The clinical value of MRA at 3.0 T for the diagnosis and therapeutic planning of patients with subarachnoid haemorrhage
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To evaluate the clinical value of unenhanced magnetic resonance angiography (MRA) at 3.0 T for the diagnosis and therapeutic planning of patients with subarachnoid haemorrhage (SAH).
A total of 165 patients with SAH were referred for three-dimensional time-of-flight MRA (3D-TOF-MRA) before digital subtraction angiography (DSA). For each aneurysm, 3D-TOF-MRA was used to determine whether the aneurysm was suitable for coil placement with or without balloon/stent-assisted coiling, surgical clipping or conservative treatment. Treatment planning with 3D-TOF-MRA was compared with actual treatment decisions or treatment that had been carried out in each aneurysm decided using DSA.
The aneurysm-based evaluation yielded accuracy of 96.9%, sensitivity of 97.6%, specificity of 93.1%, positive predictive value (PPV) of 98.8% and negative predictive value (NPV) of 87.1%, in the detection of intracranial aneurysms. Treatment planning could be correctly made on the basis of aneurysm anatomy and working view by volume rendering (VR) 3D-TOF-MRA with accuracy, sensitivity, specificity, PPV and NPV of 94.9%, 94.0%, 100%, 100% and 74.4%, respectively, on a per aneurysm-based evaluation.
VR 3D-TOF-MRA offers high diagnostic accuracy in the detection of ruptured intracranial aneurysms, and appears to be an effective treatment planning tool for most patients with SAH.
• VR 3D-TOF-MRA offers high diagnostic accuracy for detecting ruptured intracranial aneurysms.
• VR 3D-TOF-MRA helps treatment planning for patients with subarachnoid haemorrhage.
• 3D-TOF-MRA is non-invasive and avoids using ionising radiation or contrast agents.
KeywordsMagnetic resonance angiography Intracranial aneurysm Digital subtraction angiography Rotational digital subtraction angiography Volume rendering
three-dimensional time-of-flight of magnetic resonance angiography
digital subtraction angiography
rotational digital subtraction angiography
We would like to thank Gen-Ming Zhao, from the School of Public Health, Shanghai Fu Dan University for his kindness in checking the statistical data and analysis during preparation of this manuscript.
This study has been supported by the National Natural Scientific Fund of China (contract number 81171440, 30970793), Shanghai Important Subject Fund of Medicine (contract number 05 III 023, 074119505) and Program for Shanghai Outstanding Medical Academic Leader (contract number LJ 06016).
Conflict of interest
We declare that we have no conflict of interest.
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