady TJ (1987) Magnetic resonance angiography. Magnetic resonance annual. Raven Press, New YorkGoogle Scholar
- 8.Edelman RR, Mattle HP, Atkinson DJ, Hoogewould HM (1990) MR angiography. AJR 154: 937–946Google Scholar
- 9.Pernicone JR, Siebert JE, Potchen EJ, Pera A, Dumoulin CL, Souza SP (1990) Three-dimensional phase-contrast MR angiography in the head and neck: preliminary report. AJNR 11: 457–466Google Scholar
- 10.Locksley HB (1969) Natural history of subarachnoid hemorrhage, intracranial aneurysms, and arteriovenous malformations. In: Sahs AL, Perret GE, Locksley HB, et al. (eds) Intracranial aneurysms and subarachnoid hemorrhage. A cooperative study. Lippincott, Philadelphia, pp 37–108Google Scholar
- 11.McCormick WF, Agosta-Rua GJ (1970) The size of intracranial saccular aneurysms. An autopsy study. J Neurosurg 33:422–427Google Scholar