Diagnostic accuracy of 3D time-of-flight MR angiography compared with digital subtraction angiography for follow-up of coiled intracranial aneurysms: influence of aneurysm size

BACKGROUND AND PURPOSE: 3D time-of-flight MR angiography (3D TOF MRA) may be used as noninvasive alternative to digital subtraction angiography (DSA) for the follow-up of patients with intracranial aneurysms treated with Guglielmi detachable coils (GDCs). We aimed to determine the influence of aneurysm size and location on diagnostic accuracy of 3D TOF MRA for follow-up of intracranial aneurysms treated with GDCs. MATERIALS AND METHODS: Two hundred and one 3D TOF MRAs in 127 consecutive patients with 136 aneurysms were compared with DSA as standard of reference. Sensitivity and specificity of 3D TOF MRA for detection of residual or reperfusion of the aneurysms was calculated with regard to aneurysm size and location. RESULTS: Overall sensitivity and specificity of MRA was 88.5% and 92.9%, respectively. Sensitivity was lower for aneurysms 相似文献   

MR angiography in the follow-up of coiled cerebral aneurysms after treatment with Guglielmi detachable coils

Purpose: Intra-arterial digital subtraction angiography (DSA) has been considered the gold standard examination in the follow-up of patients treated with Guglielmi detachable coils (GDCs). However, DSA is an invasive and expensive investigation and results in exposure to ionising radiation to both patient and operator. The aim of this study was to compare MR angiography (MRA) with DSA with regard to patency of the occlusion of aneurysms following GDC treatment.Material and Methods: We performed 75 MRA and DSA examinations on 51 patients treated with GDCs. The examinations were performed 3-36 months after embolisation and the interval between MRA and DSA was less than 1 week. Hard copies of both studies were interpreted retrospectively and independently for residual flow within the aneurysm, residual aneurysmal neck, and parent and branch vessel flow.Results: Patency status of parent and branch vessel flow was correctly identified with MRA in all patients except 1. The sensitivity of MRA in revealing residual flow within the aneurysm was 97%. The specificity in ruling out residual flow within the aneurysm was 91%.Conclusion: MRA may replace DSA in the long-term follow-up of coiled cerebral aneurysms. The initial follow-up examination should, however, include both modalities.     

MR angiography at 3T versus digital subtraction angiography in the follow-up of intracranial aneurysms treated with detachable coils

BACKGROUND AND PURPOSE: Digital subtraction angiography (DSA) is used to follow-up intracranial aneurysms treated with detachable coils to identify recurrence and determine need for additional treatment. However, DSA is invasive and involves a small risk of neurologic complications. We assessed the feasibility and usefulness of 3D time-of-flight (TOF) MR angiography (MRA) performed at 3T compared with DSA for the follow-up of coil-treated intracranial aneurysms. METHODS: In a prospective study, 20 consecutive patients with 21 intracranial aneurysms treated with coils underwent DSA and nonenhanced and enhanced multiple overlapping thin-slab acquisition 3D TOF MRA at 3T on the same day at a mean follow-up of 6 months (range, 4-14 months) after coil placement. MRA images were evaluated for presence of artifacts, presence and size of aneurysm remnants and recurrences, patency of parent and branch vessels, and added value of contrast material enhancement. MRA and DSA findings were compared. RESULTS: Interobserver agreement of MRA was good, as was agreement between MRA and DSA. All three recurrences that needed additional treatment were detected with MRA. Minor disagreement occurred in four cases: three coil-treated aneurysms were scored on MRA images as having a small remnant, whereas on DSA images these aneurysms were occluded; the other aneurysm was scored on MRA images as having a small remnant, whereas on DSA images this was a small recurrence. Use of contrast material had no additional value. Coil-related MR imaging artifacts were minimal and did not interfere with evaluation of the occlusion status of the aneurysm. CONCLUSION: High-spatial-resolution 3D TOF MRA at 3T is feasible and useful in the follow-up of patients with intracranial aneurysms treated with coil placement.     

Time-of-Flight Magnetic Resonance Angiography for Follow-Up of Coil Embolization with Enterprise Stent for Intracranial Aneurysm: Usefulness of Source Images

Objective

The aim of this study was to determine the interobserver and intermodality agreement in the interpretation of time-of-flight (TOF) MR angiography (MRA) for the follow-up of coiled intracranial aneurysms with the Enterprise stent.

