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European Radiology

, Volume 22, Issue 7, pp 1404–1412 | Cite as

The clinical value of MRA at 3.0 T for the diagnosis and therapeutic planning of patients with subarachnoid haemorrhage

  • Yuan-Chang Chen
  • Zhen-Kui Sun
  • Ming-Hua LiEmail author
  • Yong-Dong LiEmail author
  • Wu Wang
  • Hua-Qiao Tan
  • Bin-Xian Gu
  • Shi-Wen Chen
Neuro

Abstract

Objective

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).

Methods

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.

Results

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.

Conclusions

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.

Key Points

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.

Keywords

Magnetic resonance angiography Intracranial aneurysm Digital subtraction angiography Rotational digital subtraction angiography Volume rendering 

Abbreviations

3D-TOF-MRA

three-dimensional time-of-flight of magnetic resonance angiography

DSA

digital subtraction angiography

VR

volume rendering

RDSA

rotational digital subtraction angiography

SAH

subarachnoid haemorrhage

Notes

Acknowledgement

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.

Financial disclosure

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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Copyright information

© European Society of Radiology 2012

Authors and Affiliations

  • Yuan-Chang Chen
    • 1
  • Zhen-Kui Sun
    • 1
  • Ming-Hua Li
    • 1
    Email author
  • Yong-Dong Li
    • 1
    Email author
  • Wu Wang
    • 1
  • Hua-Qiao Tan
    • 1
  • Bin-Xian Gu
    • 1
  • Shi-Wen Chen
    • 2
  1. 1.Institute of Diagnostic and Interventional Radiology, The Sixth Affiliated People’s HospitalShanghai Jiao Tong UniversityShanghaiChina
  2. 2.Department of Neurosurgery, The Sixth Affiliated People’s HospitalShanghai Jiao Tong UniversityShanghaiChina

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