Materials and Methods

Two experienced neurointerventionists independently reviewed the follow-up MRA studies of 40 consecutive patients with 44 coiled aneurysms. All aneurysms were treated with assistance from the Enterprise stent and the radiologic follow-up intervals were greater than 6 months after the endovascular therapy. Digital subtraction angiography (DSA) served as the reference standard. The degree of aneurysm occlusion was determined by an evaluation of the maximal intensity projection (MIP) and source images (SI) of the TOF MRA. The capability of the TOF MRA to depict the residual flow within the coiled aneurysms and the stented parent arteries was compared with that of the DSA.

Results

DSA showed stable occlusions in 25 aneurysms, minor recanalization in 8, and major recanalization in 11. Comparisons between the TOF MRA and conventional angiography showed that the MIP plus SI had almost perfect agreement (κ = 0.892, range 0.767 to 1.000) and had better agreement than with the MIP images only (κ = 0.598, range 0.370 to 0.826). In-stent stenosis of more than 33% was observed in 5 cases. Both MIP and SI of the MRA showed poor depiction of in-stent stenosis compared with the DSA.

Conclusion

TOF MRA seemed to be reliable in screening for aneurysm recurrence after coil embolization with Enterprise stent assistance, especially in the evaluation of the SI, in addition to MIP images in the TOF MRA.     

Three-dimensional time-of-flight MR angiography in the evaluation of cerebral aneurysms

We review our preliminary experience with the use of three-dimensional (3D) time-of-flight (TOF) magnetic resonance (MR) angiography (MRA) in the assessment of intra- and extracranial aneurysms. Six patients were examined: Five had intracranial aneurysms and one had a cervical carotid pseudoaneurysm. A 3D rephased gradient recalled echo pulse sequence and maximum intensity projection (MIP) reconstruction algorithm were used. Magnetic resonance angiography, spin echo MR, and conventional angiography were retrospectively reviewed with specific regard to individual vessel visualization, aneurysm depiction, and presence of artifact related to acquisition techniques or MIP reconstruction. All aneurysms were detected on MRA, and anatomical correlation with conventional angiography was excellent. Significant problems included loss of visualization of small vessels, intraluminal signal loss in large vessels, subacute thrombus simulating flow on MIP reconstructions, and limited projections obtainable with MIP techniques. Adequate MRA assessment of aneurysms can be obtained using a combination of T1-weighted spin echo images and 3D TOF MRA. Review of all components of the MRA is required. MRA may be useful in screening asymptomatic patients for intracranial aneurysms as well as in the follow-up of patients treated with balloon occlusion.     

三维动态增强MR血管造影对颅内动脉瘤的诊断价值

目的 评价三维动态增强磁共振血管造影(3D DCE-MRA)在颅内动脉瘤诊断中的价值。方法 对54例高度怀疑有颅内动脉瘤的病人行3D DCE-MRA检查，随后行DSA造影及可行的血管内栓塞治疗。3D DCE-MRA用超快速三维梯度回波序列(3D FISP)(钆喷替酸葡甲胺0．2mmol／kg,1次扫描时间10s)，工作站上三维重建，比较3D DCE-MRA及常规DSA在显示动脉瘤、瘤颈及与载瘤动脉关系上的优劣，及对血管内栓塞治疗的价值。结果 39例脑动脉瘤患者共45个动脉瘤，3D DCE-MRA对动脉瘤的敏感度为96％，特异度73％，准确度90％。3D DCE-MRA对动脉瘤细节及瘤颈的显示明显优于常规DSA，尤其是颈内动脉海绵窦部及椎动脉近小脑后下动脉的动脉瘤，可指导DSA显示动脉瘤方向及预先制定治疗方案。但对周边部及动脉分岔处小动脉瘤的诊断应谨慎。结论3D DCE-MRA能无创有效地诊断颅内动脉瘤，所提供的三维信息对治疗方案的制定具有极大帮助。当诊断有怀疑时，应结合DSA检查。     

Three-dimensional time-of-flight MR angiography for evaluation of intracranial aneurysms after endosaccular packing with Guglielmi detachable coils: comparison with 3D digital subtraction angiography

The sensitivities and specificities of three-dimensional time-of-flight MR angiography (3D-TOF MRA) and 3D digital subtraction angiography (3D-DSA) were compared for evaluation of cerebral aneurysms after endosaccular packing with Guglielmi detachable coils (GDCs). Thirty-three patients with 33 aneurysms were included in this prospective study. 3D-TOF MRA and 3D-DSA were performed in the same week on all patients. Maximal intensity projection (MIP) and 3D reconstructed MRA images were compared with 3D-DSA images. The diameters of residual/recurrent aneurysms detected on 3D-DSA were calculated on a workstation. In 3 (9%) of 33 aneurysms, 3D-TOF MRA did not provide reliable information due to significant susceptibility artifacts on MRA. The sensitivity and specificity rates of MRA were 72.7 and 90.9%, respectively, for the diagnosis of residual/recurrent aneurysm. The diameters of residual/recurrent aneurysms that could not be detected by MRA were significantly smaller than those of detected aneurysms (mean 1.1 vs mean 2.3 mm). In one aneurysm of the anterior communicating artery (ACoA), the relationship between the residual aneurysm and the ACoA was more evident on MRA than DSA images. MRA can detect the recurrent/residual lumen of aneurysms treated with GDCs of up to at least 1.8 mm in diameter. 3D-TOF MRA is useful for follow-up of intracranial aneurysms treated with GDCs, and could partly replace DSA.     

Three-dimensional time-of-flight MR angiography in the evaluation of intracranial aneurysms treated with Guglielmi detachable coils

BACKGROUND AND PURPOSE: Intravascular treatment of intracranial aneurysms is a relatively new therapeutic technique and long-term controlled angiographic trials are needed to assess persistence of aneurysm occlusion. Our purpose was to evaluate the effectiveness of 3D time-of-flight (3D-TOF) MR angiography as a noninvasive screening tool in the follow-up of cerebral aneurysms treated with Guglielmi detachable coils (GDCs). METHODS: Forty-nine patients with 50 intracranial aneurysms previously treated with GDCs were studied with both DSA and 3D-TOF MR angiography. In 14 cases, a second follow-up examination was performed, for a total of 64 aneurysms evaluated. In 25 aneurysms, both pre- and postcontrast MR angiographic studies were obtained. RESULTS: In seven of 64 aneurysms, the MR angiographic studies were considered to be unreliable owing to the presence of artifacts that obscured part of the parent artery and did not allow an accurate evaluation of the aneurysm neck. These seven aneurysms, however, all were shown to be completely occluded at digital subtraction angiography (DSA). In the remaining 57 aneurysms, DSA revealed complete occlusion in 39 and the presence of residual patency in 18, whereas MR angiography showed complete occlusion in 38 and residual patency in 19. Enhanced MR angiography proved to be useful in evaluating residual patency in large and giant aneurysms and in better depicting the distal branch arteries. CONCLUSION: Although artifacts related to the presence of coils are evident on a considerable number of imaging studies, our findings indicate that MR angiography is useful in the evaluation of residual patency of cerebral aneurysms treated with GDCs and may eventually prove valuable in the follow-up of those cases in which a good initial correlation with DSA was demonstrated.     

Acute subarachnoid Haemorrhage: 3D time-of-flight MR angiography versus intra-arterial digital angiography

To evaluate the efficacy and reliability of 3D time-of-flight MR angiography (TOF MRA) as a noninvasive procedure, 27 patients with acute subarachnoid haemorrhage (SAH) were studied with MRA immediately before or after intra-arterial digital subtraction angiography (DSA). 3DTOF MRA was performed with an axial slab of 60 mm centred on the circle of Willis and isotropic voxels. DSA showed 22 aneurysms and 1 dural arteriovenous fistula in 21 patients; the aneurysms ranged in size from 2 to 8 mm. MRA failed to show 2 small aneurysms, at the origin of the posterior and anterior communicating arteries. The 3D display of the intracranial vessels obtained with maximum intensity projection (MIP) or targetted MIP sometimes rendered the aneurysms better than DSA. However, due to its high spatial resolution, DSA more clearly defined the overall anatomy of the walls of the normal and abnormal vessels.1992 Scientific Award of the ESNR     

Prospective evaluation of time-of-flight MR angiography in the follow-up of intracranial saccular aneurysms treated with Guglielmi detachable coils

PURPOSE: The purpose of our study was to prospectively evaluate 3D time-of-flight (TOF) MR angiography (MRA) in the follow-up of 27 intracranial aneurysms treated with Guglielmi detachable coils (GDCs). METHOD: From February 1997 to June 1998, 26 patients with 27 aneurysms were included in this prospective study. Aneurysms were located in the anterior circulation in 23 cases and in the posterior circulation in 4 cases. All patients underwent 3D TOF MRA and digital subtraction angiography (DSA) in the same week within 4 months after aneurysmal treatment with GDCs. No clinical events occurred during the follow-up. We analyzed residual flow within the coil mass and within the aneurysmal neck and the patency of the parent and adjacent arteries on MRA and DSA. MRA analysis was based upon MIPPED and source images. DSA was our gold standard. RESULTS: In all cases, the quality of MRA was good enough to be informative. In aneurysmal analysis, the sensitivity, specificity, positive predictive value, and negative predictive value of MRA were, respectively, 80, 100, 100, and 96% to diagnose residual flow within the coil mass (one false-negative case) and 83, 100, 100, and 95.5% to diagnose residual flow within the aneurysmal neck (one false-negative case). In arterial analysis, sensitivity and positive predictive value of MRA were 89 and 100% to diagnose patency of the parent artery (three false-negative cases) and 83 and 100% to diagnose patency of adjacent arteries (seven false-negative cases). CONCLUSION: In the follow-up of intracranial aneurysms treated with GDCs, 3D TOF MRA could be used as a screening test to select patients that should undergo DSA and thus could improve patient follow-up in terms of risk-benefit.     

Three-dimensional time-of-flight (3D TOF) magnetic resonance angiography (MRA) and contrast-enhanced MRA of intracranial aneurysms treated with platinum coils

Background: Contrast-enhanced magnetic resonance angiography (CE-MRA) is less prone to flow-related signal intensity loss than three-dimensional time-of-flight (3D TOF) MRA and may therefore be more sensitive for detection of residual patency in platinum coil-treated intracranial aneurysms.

Purpose: To compare MRA and CE-MRA in the follow-up of intracranial aneurysms treated with platinum coils.

Material and Methods: CE-MRA and 3D TOF MRA (pre- and postcontrast injection) of the intracranial vasculature was performed at 1.5T in 38 patients (47 aneurysms) referred for DSA in the follow-up of coiled intracranial aneurysms.

Results: DSA showed aneurysm patency in 22/47 investigations. Patent aneurysm components were observed with CE-MRA in 18/22 cases, and with 3D TOF MRA in 21/22 cases. There was no significant difference in patent aneurysm component size between CE-MRA and 3D TOF MRA. In addition, CE-MRA showed six, 3D TOF MRA before contrast injection showed seven, and 3D TOF MRA after contrast injection showed eight cases with patent aneurysm components not observed on DSA.

Conclusion: 3D TOF MRA was highly sensitive for detection of patent aneurysm components, and at least as sensitive as CE-MRA. Residual aneurysm patency seems to be better visualized with MRA than with DSA in some cases.     

Follow-up of intracranial aneurysms selectively treated with coils: Prospective evaluation of contrast-enhanced MR angiography

BACKGROUND AND PURPOSE: The aim of this study was to determine the feasibility and usefulness of contrast-enhanced MR angiography (CE-MRA) for the follow-up of intracranial aneurysms treated with detachable coils, by comparing CE-MRA with digital subtraction angiography (DSA) and 3D time-of- flight (TOF) MRA. METHODS: Thirty-two patients with 42 treated aneurysms were included in the study; 6 had been treated for multiple aneurysms. All MRAs were performed with a 1.5T unit within 48 hours of DSA. We performed 2 types of acquisition: a 3D TOF sequence and CE-MRA. Twenty-eight patients were included 1 year after endovascular treatment, and 4 patients, after 3 years or more. DSA was the technique of reference for the detection of a residual neck or residual aneurysm. RESULTS: Compared with DSA, the sensitivity of MRA was good. For the detection of residual neck, there was no significant difference between the results of 3D TOF MRA (sensitivity, 75%-87.5%; specificity, 92.9%, according to both readers) and CE-MRA (sensitivity, 75%-82.1%; specificity, 85.7%-92.9%). For the detection of residual aneurysm, sensitivity and specificity of both techniques were the same, respectively 80%-100% and 97.3%-100%. Therefore, CE-MRA was not better than 3D TOF MRA for the detection of residual neck or residual aneurysm. For large treated aneurysms, there was no difference between decisions regarding further therapy after CE and 3D TOF MRA, even though CE-MRA with a short echotime and enhancement gave fewer artifacts and better visualization of recanalization than 3D TOF MRA. The interpretation of transverse source images and the detection of coil mesh packing seemed easier with 3D TOF imaging. CONCLUSION: This prospective study did not show that CE-MRA was significantly better than 3D TOF MRA for depicting aneurysm or neck remnants after selective endovascular treatment using coils. For aneurysms treated with coils, 3D TOF MRA seems a valid and useful technique for the follow-up of coiled aneurysms.     

Intracranial aneurysms: evaluation by MR angiography

The purpose of this study was to compare the accuracy of a volume gradient-echo MR angiography (MRA) technique with that of intraarterial digital subtraction angiography (IA DSA) in the identification of intracranial aneurysms. The intracranial vasculature was examined in 47 patients by MRA and compared with IA DSA findings in 19 of these patients who had saccular or giant intracranial aneurysms. The remaining 28 patients, in whom no aneurysm was found, served as a control group. MRA was performed with the use of a velocity-compensated gradient-echo sequence (TR = 40-50/TE = 7-15) with a 15 degrees flip angle. The sensitivity and specificity were calculated for the evaluation of the cine 3D reconstructions (cine MRA) only, cine MRA + inspection of the individual partitions, and cine MRA + individual partitions + spin-echo studies. Of 21 aneurysms, of which three were missed in two patients, the sensitivity varied from 67% for cine MRA only to 86% for the cine MRA + partitions + spin-echo studies; of the 19 patients, among whom it was assumed that the diagnosis of any one aneurysm in a patient would lead to angiography and detection of additional aneurysms, the sensitivity varied from 73% for the cine MRA only to 95% for the cine MRA + partitions + spin-echo studies. The results of this study suggest that MRA can define the circle of Willis sufficiently to allow detection of intracranial aneurysms as small as 3-4 mm. MRA holds promise as a truly noninvasive screening examination of intracranial vasculature in patients at risk for aneurysms.     

Intracranial aneurysms: evaluation by MR angiography

The purpose of this study was to compare the accuracy of a volume gradient-echo MR angiography (MRA) technique with that of intraarterial digital subtraction angiography (IA DSA) in the identification of intracranial aneurysms. The intracranial vasculature was examined in 47 patients by MRA and compared with IA DSA findings in 19 of these patients who had saccular or giant intracranial aneurysms. The remaining 28 patients, in whom no aneurysm was found, served as a control group. MRA was performed with the use of a velocity-compensated gradient-echo sequence (TR = 40-50/TE = 7-15) with a 15 degree flip angle. The sensitivity and specificity were calculated for the evaluation of the cine 3D reconstructions (cine MRA) only, cine MRA + inspection of the individual partitions, and cine MRA + individual partitions + spin-echo studies. Of 21 aneurysms, of which three were missed in two patients, the sensitivity varied from 67% for cine MRA only to 86% for the cine MRA + partitions + spin-echo studies; of the 19 patients, among whom it was assumed that the diagnosis of any one aneurysm in a patient would lead to angiography and detection of additional aneurysms, the sensitivity varied from 73% for the cine MRA only to 95% for the cine MRA + partitions + spin-echo studies. The results of this study suggest that MRA can define the circle of Willis sufficiently to allow detection of intracranial aneurysms as small as 3-4 mm. MRA holds promise as a truly noninvasive screening examination of intracranial vasculature in patients at risk for aneurysms.     

CT angiography,MR angiography and rotational digital subtraction angiography for volumetric assessment of intracranial aneurysms. An experimental study

The purpose of our experimental study was to assess the accuracy and precision of CT angiography (CTA), MR angiography (MRA) and rotational digital subtraction angiography (DSA) for measuring the volume of an in vitro aneurysm model. A rigid model of the anterior cerebral circulation harbouring an anterior communicating aneurysm was connected to a pulsatile circuit. It was studied using unenhanced 3D time-of-flight MRA, contrast-enhanced CTA and rotational DSA angiography. The source images were then postprocessed on dedicated workstations to calculate the volume of the aneurysm. CTA was more accurate than MRA (P=0.0019). Rotational DSA was more accurate than CTA, although the difference did not reach statistical significance (P=0.1605), and significantly more accurate than MRA (P<0.00001). CTA was more precise than MRA (P=0.12), although this did not reach statistical significance. Rotational DSA can be part of the diagnosis, treatment planning and support endovascular treatment of intracranial aneurysms. The emerging endovascular treatment techniques which consist of using liquid polymers as implants to exclude aneurysms from arterial circulation would certainly benefit from this precise measurement of the volume of aneurysms.     

Follow-up of intracranial aneurysms treated with detachable coils: comparison of gadolinium-enhanced 3D time-of-flight MR angiography and digital subtraction angiography

PURPOSE: To compare three-dimensional (3D) time-of-flight magnetic resonance (MR) angiography with digital subtraction angiography (DSA) in the follow-up of intracranial aneurysms treated with selective endovascular placement of detachable coils. MATERIALS AND METHODS: Sixty-eight consecutive patients with intracranial aneurysms were included in the prospective study. The goal was to evaluate 3D time-of-flight MR angiography versus DSA for the detection of a residual aneurysm neck or residual flow inside the coil mesh. RESULTS: Eighty-one MR angiographic and 83 DSA examinations were performed; 15 patients were examined with both modalities twice. MR angiography was not possible in two patients. In another patient, the quality of MR angiography was not sufficient to assess the treated aneurysm. In 72 of the remaining 80 MR angiographic and DSA examinations, there was good correlation between the two modalities. In 54 cases, neither image type showed remnants or recurrence, but in 18, both showed residual aneurysm. In eight cases, the MR angiographic and DSA results differed. In one of these cases, MR angiography depicted residual aneurysm but DSA depicted an arterial loop. In seven cases, a small (<3-mm) remnant was not detected at MR angiography. CONCLUSION: Because very small aneurysm remnants or recurrences probably are not clinically important, MR angiography is an option for following up intracranial aneurysms treated with detachable coils and may partly replace DSA.     

Intravenous 3D digital subtraction angiography in the diagnosis of unruptured intracranial aneurysms

Recent progress in digital subtraction angiography (DSA) devices makes it possible to perform rotational angiography with high resolution and high sensitivity. We tried intravenous (IV) 3D DSA in patients who had undergone MR angiography (MRA) suggestive of unruptured intracranial aneurysms. IV 3D DSA can be used as an alternative method for imaging unruptured intracranial aneurysms suggested on MRA.     

Magnetic resonance angiography of giant intracranial aneurysms

3D time-of-flight magnetic resonance angiography (3D TOF MRA) and 2D MRA with presaturation were evaluated in 18 patients with 21 giant intracranial aneurysms. 3D TOF MRA gave optimal images of proximal unruptured and nonthrombosed aneurysms. 2D MRA with presaturation was more informative in cases of distal, haemorrhagic or thrombosed aneurysms and in assessment of their components (thrombus, haemorrhage, patent residual lumen).     

Three-dimensional reconstructed rotational digital subtraction angiography in planning treatment of intracranial aneurysms

We evaluated three-dimensional (3D) reconstructions of 200 ° rotational digital subtraction angiography (DSA) images for their contributions to improving the safety of endovascular embolization of intracranial aneurysms. Standard DSA and 200 ° rotational DSA were performed in 40 adult patients (aged 21–77 years) with 45 intracranial aneurysms. Information obtainable from standard DSA and 3D-DSA images about aneurysm shape and size was compared. In 40 (89 %) of the 45 aneurysms 3D-DSA gave additional information about the anatomy of the aneurysm. In 17 (43 %) of these cases aneurysm anatomy could be visualized better on 3D-DSA than on standard DSA images. In three cases only 3D-DSA images showed blood vessels originating from the aneurysm. Reconstructed 3D images were also helpful in visualizing partially clipped aneurysms. On maximum-intensity projection images it was even possible to depict previously embolized aneurysms. Blood vessels originating from the aneurysm are visible on 3D-DSA images, and even previously clipped aneurysms can be visualized well. Rotational DSA with 3D reconstruction is a helpful tool in the assessment of intracranial aneurysms. Received: 7 September 1999; Revised: 26 November 1999; Accepted: 26 November 1999     

3D-T0F MRA对颅内动脉瘤GDC治疗随访的预期评估

目的：评价磁共振血管成像(MRA)在随访43例病人的45个颅内动脉瘤GDC栓塞后的价值。材料和方法：以数字减影血管造影(DSA)作为诊断的金标准，回顾研究43例病人的45个颅内动脉瘤(前循环34个，后循环11个)MRA检查。所有的病人在GDC栓塞治疗后9个月之内的同一周行DSA和MRA检查，这期间不作处理。分析弹簧圈内残余血流、载瘤动脉和邻近动脉血流，MRA以最大强度投影(MIP)重建和源图像为基础。结果：所有病例中，MRA能提供良好的信息。对于动脉瘤的分析，MRA的敏感性、特征性、阳性预测价值、阴性预测价值，诊断弹簧圈内残余血流分别为87．5％、100％、100％、97％，诊断瘤颈的残余血流分别为90％、100％、100％、97％。对于动脉通畅性分析，MRA的敏感性和阴性预测价值，载瘤动脉分别是90．5％和100％，邻近动脉分别是85．7％和100％。结论：在随访GDC栓塞的动脉瘤中，MRA可以作为一个筛选手段，提高检查效率，减少病人的随访风险。